1
|
Wen W, Zhang D, Liu X, Shi J, Cai H. Embryo development and live birth in women with one previously failed full IVF/ICSI cycle. J Assist Reprod Genet 2024:10.1007/s10815-024-03107-8. [PMID: 38739214 DOI: 10.1007/s10815-024-03107-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/25/2024] [Indexed: 05/14/2024] Open
Abstract
PURPOSE To evaluate the embryological and pregnancy outcomes of women who failed in their first IVF treatment if they attempted a second cycle. METHODS For evaluating the embryological outcomes, the study cohort included 1,227 women who failed to obtain a live birth after the initial IVF cycle from September 2018 to August 2021 and returned for a second attempt. To evaluate reproductive outcomes including live birth rates (LBRs), 1227 women who returned for a second attempt were compared with 13,195 women undergoing their first oocyte retrieval with blastocyst culture attempted during the same study period. RESULTS In women who had a second cycle, the median number of oocyte retrieved (11 vs 9), fertilized oocytes (7 vs 5), usable embryos (6 vs 4) and blastocysts (3 vs 1) was higher in the second cycle compared to the first cycle (All p < 0.001). Blastocyst formation rates were significantly increased from 33% in the first cycle to 50% in the second cycle across the age group (p < 0.001). However, the primary transfer LBRs were significantly lower in the second cycle than that in the initial cycle (40.82% versus 51.79%, aOR: 0.74 [0.65, 0.84]). LBRs in the second cycle were 42.26%, 42.68%, 25.49% and 16.22% in women aged < 35, 35-37, 38-40, and > 40 years. CONCLUSION There was a notable enhancement in laboratory outcomes following the second attempt in women whose initial IVF cycles were unsuccessful. However, the uncertainty inherent in the successful implantation and the consequent progression to live birth remains a significant challenge.
Collapse
Affiliation(s)
- Wen Wen
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Houzaimen North Street, Xi'an, 73#, China
| | - Dian Zhang
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Houzaimen North Street, Xi'an, 73#, China
- Graduate Department, Xi'an Medical University, Xi'an, China
| | - Xiaohua Liu
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Houzaimen North Street, Xi'an, 73#, China
| | - Juanzi Shi
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Houzaimen North Street, Xi'an, 73#, China
| | - He Cai
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Houzaimen North Street, Xi'an, 73#, China.
| |
Collapse
|
2
|
Zareii A, Davoodi S, Alborzi M, Moghadam ME, Askary E. Co-administration of GnRH agonists with vaginal progesterone compared to vaginal progesterone in luteal phase support of the frozen-thawed embryo transfer cycle: An RCT. Int J Reprod Biomed 2021; 19:863-872. [PMID: 34805726 PMCID: PMC8595909 DOI: 10.18502/ijrm.v19i10.9817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/01/2020] [Accepted: 11/24/2020] [Indexed: 12/02/2022] Open
Abstract
Background Since progesterone alone does not seem to be enough for luteal phase support (LPS), especially in frozen embryo transfer (FET) cycles, so gonadotropin-releasing hormone agonist (GnRH-a) is suggested as an adjuvant therapy in combination with progesterone for LPS. Objective To evaluate the effects of the administration of GnRH-a with vaginal progesterone compared to vaginal progesterone alone in luteal phase support of the frozen-thawed embryo transfer cycles. Materials and Methods In this randomized controlled clinical trial, 240 infertile women who were candidates for FET were evaluated into two groups (n = 120/each). Group I received 400 mg vaginal progesterone twice a day from the time of transfer. The second group received vaginal progesterone and also 0.1 mg diphereline on days 0, 3, and 6 of FET for LPS. Finally, the clinical and ongoing pregnancy rates, and the implantation, and spontaneous abortion rates were compared in two groups. Results Results showed that there was no significant difference between the mean age of women and the duration of infertility (p = 0.78, p = 0.58, respectively). There were no significant differences between groups in the terms of implantation and spontaneous abortion rates (p = 0.19, p = 0.31, respectively). However, in terms of clinical and ongoing pregnancy rates, the significant differences were seen between groups (p = 0.008 and p = 0.005, respectively). Conclusion Co-administration of GnRH-a and vaginal progesterone in LPS may be superior to vaginal progesterone alone in women who underwent a frozen-selected embryo transfer cycle.
Collapse
Affiliation(s)
- Afsoon Zareii
- Infertility Division, Infertility Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Davoodi
- Infertility Division, Infertility Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahshid Alborzi
- Infertility Division, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Elham Askary
- Department of Obstetrics and Gynecology, Laparoscopy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
3
|
Song J, Duan C, Cai W, Xu J. Predictive value of the number of frozen blastocysts in live birth rates of the transferred fresh embryos. J Ovarian Res 2021; 14:83. [PMID: 34174916 PMCID: PMC8236141 DOI: 10.1186/s13048-021-00838-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Abstract
Background Blastocyst development by extended culture in vitro allows the embryos to ‘select’ themselves, thus successful growth to the blastocyst stage is a reflection of the developmental competence of cleavage stage embryos in a cohort. The study aims to determine whether the number of frozen blastocysts is associated with live birth rates of the transferred fresh embryos. Method The retrospective study included 8676 cycles of first fresh embryo transfer from January 2016 to June 2019 at a fertility center of a university hospital. The patients with ≥ 10 oocytes retrieved were divided into three groups according to the number of frozen blastocysts: 0 (group 1), 1–2 (group 2), and ≥ 3 (group 3). The primary outcome measure was the live birth. The secondary outcome measures included clinical pregnancy rates and implantation rates. Logistic regression analysis was also performed. Results Live birth rates in patients with ≥ 3 and 1–2 frozen blastocysts were 47.6% and 46.1%, respectively, which were significantly higher than that in patients without blastocyst (36.0%). The clinical pregnancy rate in group 3 was 65.1%, which was also significantly higher than the other two groups (47.0% and 59.2%). The implantation rates were 35.5%, 47.6%, and 56.0% in the three groups, respectively (P < 0.001). Compared with groups of frozen blastocysts, 0 frozen blastocyst yielded a lower rate of live birth (the adjusted odds ratio: 0.526, 95% CI: 0.469, 0.612). Conclusion In patients with optimal ovarian response that retrieved ≥ 10 oocytes, fresh embryos transfer followed by having blastocysts frozen is a strong indicator of pregnancy achievement, but the number of frozen blastocysts (if not = 0) has limited value in predicting live birth rates.
Collapse
Affiliation(s)
- Jianyuan Song
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No.1 Shang Cheng Avenue, Yiwu, 322000, Zhejiang, China
| | - Cuicui Duan
- Women's Hospital School Of Medicine, Zhejiang University, No.1 Xue Shi Road, Hangzhou, 310006, Zhejiang, China
| | - Wangyu Cai
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No.1 Shang Cheng Avenue, Yiwu, 322000, Zhejiang, China
| | - Jian Xu
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No.1 Shang Cheng Avenue, Yiwu, 322000, Zhejiang, China.
| |
Collapse
|
4
|
The association between quality of supernumerary embryos in a cohort and implantation potential of the transferred blastocyst. J Assist Reprod Genet 2018; 35:1651-1656. [PMID: 29974298 DOI: 10.1007/s10815-018-1254-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 06/26/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Despite studies focused on the association between embryo morphology and implantation potential, it is unknown how the collective quality of the supernumerary embryos in a cohort is associated with the implantation rate (IR) of the transferred embryo. This study tested the hypothesis that a relationship exists between the quality of the supernumerary cohort and IR. METHODS A retrospective cohort study of first fresh autologous IVF cycles from 05/2012 to 09/2016, with ≥ 3 blastocysts, resulting in a single blastocyst transfer (n = 819) was performed. Cohorts were grouped in two ways: by mean priority score (PS; 1 being best) of supernumerary embryos and by percent supernumerary embryos with low implantation potential. The relationship between cohort quality and IR was assessed using logistic regression. RESULTS As mean cohort PS increased, IR of the transferred embryo decreased (test for linear trend, p = 0.05). When ≥ 75% of the supernumerary cohort was predicted to have low implantation potential, IR of the transferred embryo was significantly lower compared to when < 75% of the cohort was predicted to have low implantation potential (OR 0.71; 95% CI (0.53-0.94)). All associations were attenuated when adjusting for PS of the transferred embryo. CONCLUSIONS Our findings suggest that quality of supernumerary embryos is associated with IR of the transferred embryo, among patients with ≥ 3 blastocysts available on day 5. As cohort quality declines and the proportion of low implantation potential embryos increases, the IR of the transferred embryo declines. These associations are attenuated when controlling for quality of the transferred embryo, suggesting that the relationship between embryo cohort quality and implantation is not independent of the transferred embryo quality.
Collapse
|
5
|
Molecular Mechanisms Responsible for Increased Vulnerability of the Ageing Oocyte to Oxidative Damage. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:4015874. [PMID: 29312475 PMCID: PMC5664291 DOI: 10.1155/2017/4015874] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/03/2017] [Indexed: 12/23/2022]
Abstract
In their midthirties, women experience a decline in fertility, coupled to a pronounced increase in the risk of aneuploidy, miscarriage, and birth defects. Although the aetiology of such pathologies are complex, a causative relationship between the age-related decline in oocyte quality and oxidative stress (OS) is now well established. What remains less certain are the molecular mechanisms governing the increased vulnerability of the aged oocyte to oxidative damage. In this review, we explore the reduced capacity of the ageing oocyte to mitigate macromolecular damage arising from oxidative insults and highlight the dramatic consequences for oocyte quality and female fertility. Indeed, while oocytes are typically endowed with a comprehensive suite of molecular mechanisms to moderate oxidative damage and thus ensure the fidelity of the germline, there is increasing recognition that the efficacy of such protective mechanisms undergoes an age-related decline. For instance, impaired reactive oxygen species metabolism, decreased DNA repair, reduced sensitivity of the spindle assembly checkpoint, and decreased capacity for protein repair and degradation collectively render the aged oocyte acutely vulnerable to OS and limits their capacity to recover from exposure to such insults. We also highlight the inadequacies of our current armoury of assisted reproductive technologies to combat age-related female infertility, emphasising the need for further research into mechanisms underpinning the functional deterioration of the ageing oocyte.
Collapse
|
6
|
Barash OO, Hinckley MD, Rosenbluth EM, Ivani KA, Weckstein LN. High gonadotropin dosage does not affect euploidy and pregnancy rates in IVF PGS cycles with single embryo transfer. Hum Reprod 2017; 32:2209-2217. [DOI: 10.1093/humrep/dex299] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/11/2017] [Indexed: 11/15/2022] Open
|
7
|
Martin C, Chang J, Boulet S, Jamieson DJ, Kissin D. Factors predicting double embryo implantation following double embryo transfer in assisted reproductive technology: implications for elective single embryo transfer. J Assist Reprod Genet 2016; 33:1343-1353. [PMID: 27416834 PMCID: PMC5065549 DOI: 10.1007/s10815-016-0770-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 07/01/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The aim of this study was to identify factors associated with double embryo implantation following double embryo transfer (DET) during assisted reproductive technology (ART) procedures and to evaluate the implications of findings in selecting candidates for elective single embryo transfer (eSET). METHODS Factors predicting double embryo implantation, defined as embryo transfers with two or more heartbeats on 6-week ultrasound following DET, were assessed using the US National ART Surveillance System data from 2000 to 2012 (n = 1,793,067 fresh, autologous transfers). Adjusted risk ratios (aRRs) were estimated after stratifying by prognosis. Favorable prognosis was defined as first-time ART with supernumerary embryo(s) cryopreserved. Average prognosis was defined as first-time ART without supernumerary embryo(s) cryopreserved, prior unsuccessful ART with supernumerary embryo(s) cryopreserved, or prior ART with previous birth(s) conceived with ART or naturally. Rates and factors associated with double embryo implantation were compared with single embryo implantation following DET among both prognosis groups. RESULTS Double embryo implantation was positively associated with blastocyst (versus cleavage) transfer in favorable (aRR = 1.58 (1.51-1.65)) and average (aRR = 1.67 (1.60-1.75)) prognosis groups and negatively associated with age >35 years in both prognosis groups. For average prognosis patients, double embryo implantation was associated with retrieving >10 oocytes (aRR = 1.22 (1.18-1.24)). CONCLUSIONS Regardless of prognosis, patients aged <35 years with blastocyst-stage embryos and average prognosis patients from whom >10 oocytes were retrieved may be good candidates for eSET. Physicians may consider using these data to counsel patients on eSET, which would reduce multiple gestations and associated complications.
Collapse
Affiliation(s)
- Caitlin Martin
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-74, Atlanta, GA 30341 USA
- Department of Gynecology and Obstetrics, Emory University, Glenn Building, 4th Floor, 69 Jesse Hill Jr Drive SE, Atlanta, GA 30303 USA
| | - Jeani Chang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-74, Atlanta, GA 30341 USA
| | - Sheree Boulet
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-74, Atlanta, GA 30341 USA
| | - Denise J. Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-74, Atlanta, GA 30341 USA
| | - Dmitry Kissin
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-74, Atlanta, GA 30341 USA
| |
Collapse
|
8
|
Kissin DM, Kawwass JF, Monsour M, Boulet SL, Session DR, Jamieson DJ. Assisted hatching: trends and pregnancy outcomes, United States, 2000-2010. Fertil Steril 2014; 102:795-801. [PMID: 25044084 DOI: 10.1016/j.fertnstert.2014.06.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/23/2014] [Accepted: 06/06/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess trends and outcomes of assisted hatching among assisted reproductive technology (ART) cycles. DESIGN Retrospective cohort analysis using National ART Surveillance System (NASS) data. SETTING U.S. fertility centers reporting to NASS. PATIENT(S) Fresh autologous noncanceled ART cycles conducted from 2000-2010. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Implantation, clinical pregnancy, live-birth, miscarriage, multiple gestation. RESULT(S) Assisted hatching use statistically significantly increased in absolute number (from 25,724 to 35,518 cycles), percentages of day-3 (from 50.7% to 56.3%) and day-5 transfers (from 15.9% to 22.8%), and percentage of transfers among women ≥38 years (from 17.8% to 21.8%) or women with ≥2 prior ART cycles and no live birth(s) (from 4.3% to 7.4%). Both day-3 and day-5 cycles involving assisted hatching were associated with lower odds of implantation (adjusted odds ratios [aOR] 0.7 and 0.6, respectively), clinical pregnancy (aOR 0.8 and 0.7, respectively), live birth (aOR 0.8 and 0.7, respectively), and increased odds of miscarriage (aOR 1.4 and 1.4, respectively), as compared with cycles without assisted hatching. Assisted hatching was associated with lower odds of multiple gestation in day-5 cycles (aOR 0.8). In cycles for women with a "poor prognosis," the association of assisted hatching with pregnancy outcomes was not statistically significant. CONCLUSION(S) Assisted hatching use had an increasing trend but was not associated with improved pregnancy outcomes, even in poor-prognosis patients. Prospective studies are needed to identify the patients who may benefit from assisted hatching.
Collapse
Affiliation(s)
- Dmitry M Kissin
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia.
| | - Jennifer F Kawwass
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Michael Monsour
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sheree L Boulet
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Donna R Session
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Denise J Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| |
Collapse
|
9
|
Abstract
OBJECTIVE To assess the association between number of embryos transferred and a measure of assisted reproductive technology success that emphasizes good perinatal outcome. METHODS We analyzed assisted reproductive technology cycles initiated in 2011 that progressed to fresh embryo transfer among women using autologous oocytes and reported to the U.S. National Assisted Reproductive Technology Surveillance System (n=82,508). Percentages of good perinatal outcome (live birth of a term [at or after 37 weeks of gestation], normal birth weight [2,500 g or greater] singleton) were stratified by prognosis (favorable, average, less favorable), age, embryo stage (day 3, day 5), and number of embryos transferred. Differences in the percentages by number of embryos transferred were evaluated using Fisher's exact test with Bonferroni correction. RESULTS Among patients younger than 35 years with a favorable prognosis, chances of a good perinatal outcome were higher with transferring a single (compared with double) day 5 (43% compared with 27%) or day 3 embryo (36% compared with 30%). Likewise, a higher chance of a good perinatal outcome was observed with transferring a single day 5 embryo in patients 35-37 years old with a favorable prognosis (39% compared with 28%) or patients younger than 35 years old with an average prognosis (35% compared with 26%). A higher chance of good perinatal outcome was associated with transferring two (compared with one) day 3 embryos among patients aged 40 years or younger with an average prognosis or patients younger than 35 years old with a less favorable prognosis. CONCLUSION The association between number of embryos transferred and the birth of a term, normal birth weight singleton is described. Among patients younger than 35 years of age undergoing in vitro fertilization with a favorable prognosis, the highest chance of good perinatal outcome is associated with a single embryo transfer. LEVEL OF EVIDENCE II.
Collapse
|
10
|
Is cryopreservation of embryos a legitimate surrogate marker of embryo quality in studies of assisted reproductive technology conducted using national databases? Fertil Steril 2012; 97:890-3. [PMID: 22265032 DOI: 10.1016/j.fertnstert.2011.12.050] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 12/22/2011] [Accepted: 12/29/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate whether cryopreservation of supernumerary embryos is a good surrogate for embryo quality. DESIGN Retrospective study of 6,859 assisted reproductive technology (ART) cycles from women aged <35 years with two fresh day 3 embryos transferred. SETTING National Society for Assisted Reproductive Technology Clinic Outcome Reporting System data from 2006-2008. PATIENT(S) Women undergoing ART. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Embryo quality (good, fair, or poor), cell number, and live births were compared for cycles with and without cryopreservation, using χ(2) to evaluate statistical significance. The association of freezing with embryo quality was examined using multiple logistic regression after adjusting for confounders (patient age, oocyte yield, intracytoplasmic sperm injection [ICSI], assisted hatching, male factor infertility). RESULT(S) Cycles with cryopreservation were more likely to have two embryos of good quality transferred (81.3% vs. 48.5%) and had more 8-cell embryos transferred (76.0% vs. 50.1%). Relative to cycles with two good embryos (good-good), the adjusted odds ratios (OR) for cryopreservation were: good-fair (OR = 0.301, 95% confidence interval [CI] = 0.257-0.354), fair-fair (OR = 0.308, 95% CI = 0.258-0.367), and any poor (OR = 0.058, 95% CI = 0.040-0.083). The live birth rate was 52.4% for cycles with freezing and 40.6% for cycles without. CONCLUSION(S) Embryo quality and cell number were both associated with embryo cryopreservation. However, although cryopreservation was a strong marker for good quality, not having cryopreservation did not reliably indicate poor quality, as almost half of those cycles had two good quality embryos.
Collapse
|
11
|
Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C, Thomas S. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfers in high responders. Fertil Steril 2011; 96:516-8. [PMID: 21737071 DOI: 10.1016/j.fertnstert.2011.02.059] [Citation(s) in RCA: 182] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 01/31/2011] [Accepted: 02/01/2011] [Indexed: 11/25/2022]
Abstract
Clinical pregnancy rates of 80% and 65% were observed in cycles using thawed and fresh embryos, respectively, although embryo quality indicators revealed morphologically and numerically inferior embryo cohorts after cryopreservation. Subsequent logistic regression analysis controlled for differences in embryo quality and revealed significantly greater probability of clinical pregnancy with thawed embryos when compared with fresh, suggesting a negative effect of ovarian stimulation on endometrial receptivity.
Collapse
Affiliation(s)
- Bruce S Shapiro
- Fertility Center of Las Vegas, Las Vegas, Nevada 89117, USA.
| | | | | | | | | | | |
Collapse
|
12
|
Santos MA, Kuijk EW, Macklon NS. The impact of ovarian stimulation for IVF on the developing embryo. Reproduction 2010; 139:23-34. [PMID: 19710204 DOI: 10.1530/rep-09-0187] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The use of assisted reproductive technologies (ART) has been increasing over the past three decades, and, in developed countries, ART account for 1-3% of annual births. In an attempt to compensate for inefficiencies in IVF procedures, patients undergo ovarian stimulation using high doses of exogenous gonadotrophins to allow retrieval of multiple oocytes in a single cycle. Although ovarian stimulation has an important role in ART, it may also have detrimental effects on oogenesis, embryo quality, endometrial receptivity and perinatal outcomes. In this review, we consider the evidence for these effects and address possible underlying mechanisms. We conclude that such mechanisms are still poorly understood, and further knowledge is needed in order to increase the safety of ovarian stimulation and to reduce potential effects on embryo development and implantation, which will ultimately be translated into increased pregnancy rates and healthy offspring.
Collapse
Affiliation(s)
- Margarida Avo Santos
- University Medical Centre Utrecht, Reproductive Medicine and Gynaecology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | | | | |
Collapse
|
13
|
Provoost V, Pennings G, De Sutter P, Gerris J, Van de Velde A, Dhont M. Patients' conceptualization of cryopreserved embryos used in their fertility treatment. Hum Reprod 2009; 25:705-13. [PMID: 20023294 DOI: 10.1093/humrep/dep387] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- V Provoost
- Bioethics Institute Ghent, Ghent University, Blandijnberg 2, 9000 Ghent, Belgium.
| | | | | | | | | | | |
Collapse
|
14
|
Cobo A, Domingo J, Pérez S, Crespo J, Remohí J, Pellicer A. Vitrification: an effective new approach to oocyte banking and preserving fertility in cancer patients. Clin Transl Oncol 2008; 10:268-73. [PMID: 18490243 DOI: 10.1007/s12094-008-0196-7] [Citation(s) in RCA: 135] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Oocyte cryopreservation is a useful tool for preserving the fertility of cancer patients at risk of losing ovarian function due to undergoing potentially sterilising therapies. Results obtained with different cryopreservation protocols have been disappointing, particularly those obtained with slow cooling procedures. The efficacy of vitrification as an application in clinical practice has recently been demonstrated. The aim of this study is to report results obtained with the Cryotop method of oocyte vitrification in a population of healthy women and to point out its potential usefulness for fertility preservation in oncological patients. MATERIALS AND METHODS The study population consisting of non-oncological patients included 47 oocyte donors and 57 recipients undergoing an oocyte donation cycle of assisted reproductive technology (ART). A total of 693 mature metaphase II oocytes were collected following ovarian stimulation using long protocol down-regulation plus gonadotropin administration. Vitrification was carried out by means of the Cryotop method. Oocytes were donated to a compatible recipient after endometrial preparation. RESULTS Of the 693 oocytes, 666 (96.1%) survived. A total of 487 (73.1%) were fertilised successfully. One hundred and seventeen embryos were transferred to 57 recipients. Pregnancy rate per transfer and implantation rates were 63.2% and 38.5% respectively. Twenty-eight healthy babies were later born. CONCLUSIONS Oocyte cryo-banking by means of the Cryotop vitrification method represents a viable option for healthy women, producing excellent survival rates and a clinical outcome similar to that obtained with fresh oocytes. This approach could potentially be used in cancer patients who want to safeguard their fertility. Cancer patients could potentially benefit from this approach by storing their oocytes before the onset of the oncological therapy.
Collapse
Affiliation(s)
- A Cobo
- IVF Laboratory, IVI, Valencia, Spain.
| | | | | | | | | | | |
Collapse
|
15
|
Jancar N, Virant-Klun I, Osredkar J, Bokal EV. Apoptosis, reactive oxygen species and follicular anti-Müllerian hormone in natural versus stimulated cycles. Reprod Biomed Online 2008; 16:640-8. [DOI: 10.1016/s1472-6483(10)60477-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|