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Sokteang S, Ou P, Tran C, de Ziegler D. Programming the onset of ovarian stimulation: from early follicular phase start to oral contraceptive pill, to luteal phase E2, Duostim, and random start oral contraceptive protocols. Fertil Steril 2024:S0015-0282(24)02224-6. [PMID: 39270829 DOI: 10.1016/j.fertnstert.2024.09.011] [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: 08/13/2024] [Revised: 09/03/2024] [Accepted: 09/05/2024] [Indexed: 09/15/2024]
Abstract
Ovarian stimulation has been the single most efficient measure ever taken in assisted reproductive technology for improving outcomes by harvesting multiple oocytes and ultimately, embryos. Today, ovarian stimulation protocols consist of administrating exogenous gonadotropins to override the natural mechanisms that control the ovulatory quota to one in humans. For practicality issues, there have been numerous attempts to control, or "program," when ovarian stimulation is initiated to improve functionality and in turn efficacy for assisted reproductive technology programs. The different options for controlling the onset of ovarian stimulation currently available are discussed here, as well as the novel possibility of using progestins for blocking premature ovulation.
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Affiliation(s)
- Sean Sokteang
- Fertility Clinic of Cambodia (FCC), Phnom Penh, Cambodia
| | - Pichetra Ou
- Fertility Clinic of Cambodia (FCC), Phnom Penh, Cambodia
| | - Chloe Tran
- Fertility Clinic of Cambodia (FCC), Phnom Penh, Cambodia
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Ozgur K, Tore H, Berkkanoglu M, Bulut H, Donmez L, Coetzee K. Comparable ongoing pregnancy and pregnancy loss rates in natural cycle and artificial cycle frozen embryo transfers with intensive method-specific luteal phase support; a retrospective cohort study. J Gynecol Obstet Hum Reprod 2024; 53:102797. [PMID: 38735575 DOI: 10.1016/j.jogoh.2024.102797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024]
Abstract
STUDY OBJECTIVE The absence of corpus lutea in artificial cycle (AC) frozen embryo transfers (FET) may increase the chances of pregnancy loss. In this retrospective cohort study, the efficacy of AC endometrial preparation was compared natural cycle (NC) endometrial preparation in terms of ongoing pregnancy. METHODS One thousand six hundred and eighteen consecutive vitrified-warmed blastocyst FET performed between December 2021 and November 2022 were included, with 1023 compared after exclusions according to the endometrial preparation method; 293 NC-FET, 143 modified NC-FET, 204 unprogrammed AC-FET, and 383 oral contraceptive pill (OCP) programmed AC-FET. Intensive method-specific luteal phase support (LPS) was administered in NC- (human chorionic gonadotropin and micronized vaginal progesterone), mNC- (micronized vaginal progesterone), and in AC-FET (micronized vaginal progesterone, intramuscular progesterone, and oral dydrogesterone). RESULTS Clinician choice of endometrial preparation method resulted in the NC- or AC-FET groups having distinct differences, with female age, antral follicle count and body mass index as well as the percentage of DOR or PCOS diagnosed patients significantly different. The unadjusted ongoing pregnancy and total pregnancy loss rates for NC-, mNC-, AC-, and ocp-AC-FET were 61.8 %, 55.2 %, 57.4 %, and 58.5 %, and 19.2 %, 24.0 %, 23.5 % and 23.8 %, respectively. In multivariate logistic regressions to predict the dependent outcomes of ongoing pregnancy and total pregnancy loss, none of the FET methods were selected as independent predictors. CONCLUSION Patients undergoing NC- and AC-FET with method-specific progesterone LPS had comparable ongoing pregnancy rates as well as total pregnancy loss rates, with NC-FET ranked first in the regression analysis.
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Affiliation(s)
| | - Hande Tore
- Antalya IVF Centre, Antalya, 07080, Turkey
| | - Murat Berkkanoglu
- Antalya IVF Centre, Antalya, 07080, Turkey; Istanbul Atlas University, School of Medicine, Department of Gynecology and Obstetrics, Istanbul 34408, Turkiye
| | - Hasan Bulut
- Antalya IVF Centre, Antalya, 07080, Turkey; Antalya Bilim University, School of Medicine, Department of Health Science, Antalya 07190, Turkiye
| | - Levent Donmez
- Akdeniz University, School of Medicine, Department of Public Health, Antalya, 07058, Turkiye
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3
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Guo C, Wang J, Yang L, Wu Y, Liu X, Zhou Q. Cohort differences between preschool development of in vitro fertilization and naturally conceived infants. Medicine (Baltimore) 2024; 103:e38190. [PMID: 38968475 PMCID: PMC11224888 DOI: 10.1097/md.0000000000038190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/18/2024] [Indexed: 07/07/2024] Open
Abstract
To explore the differential cohort situation between preschool development of in vitro fertilization (IVF) and naturally conceived infants. From April 2014 to June 2022, 60 preschool IVFs were selected as the research subjects for follow-up at the pediatric health clinic of hospital's prevention and health department. They were set as the experimental group (Group S), and 60 naturally conceived infants of the same age were selected as the control group (Group Z). Data from both groups were collected through telephone follow-up and other methods. No significant difference showed between the 2 groups in age specific height, age specific weight, Gesell developmental score, Denver developmental screening test screening results, intellectual development index, and motor development index (P > .05). The influence of birth environment factors such as family background and maternal education level on children's height and weight was not significant (P > .05), while maternal education level had a significant impact on children's intellectual development index (P < .05). No significant difference showed in the development of preschool children in IVF compared to naturally conceived children, and the level of parental education has a significant impact on children's mental and motor development.
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Affiliation(s)
- Chunyan Guo
- Department of Neonatology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
| | - Jingcai Wang
- Department of Neonatology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
| | - Lixin Yang
- Department of Neonatology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
| | - Yanqiu Wu
- Department of Neonatology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
| | - Xia Liu
- Department of Neonatology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
| | - Qili Zhou
- Department of Neonatology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, China
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Sium AF, Surur F, Negash M. Opening the first and only public in vitro fertilization (IVF) center in sub-Saharan Africa: The experience of Ethiopia. Int J Gynaecol Obstet 2024. [PMID: 38796783 DOI: 10.1002/ijgo.15709] [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: 03/20/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
SynopsisOpening public in vitro fertilization (IVF) center in low‐income countries is feasible and sustainable.
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Affiliation(s)
- Abraham Fessehaye Sium
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
| | - Feiruz Surur
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
| | - Mustefa Negash
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
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de Ziegler D, Scott RT, Pirtea P. If recurrent implantation failure is rare, what could be the cause of repeated unsuccessful assisted reproductive technologies? Fertil Steril 2024; 121:754-755. [PMID: 38048900 DOI: 10.1016/j.fertnstert.2023.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Dominique de Ziegler
- Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch - Université de Paris Ouest (UVSQ)
| | | | - Paul Pirtea
- Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch - Université de Paris Ouest (UVSQ)
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Pirtea P, de Ziegler D, Toner J, Scott R, Ayoubi JM. Hiding in plain sight. Hum Reprod Open 2023; 2023:hoad015. [PMID: 37273769 PMCID: PMC10234701 DOI: 10.1093/hropen/hoad015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Affiliation(s)
- Paul Pirtea
- Correspondence address. Hospital Foch, 40 Rue Worth, 92150 Suresnes, France. E-mail:
| | | | | | - Richard Scott
- Reproductive Medicine Associates of New Jersey, Basking Ridge, NJ, USA
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Galati G, Esposito G, Somigliana E, Muzii L, Franchi M, Corrao G, Parazzini F. Trends in the incidence of major birth defects after assisted reproductive technologies in Lombardy Region, Northern Italy. J Assist Reprod Genet 2023; 40:857-863. [PMID: 36763300 DOI: 10.1007/s10815-023-02732-z] [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: 10/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
PURPOSE The incidence of birth defects is increased in children born after assisted reproductive technologies (ART). However, changes in ART over time could influence this incidence. To investigate this issue, we present the frequency and trends of birth defects in ART and natural pregnancies in Lombardy, Northern Italy, during the period 2014-2020. METHODS This is a population-based study using automated system of healthcare utilization (HCU) databases. ART pregnancies included only those obtained with conventional IVF or ICSI. After identifying the total number of deliveries, the rate of newborns with birth defects was compared between natural and ART pregnancies. A logistic regression model was used to calculate the adjusted odd ratio (OR). Analyses were repeated for every calendar year. RESULTS Overall, 508,421 deliveries were identified, of which 14,067 (2.8%) were achieved after IVF-ICSI. A decreasing trend in birth defects over time was highlighted. The adjusted OR dropped from 1.40 (95%CI: 1.03-1.91) in 2014 to 0.92 (95%CI: 0.69-1.22) in 2020. During the study period, a significant reduction in multiple pregnancy and in the ratio of ICSI to conventional IVF was also observed, explaining at least in part the positive trend observed for birth defects. CONCLUSION The increased risk of birth defects in children born after IVF-ICSI is not steady over time. A decline of this risk emerged in our region. Policy changes in ART may explain this beneficial effect.
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Affiliation(s)
- Giulia Galati
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy.
| | - Giovanna Esposito
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Edgardo Somigliana
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. .,Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Franchi
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.,National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Giovanni Corrao
- Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.,National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Kucherov A, Fazzari M, Lieman H, Ball GD, Doody K, Jindal S. PGT-A is associated with reduced cumulative live birth rate in first reported IVF stimulation cycles age ≤ 40: an analysis of 133,494 autologous cycles reported to SART CORS. J Assist Reprod Genet 2023; 40:137-149. [PMID: 36454362 PMCID: PMC9840738 DOI: 10.1007/s10815-022-02667-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE To evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on cumulative live birth rate (CLBR) in IVF cycles. METHODS Retrospective cohort study of the SART CORS database, comparing CLBR for patients using autologous oocytes, with or without PGT-A. The first reported autologous ovarian stimulation cycle per patient between January 1, 2014, and December 31, 2015, and all linked embryo transfer cycles between January 1, 2014, and December 31, 2016, were included in the study. Exclusion criteria were donor oocyte cycles, donor embryo cycles, gestational carrier cycles, cycles which included both a fresh embryo transfer (ET) combined with a thawed embryo previously frozen (ET plus FET), or cycles with a fresh ET after PGT-A. RESULTS A total of 133,494 autologous IVF cycles were analyzed. Amongst patients who had blastocysts available for either ET or PGT-A, including those without transferrable embryos, decreased CLBR was noted in the PGT-A group at all ages, except ages > 40 (p < 0.01). A subgroup analysis of only those patients who had PGT-A and a subsequent FET, excluding those without transferrable embryos, demonstrated a very high CLBR, ranging from 71.2% at age < 35 to 50.2% at age > 42. Rates of multiple gestations, preterm birth, early pregnancy loss, and low birth weight were all greater in the non-PGT-A group. CONCLUSIONS PGT-A was associated with decreased CLBR amongst all patients who had blastocysts available for ET or PGT-A, except those aged > 40. The negative association of PGT-A use and CLBR per cycle start was especially pronounced at age < 35.
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Affiliation(s)
| | - Melissa Fazzari
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Harry Lieman
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
- Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, NY, USA
| | - G David Ball
- Reproductive Medicine and Infertility Associates, Woodbury, MN, USA
| | - Kevin Doody
- Center for Assisted Reproduction, Bedford, TX, USA
| | - Sangita Jindal
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
- Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, NY, USA
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Scaravelli G, Pisaturo V, Levi Setti PE, Ubaldi FM, Livi C, Borini A, Greco E, Villani MT, Coccia ME, Revelli A, Ricci G, Fusi F, Costa M, Migliorati E, De Luca R, Vigiliano V, Bolli S, Reschini M. Monozygotic twin rate among ART centers: a multicenter analysis of data from 18 Italian units. J Assist Reprod Genet 2022; 39:2349-2354. [PMID: 36053372 PMCID: PMC9596663 DOI: 10.1007/s10815-022-02603-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022] Open
Abstract
PURPOSE The risk of monozygotic twins (MZTs) is increased in couples undergoing assisted reproductive technology (ART) treatments. Several systematic reviews have investigated the possible determinants linked to ART, but results obtained have not been conclusive. The study aims to investigate whether the incidence of MZT differed among ART centers. METHODS This is a multicenter retrospective cohort study using the Italian ART National Registry database and involving the centers reporting data from individual ART cycles from 2015 to 2019. To investigate the incidence of MZT, only single embryo transfer cycles were considered. Women who had sex-discordant deliveries were excluded. MZT rate was calculated as the number of multiple pregnancies (more than one gestational sac at first ultrasound) out of the total number of clinical pregnancies. A binomial distribution model was used to determine the 95% CI of the frequency of MZT. RESULTS Eighteen centers were included, and they provided data on 10,433 pregnancies. The total number of MZT was 162, corresponding to an incidence of 1.5% (95% CI: 1.3-1.8%). The rate of MZT among centers varied between 0% (95% CI: 0.0-25.9%) and 3.2% (95% CI: 1.3-8.1%). All the 95% CIs included 1.5%, rejecting the hypothesis that the MZT rate may significantly differ among centers. CONCLUSIONS The rate of MZT did not significantly vary among ART centers. Local factors are unlikely to explain the increased rate of MZT in ART pregnancies.
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Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Valerio Pisaturo
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via M. Fanti 6, 20122, Milan, Italy.
| | - Paolo Emanuele Levi Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Claudia Livi
- Demetra GeneraLife Assisted Procreation Center, Florence, Italy
| | | | - Ermanno Greco
- Villa Mafalda, Rome, Italy
- UniCamillus, International Medical University, Rome, Italy
| | - Maria Teresa Villani
- Department of Obstetrics and Gynaecology, Fertility Centre, Arcispedale Santa Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Alberto Revelli
- Gynecology and Obstetrics 1U/2U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Torino, Turin, Italy
| | - Giuseppe Ricci
- Department of Obstetrics and Gynecology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Francesco Fusi
- Department of Maternal Fetal and Pediatric Medicine, ASST, Papa Giovanni XXIII, Bergamo, Italy
| | - Mauro Costa
- Department of Reproductive Medicine, Ospedale Evangelico Internazionale, Genoa, Italy
| | - Emanuela Migliorati
- Surgery for Gynecology and Obstetrics, Genera Umbria S.R.L, Umbertide, Perugia, Italy
| | - Roberto De Luca
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Vincenzo Vigiliano
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Simone Bolli
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Marco Reschini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via M. Fanti 6, 20122, Milan, Italy
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Quinn MM, Marsh P, Ribeiro S, Simbulan RK, Rosen MP. A deep dive into the morphokinetics and ploidy of low-quality blastocysts. F S Rep 2022; 3:231-236. [PMID: 36212568 PMCID: PMC9532888 DOI: 10.1016/j.xfre.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 10/28/2022] Open
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Burks HR. Birthweight after assisted reproductive technology: clinical decision-making and patient counseling. F S Rep 2022; 3:8-9. [PMID: 35386507 PMCID: PMC8978074 DOI: 10.1016/j.xfre.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Heather R Burks
- Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, Oklahoma City, Oklahoma
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12
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Hosseinzadeh P, Hoyos LR, Evans MB. Following the leaders: common practices among high-performing in vitro fertilization programs. Fertil Steril 2021; 117:51-52. [PMID: 34863517 DOI: 10.1016/j.fertnstert.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Pardis Hosseinzadeh
- University of Oklahoma Health Science Center, Department of Obstetrics and Gynecology, Oklahoma City, Oklahoma
| | - Luis R Hoyos
- IVF Florida Reproductive Associates, Margate, Florida; Department of Obstetrics and Gynecology, Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
| | - M Blake Evans
- University of Oklahoma Health Science Center, Department of Obstetrics and Gynecology, Oklahoma City, Oklahoma
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