The effect of air bubble position on ART outcome in frozen-thawed blastocyst transfer

Background So far, only few literatures have studied the relationship between blastocyst transfer position and ART outcomes, and the conclusions are still controversial. Our study is to evaluate the effect of air bubble position on ART outcome and to find the optimal embryo transfer position in frozen-thawed blastocyst transfer. Methods This study included a retrospective cohort analysis of 399 frozen-thawed single blastocyst transfers ultrasound-guided performed between June 1, 2017 and November 30, 2020. All of the women scheduled for frozen-thawed single blastocyst transfers ultrasound-guided. The primary outcome is clinical pregnancy rate and the secondary outcome is live birth rate. Statistical analyses were conducted using One-way Anova, Kruscal Whallis H test, chi-square test and Smooth curve fitting. Results When BFD was less than 19 mm, there was no significant change in clinical pregnancy rate as BFD increased (OR = 0.95, 95% CI: 0.89 to 1.02, P = 0.1373); when BFD was more than 19 mm, the clinical pregnancy rate decreased by 16% for every 1 mm increase in BFD (OR = 0.84, 95% CI: 0.72 to 0.98, P = 0.0363). The effect of BFD on live birth rate were similar to that on clinical pregnancy rate, the inflection point was 19mm, when BFD was more than 19 mm, the live birth rate decreases by 58% for every 1 mm increase in BFD (OR = 0.42, 95% CI: 0.21 to 0.86, P = 0.0174) Conclusions The ideal pregnancy outcome can be achieved within 19mm from uterus fundus after single blastocyst transfer, The clinical pregnancy and live birth at a distance of more 19mm from the uterus fundus have a cliff-like downward trend.

Lower Spermatozoal PIWI-LIKE 1 and 2 Transcript Levels Are Significantly Associated with Higher Fertilization Rates in IVF

The four human PIWI-LIKE gene family members PIWI-LIKE 1–4 play a pivotal role in stem cell maintenance and transposon repression in the human germline. Therefore, dysregulation of these genes negatively influences the genetic stability of the respective germ cell and subsequent development and maturation. Recently, we demonstrated that a lower PIWI-LIKE 2 mRNA expression in ejaculated spermatozoa is more frequent in men with oligozoospermia. In this study, we analysed how PIWI-LIKE 1–4 mRNA expression in ejaculated spermatozoa predicts ART outcome. From 160 IVF or ICSI cycles, portions of swim-up spermatozoa used for fertilization were collected, and the total RNA was isolated. PIWI-LIKE 1–4 mRNA expression was measured by qPCR using TaqMan probes with GAPDH as a reference gene. PIWI-LIKE 1 and 2 transcript levels in the spermatozoa of the swim-up fraction were positively correlated to each other (rS = 0.78; p < 0.001). Moreover, lower PIWI-LIKE 2 mRNA levels, as well as lower PIWI-LIKE 1 mRNA levels, in these spermatozoa were positively associated with a fertilization rate ≥ 50% in the respective ART cycles (p = 0.02 and p = 0.0499, Mann–Whitney U-Test). When separately analysing IVF and ICSI cycles, PIWI-LIKE 1 and 2 transcript levels were only significantly associated to increased fertilization rates in IVF, yet not in ICSI cycles. Spermatozoal PIWI-LIKE 3 and 4 transcript levels were not significantly associated to fertilization rates in ART cycles. In conclusion, lower levels of spermatozoal PIWI-LIKE 1 and 2 mRNA levels are positively associated with a higher fertilization rate in IVF cycles.

Recombinant luteinizing hormone supplementation in assisted reproductive technology: a review of literature

Background Luteinizing hormone (LH) has the main role in ovarian function in both natural and artificial cycles. A normal LH concentration during controlled ovarian hyperstimulation is positively correlated to the number and quality of retrieved oocytes and resulting embryos. Main body of the abstract In this study, we reviewed whether rLH administration, adjunct to the ovarian stimulation regimen, could improve clinical outcomes. The literature review showed that rLH supplementation improves assisted reproductive technology (ART) outcomes among women with hypogonadotropic hypogonadism, and hyporesponsive women to follicle-stimulating hormone monotherapy. Besides, rLH supplementation has advantages for poor responder women 36–39 years of age. Even though the data suggested no priority regarding the LH source for improving ART outcome, women with different LH polymorphisms who did not respond similarly to ovarian stimulation may benefit from adjuvant rLH therapy. Conclusion rLH usage for improving ART outcome should be scrutinized via well-designed studies considering the subgroups of infertile women who benefit the most from rLH adjuvant therapy, the type of ovarian stimulation protocol to which rLH would be added, and also the exact dosage, as well as the proper timing (during or prior to a cycle).

Seasonal Dynamic of Cholecalciferol (D3) And Anti-Muellerian Hormone (AMH) With Impact On Ovarian Response And IVF/ICSI

Objective:Recent studies revealed intriguing associations between cholecalciferol (D3) and reproductive functions. Seasonal changes of D3 concentrations are well known, however they are not always considered in the context of reproductive functions. In this study, we analysed D3 serum concentration in IVF/ICSI patients with respect to seasonal 3-month quartiles and anti-Muellerian hormone (AMH) referring to the impact on Assisted Reproductive Technologies (ART) outcome. Materials and Research Methods:We studied 497 female patients, presenting between 2012 and 2018 for ART treatment in our fertility center. D3 as well as the AMH serum concentrations were measured at the beginning of the follicle stimulation (d 3-5 of menstrual cycles). Results were evaluated with respect to seasonal quartiles and outcome of the ART cycles. Results:D3 concentrations showed significant fluctuations within annual quartiles with a pronounced peak in August-October and a minimum in February-April (27.7mg/dl vs. 20.9mg/dl; p<0.0001). Similar seasonal dynamics were found for AMH (3.19ng/ml vs. 2.24ng/ml; p=0.013) and these were associated with significantly shorter stimulation periods during August-October (11.36d vs. 12.01d; p=0.044), higher number of fertilized oocytes between August-October (6.21 vs. 5.21; p=0.05) along with a trend towards higher numbers of Cumulus-Oocyte-complexes. However, no such differences were found for the numbers of MII-oocytes or pregnancy rates.Conclusion: Our data indicate, seasonal 3-month quartile variations of AMH concentrations and characteristics of ART, such as days of ovarian stimulation and number of fertilised oocytes. Highest AMH concentrations were found between August and October and this quartile was associated with highest D3 concentrations.

P–729 Seasonality and lunar phase impact zona pellucida thickness while assisted reproductive treatment outcome shown no differences between seasons

Study question Does seasonal variation impact zona pellucida (ZP) thickness, other assisted reproductive treatment (ART) factors and ART outcome? Summary answer Seasonality and lunar phase impact ZP thickness while specific weather conditions alone do not, however, seasonality does not impact other ART factors or ART outcome. What is known already: Several epidemiological studies have demonstrated seasonal variation in natural pregnancy and birth rate, which varies across geographic regions. It has been suggested that temperature and light may affect the ability to conception via hormonal changes. However, data regarding the seasonal variation during ART is controversial and several studies with conflicting results have been published. One retrospective observational cohort study reported the significant influence of seasonality on fertilization rates with highest ones during the spring and the lowest ones in the autumn. However, another retrospective study did not demonstrate any significant influence of the seasons on ART outcome. Study design, size, duration This retrospective study was performed in the Fertility Center, VUH Santaros Clinics, Lithuania. 959 IVF/ICSI cycles conducted in IVF laboratory between 2017 and 2019 were analysed. The thickness of ZP was measured of 5002 oocytes retrieved between 2017 and 2018. Degenerated oocytes were excluded from the study. Average temperature (AT), precipitation (AP) and sunshine hours (ASH) of every month were taken from Lithuanian Hydrometeorological Service database. Lunar phase (LP) data was collected using Google Calendar. Participants/materials, setting, methods IVF/ICSI cycles were divided into four seasonal groups according to the day of oocyte pick-up. The number of retrieved and fertilized oocytes, transferred embryos, fertilization and pregnancy rates were compared among groups. Then, to avoid bias in fertilization rate, ICSI cycles were excluded and only IVF cycles were analysed. Measurements of ZP thickness were taken using NIS-Elements F software. It was evaluated if AT, AP, ASH, LP and seasonality had an effect on ZP thickness. Main results and the role of chance The mean number of retrieved oocytes and fertilized oocytes as well as the percentage of women who conceived was highest in the spring and lowest in the summer without statistical significance among all seasonal groups (p &gt; 0.05). The fertilization rate was lowest in the spring (66.60%) and highest in the autumn (68.76%) without statistical significance among all four groups. The odds were 1.49 times higher to conceive in spring compared to summer and this result was statistically significant (95% CI 1.01–2.21; p = 0.046), however, when comparing all four seasons together, the difference was not significant. The calculations with only IVF cycles followed the same pattern except that the odds ratio results were not significant and the fertilization rate was highest in the winter. None of the weather conditions (average temperature, average precipitation and average sunshine hours) had an impact on ZP thickness. However, the mean ZP thickness was lowest in the summer (18.86 ± 3.08 µm) and highest in the autumn (19.43 ± 2.98 µm) and the difference among all four seasons was statistically significant (p &lt; 0.05). The mean ZP thickness was lowest during the first quarter lunar phase and highest during the new moon phase with statistical significance among groups (p &lt; 0.05). Limitations, reasons for caution A limitation of our study is unequal number of the IVF/ICSI procedures between months/seasons (e.g., the sample size of autumn was 340 while the sample size of summer was only 161). Also, the measurements of ZP were taken manually therefore there could be some errors. Wider implications of the findings: Understanding possible effects of external factors on ART outcome is important for the best treatment results. Even though seasonality and lunar phase significantly impact ZP thickness, we could not demonstrate any significant seasonal influence on other ART factors or ART outcome. Further studies with higher number of patients are required. Trial registration number Not applicable