scholarly journals Prolonged pituitary down-regulation with full-dose of gonadotropin-releasing hormone agonist in different menstrual cycles: a retrospective cohort study

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6837 ◽  
Author(s):  
Yingfen Ying ◽  
Tanchu Yang ◽  
Huina Zhang ◽  
Chang Liu ◽  
Junzhao Zhao
Keyword(s):  
Pregnancy Rate ◽  
Birth Rate ◽  
Formation Rate ◽  
Live Birth Rate ◽  
Cyst Formation ◽  
Follicular Phase ◽  
Down Regulation ◽  
Ongoing Pregnancy Rate ◽  
Full Dose ◽  
Phase Group

Background The efficiency of prolonged down-regulation caused by a full-dose of gonadotropin-releasing hormone agonist (GnRH-a) injected during different menstrual phases has not yet been researched. Our goal was to evaluate the effects of GnRH-a, which was used in different phases of the menstrual cycle in patients undergoing in vitro fertilization and embryo transfer. Methods This was a retrospective cohort study. A total of 320 patients received a prolonged pituitary down-regulated full-dose (3.75 mg) of triptorelin in the early follicular phase, and 160 patients received the same full-dose of triptorelin during the mid-luteal phase. Clinical and laboratory outcomes were compared between the two groups. Results The basic characteristics of the two groups were comparable. The mean number of retrieved oocytes, fertilized oocytes, cleavage oocytes and good quality embryos were comparable between the two groups. Although there was a higher antral follicle count, cyst formation rate, fertilization rate and cleavage rate in the follicular phase group, no statistically significant effects were seen on implantation rate (41.15% vs. 45.91%), clinical pregnancy rate (60.38% vs. 61.36%), ongoing pregnancy rate (57.74% vs. 57.58%), live birth rate (56.23% vs. 57.58%) or early abortion rate (2.64% vs. 3.79%) per fresh transfer cycle. Moreover, severe ovarian hyperstimulation syndrome rates at the early stage (1.89% vs. 2.27%) were low in both groups. Conclusions Prolonged pituitary down-regulation achieved by utilizing a full-dose of GnRH-a administrated in either phase of the menstrual cycle can have a positive effect on ongoing pregnancy rate and live-birth rate per fresh embryo transfer cycle. Ovarian cyst formation rate was higher in the follicular phase group, but this did not have any adverse impact on clinical results.

Acupuncture versus placebo acupuncture for in vitro fertilisation: a systematic review and meta-analysis

2020 ◽  
pp. 096452842095871
Author(s):  
Meaghan E Coyle ◽  
Ieva Stupans ◽  
Katherine Abdel-Nour ◽  
Hiba Ali ◽  
Michelle Kotlyarsky ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
In Vitro Fertilisation ◽  
Ongoing Pregnancy ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Placebo Acupuncture

Objective: To evaluate the efficacy of acupuncture compared to placebo acupuncture for women undergoing in vitro fertilisation (IVF) in a systematic review and meta-analysis. Methods: A search was conducted in seven English-language biomedical databases from their inception to 3 April 2019 to identify studies evaluating acupuncture as an adjunct to IVF treatment. Randomised controlled trials (RCTs) that compared acupuncture with placebo acupuncture using a non-invasive placebo acupuncture device in women undergoing a fresh or frozen IVF cycle were eligible, as were studies that tested placebo acupuncture as the intervention. Outcomes were clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, live birth rate and adverse events. Results: Eight RCTs involving 3607 women were included. Studies were judged to be low risk for most of the risk of bias domains. Acupuncture around the time of embryo transfer was not significantly different to placebo acupuncture in terms of the clinical pregnancy rate (6 RCTs, 2473 women, risk ratio (RR) = 0.99 (95% confidence interval (CI) = 0.88, 1.11), I2 = 51%, moderate certainty evidence), ongoing pregnancy rate (4 RCTs, 1459 women, RR = 0.88 (95% CI = 0.75, 1.02), I2 = 50%, moderate certainty evidence), miscarriage rate (4 RCTs, 502 women, RR = 1.23 (95% CI = 0.89, 1.71), I2 = 30%, high certainty evidence) or live birth rate (4 RCTs, 1835 women, RR = 0.87 (95% CI = 0.75, 1.01), I2 = 0%, high certainty evidence). Outcomes with placebo acupuncture were not significantly different to usual care. Adverse events relating to acupuncture, such as discomfort and bruising, were mild to moderate. Conclusion: Acupuncture administered around the time of embryo transfer did not have a statistically significant effect on IVF outcomes compared with placebo acupuncture.

scholarly journals rLH/rFSH Combination Improved Cumulative Live Birth Rate in Patients With LH Over-Suppression Following GnRH Agonist Pituitary Down-Regulation Compared to rFSH or hMG Alone: A Retrospective Cohort Study With Propensity Score Matching

2021 ◽  
Author(s):  
Ansu Tu ◽  
Lihong Geng ◽  
Ying Zhong
Keyword(s):  
Propensity Score ◽  
Pregnancy Rate ◽  
Propensity Score Matching ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Down Regulation ◽  
Cumulative Live Birth ◽  
Secondary Endpoints

Abstract PurposeThe suppression of luteinizing hormone (LH) in patients undergoing gonadotropin-releasing hormone agonist (GnRH-a) pituitary down-regulation may cause LH deficiency which may impact follicular development. However, little is known about effect of LH adding in patients with LH over-suppression. This study to investigate the effects of different gonadotropins on the cumulative live birth rate (CLBR) in the patients with LH over-suppression after GnRH-a pituitary down-regulation. MethodsThis retrospective study used propensity score-matching methodology to compare CLBR, as the primary endpoint, in the patients with LH over-suppression after different GnRH-a pituitary down-regulation regimens, including recombinant follicle stimulating hormone (rFSH) combined with recombinant LH (rLH), or using rFSH alone, or human menopausal gonadotropin (hMG) alone. The secondary endpoints included biochemical pregnancy rate, clinical pregnancy rate, and live birth rate in fresh embryo transfer cycles. ResultsA total of 88 patients were enrolled after matching: 22 patients in the rFSH+rLH group, 44 in the rFSH group, and 22 in the hMG group. The CLBR of the rFSH+rLH group was significantly higher than that of the rFSH and hMG groups (19/22, 86.4% vs. 25/44, 56.8%, P = 0.014; vs. 7/22, 31.8%, P < 0.001). Moreover, the rFSH group had a higher CLBR than the hMG group (P = 0.048). There were no significant differences in any of the secondary endpoints (all P > 0.05). ConclusionExogenous rLH supplementation achieved a higher CLBR than rFSH or hMG alone among patients with LH over-suppression; furthermore, rFSH alone was superior to hMG alone for CLBR.

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 Effects of the Oocyte Maturation Rate on Clinical Outcomes of Conventional IVF and ICSI in Female Patients Aged ≥38 Years

2020 ◽  
Author(s):  
shuang liu ◽  
Hongjun Yu ◽  
Baoshan Li ◽  
Chunyi Li ◽  
Dongkai Cheng
Keyword(s):  
Pregnancy Rate ◽  
Oocyte Maturation ◽  
Birth Rate ◽  
Formation Rate ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Blastocyst Formation ◽  
Oocyte Maturity ◽  
Cleavage Rate ◽  
Maturation Rate

Abstract Research Question: The average female reproductive potential peaks at age 25 and then begins to decline. As women are delaying childbearing, the prevalence of infertility has risen, leading to increasing demand for assisted reproductive technology (ART). Oocyte quality remains the most important issue during in vitro fertilization (IVF) cycles. This study investigated the effects of the oocyte maturation rate (OMR) on clinical outcomes of conventional IVF and intracytoplasmic sperm injection (ICSI) in female patients aged ≥38 years. Design: A retrospective analysis of 6562 infertile patients who were treated with IVF/ICSI at the reproductive medicine center of our hospital from January 2011 to December 2017 was performed. According to the oocyte maturity (the ratio of the number of mature oocytes to the number of oocytes) on the day of egg collection, the patients were divided into three groups: group A (oocyte maturity ≤30%, n=422), and group B (oocyte maturity from 30-75%, n=1290), and group C (oocyte maturity ≥75%, n=4850). The patient age, years of infertility years, days of gonadotropin (Gn), Gn dosage, serum luteinizing hormone (LH), estradiol (E2), and progesterone (P) levels on the day of human chorionic Gn (HCG) injection, E2 levels per mature oocyte, E2 levels per oocyte, number of mature oocytes, oocyte recovery rate, fertilization rate, cleavage rate, excellent embryo rate, blastocyst formation rate, pregnancy rate, and live birth rate were compared among the three groups. Results: Factors including age, years of infertility, number of eggs obtained, number of mature eggs, normal fertilization rate, cleavage rate, excellent embryo rate, blastocyst formation rate, pregnancy rate, and live birth rate were all found to be related to oocyte maturity on the day of HCG administration (P<0.05). Conclusions: There is a close relationship between oocyte maturity and embryo quality, and a low OMR may be related to a poor ovarian response or decreased sensitivity to Gn. Therefore, a low OMR may affect the fertilization and embryonic development potential in elderly patients undergoing IVF/ICSI, thus affecting the pregnancy rate.

scholarly journals Efficacy of Natural Cycle versus GnRH-a Down Regulation Cycle of Endometrial Preparation in Minimal and Mild endometriosis Patients Undergoing Frozen-Thawed Embryo Transfer

2020 ◽  
Author(s):  
Ya Li ◽  
Jing Zhong ◽  
Songyuan Tang ◽  
Lili Wang ◽  
Ying Zhong
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Natural Cycle ◽  
Down Regulation ◽  
Endometrial Preparation ◽  
Cycle Group ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background Minimal and mild endometriosis patients with infertility are treated by in vitro fertilization and embryo transfer/intracytoplasmic sperm injection (IVF-ET/ICSI) in recent years. However, inconsistencies in findings within and across individual studies raise concerns as to determine which method is the best treatment, especially in the frozen-thawed embryo transfer cycle (FET). We hope to compare the efficacy of natural cycle versus GnRH-a down regulation cycle endometrial preparations in minimal and mild endometriosis patients undergoing FET. Methods We retrospectively analyzed a cohort of 1170 minimal and mild endometriosis patients receiving FET at the Reproductive Medicine Centre from Chengdu Jinjiang Hospital for Maternal and Child Health Care from January 1, 2016 to December 31, 2018. They were assigned to the natural cycle group and the GnRH-a down regulation cycle group based on endometrial preparation protocols. Baseline characteristics, frozen-thawed embryo transfer cycle and pregnancy outcomes were compared between the two groups. Results There were nonsignificant differences in baseline characteristics including age, BMI, types of infertility, the duration of infertility and the delivery history between the natural cycle group and the GnRH-a down regulation cycle group (P>0.05). The biochemical pregnancy rate (63.62% v.s. 53.83%), clinical pregnancy rate (56.10% v.s. 47.49%), implantation rate (43.19% v.s. 34.88%) and live birth rate (44.31% v.s. 35.84%) in the natural cycle group were significantly higher than those in the GnRH-a down regulation cycle group (P<0.05). However, there were nonsignificant differences in the multiple birth rate, abortion rate, ectopic pregnancy rate, premature birth rate, neonatal weight and length between the two groups (P>0.05). The multivariate regression analysis showed that age, anti-Müllerian hormone (AMH), the number of transplanted high-quality blastocysts and endometrial preparation protocols were associated with the live birth rate in minimal and mild endometriosis women undergoing FET (P<0.05). Conclusion Compared with GnRH-a down regulation cycle, natural cycle endometrial preparation of FET is a prominent endometrial preparation method for improving the implantation rate, clinical pregnancy rate, and live birth rate in minimal and mild endometriosis patients, which is more cost-effective in clinical practice.

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.

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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