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Cheng T, Fan J, Yuan F, Xie H, Zhang C, He Q. Association with pre-pregnancy BMI on early pregnancy loss in infertility patients in first HRT-FET cycles: A retrospective cohort study. Obes Res Clin Pract 2024; 18:141-146. [PMID: 38453594 DOI: 10.1016/j.orcp.2024.03.001] [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: 03/24/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To investigate the association between pre-pregnancy body mass index (BMI) and the early pregnancy loss rate in patients in first hormone replacement therapy-frozen-thawed embryo transfer (HRT-FET) cycles and find the threshold. METHODS A retrospective cohort study was conducted using a total of 14030 HRT-FET cycles at the Reproductive Center from January 2017 to December 2021. The association of pre-pregnancy BMI on early pregnancy loss rate in patients in HRT-FET cycles was assessed by performing univariate analysis, multivariable logistic regression, curve fitting and threshold effect analysis. RESULTS There were 2076 cycles of early pregnancy loss, and the pregnancy loss rate was 14.80%. After adjusting for confounding factors, the early pregnancy loss rate of the obese group was significantly higher than that of the normal weight group (P < 0.05). The threshold effect analysis showed that as the pre-pregnancy BMI ranged from 21.2 to 25.8 kg/m2, the early pregnancy loss rate came to the plateau phase at the low level. In addition, when the BMI was ≥ 25.8 kg/m2, the early pregnancy loss rate increased by 3% (aOR = 1.03, P = 0.01) with each 1 kg/m2 increment of BMI. CONCLUSION The early pregnancy loss rate might achieve a low level when the pre-pregnancy BMI was within the range of 21.2- 25.8 kg/m2. The early pregnancy loss rate would increase when pre-pregnancy BMI is more than 25.8 kg/m2. For patients in HRT-FET cycles, adjusting their pre-pregnancy BMI to the optimal level by following a healthy diet and daily exercise may help to reduce the early pregnancy loss.
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Affiliation(s)
- Tiantian Cheng
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Jingjing Fan
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Fang Yuan
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Huanhuan Xie
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Cuilian Zhang
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Qiaohua He
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China.
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Fabozzi G, Cimadomo D, Maggiulli R, Vaiarelli A, Badajoz V, Aura M, Canosa S, Bongioanni F, Benini F, Livi C, Zacà C, Borini A, Alviggi E, Iussig B, Hebles M, Sànchez P, Cimadomo V, Rienzi L, Llàcer J. Association between oocyte donors' or recipients' body mass index and clinical outcomes after first single blastocyst transfers-the uterus is the most affected. Fertil Steril 2024; 121:281-290. [PMID: 37549838 DOI: 10.1016/j.fertnstert.2023.07.029] [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: 02/28/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE To assess whether high body mass index (BMI) in either oocyte donors or recipients is associated with poorer outcomes after the first single blastocyst transfer. DESIGN Retrospective study including 1,394 first blastocyst single embryo transfers (SETs) conducted by 1,394 recipients during oocyte donation cycles with the gametes retrieved from 1,394 women (January 2019-July 2021). Four BMI clusters were defined for both donors and recipients (underweight: <18.5 kg; normal weight: 18.5-24.9 kg; overweight: 25-29.9 kg; and obese: ≥30 kg). SETTING Network of private IVF centers. PATIENTS A total of 1,394 recipients aged 42.4 ± 4.0 and with a BMI of 23.2 ± 3.8 kg/m2, and 1,394 donors aged 26.1 ± 4.2 and with a BMI of 21.9 ± 2.5 kg/m2. INTERVENTION All oocytes were vitrified at 2 egg banks and warmed at 8 in vitro fertilization clinics that were part of the same network. Intracytoplasmic sperm injection, blastocyst culture, and either fresh or vitrified-warmed SETs were conducted. Putative confounders were investigated, and the data were adjusted through regression analyses. MAIN OUTCOME MEASURES The primary outcome was the live birth rate (LBR) per SET according to donors' and/or recipients' BMI. The main secondary outcome was the miscarriage rate (<22 gestational weeks) per clinical pregnancy. RESULTS The LBR per blastocyst SET showed no significant association with donors' BMI. Regarding recipients' BMI, instead, the multivariate odds ratio was significant in obese vs. normal-weight recipients (0.58, 95% confidence interval, 0.37-0.91). The miscarriage rate per clinical pregnancy was also significantly associated with recipients' obesity, with a multivariate odds ratio of 2.31 (95% confidence interval, 1.18-4.51) vs. normal-weight patients. A generalized additive model method was used to represent the relationship between predicted LBR or miscarriage rates and donors' or recipients' BMI; it pictured a scenario where the former outcome moderately but continuously decreases with increasing recipients' BMI to then sharply decline in the BMI range of 25-35 kg/m2. The miscarriage rate, instead, increases almost linearly with respect to both donors' and recipients' increasing BMI. CONCLUSION Obesity mostly affects the uterus, especially because of higher miscarriage rates. Yet, poorer outcomes can be appreciated already with a BMI of 25 kg/m2 in both oocyte donors and recipients. Finer markers of nutritional homeostasis are therefore desirable; recipients should be counseled about poorer expected outcomes in cases of overweight and obesity; and oocyte banks should avoid assigning oocytes from overweight donors to overweight and obese recipients.
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Affiliation(s)
- Gemma Fabozzi
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy; IVIRMA Global Research Alliance, B-WOMAN, Rome, Italy; Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy
| | - Danilo Cimadomo
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy.
| | - Roberta Maggiulli
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Alberto Vaiarelli
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | | | - Monica Aura
- IVIRMA Global Research Alliance, GINEFIV, Barcelona, Spain
| | | | | | | | - Claudia Livi
- IVIRMA Global Research Alliance, DEMETRA, Florence, Italy
| | - Carlotta Zacà
- IVIRMA Global Research Alliance, 9.baby, Bologna, Italy
| | - Andrea Borini
- IVIRMA Global Research Alliance, 9.baby, Bologna, Italy
| | - Erminia Alviggi
- IVIRMA Global Research Alliance, GENERA, Clinica Ruesch, Naples, Italy
| | - Benedetta Iussig
- IVIRMA Global Research Alliance, GENERA, GENERA Veneto, Marostica, Italy
| | - Maria Hebles
- IVIRMA Global Research Alliance, GINEMED, Sevilla, Spain
| | | | | | - Laura Rienzi
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy; Department of Biomolecular Sciences, the University of Urbino "Carlo Bo", Urbino, Italy
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Zheng Y, Dong X, Chen B, Dai J, Yang W, Ai J, Jin L. Body mass index is associated with miscarriage rate and perinatal outcomes in cycles with frozen-thawed single blastocyst transfer: a retrospective cohort study. BMC Pregnancy Childbirth 2022; 22:118. [PMID: 35148705 PMCID: PMC8840631 DOI: 10.1186/s12884-022-04443-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/31/2022] [Indexed: 11/20/2022] Open
Abstract
Background The association between body mass index (BMI) and IVF cycle outcomes remain inconclusive. In addition, the impact of BMI on perinatal outcomes has been less well-studied. The aim of this study was to assess the effects of BMI on pregnancy outcomes, as well as maternal and neonatal outcomes. Methods This was a retrospective cohort study on 10,252 frozen-thawed cycles with single blastocyst transfer between January 2016 and December 2019. Patients were divided into four groups: underweight (< 18.5 kg/m2), normal-weight (18.5–24 kg/m2), overweight (24–28 kg/m2), and obesity (≥ 28 kg/m2), according to the Chinese classification. Multivariate logistic regression and multivariate general linear model were used for statistical analysis. Results The rates of live birth and clinical pregnancy were comparable among groups. Miscarriage rate was higher in the obese women than that in the normal controls (27.51 vs. 20.91%, aOR = 1.453 (1.066–1.982)). Using the normal-weight women as reference, the underweight women had lower incidences of preterm birth (6.97 vs. 11.19%, aOR = 0.611 (0.422–0.884)), macrosomia (4.90 vs. 8.65%, aOR = 0.544 (0.353–0.837)) and large-for-gestational age (LGA, 11.18 vs. 16.54%, aOR = 0.643 (0.477–0.866)); the overweight women had higher prevalence of gestational diabetes (6.56 vs. 3.82%, aOR = 1.744 (1.232–2.468)), hypertension (4.42 vs. 2.32%, aOR = 1.822 (1.186–2.800)), macrosomia (12.93 vs. 8.65%, aOR = 1.596 (1.240–2.054)) and LGA (23.22 vs. 16.54%, aOR = 1.549 (1.270–1.890)); the obese women had higher incidences of preterm birth (16.87 vs. 11.19%, aOR = 1.646 (1.068–2.536)), cesarean delivery (93.98 vs. 87.91%, aOR = 2.078 (1.083–3.987)), gestational hypertension (4.82 vs. 2.32%, aOR = 2.138 (1.005–4.547)), macrosomia (14.88 vs. 8.65%, aOR = 1.880 (1.192–2.964)) and LGA (25.60 vs. 16.54%, aOR = 1.764 (1.218–2.555)). Conclusions BMI has no significant effect on the chance of pregnancy or live birth, but obesity increases the risk of miscarriage. Underweight is associated with better maternal and neonatal outcomes, while overweight and obesity are associated with worse maternal and neonatal outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04443-2.
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Affiliation(s)
- Yu Zheng
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiyuan Dong
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Biao Chen
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Dai
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Yang
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jihui Ai
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
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Roca M, Clua E, García S, Polyzos NP, Martínez F. The impact of the oocyte donor's age on the recipient's outcomes: should we exclude very young women from oocyte donation? Reprod Biomed Online 2022; 44:867-873. [DOI: 10.1016/j.rbmo.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/14/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
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Maternal body mass index associates with blastocyst euploidy and live birth rates: the tip of an iceberg? Reprod Biomed Online 2021; 43:645-654. [PMID: 34446374 DOI: 10.1016/j.rbmo.2021.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/05/2021] [Accepted: 07/12/2021] [Indexed: 01/14/2023]
Abstract
RESEARCH QUESTION Does maternal preconceptional body mass index (BMI) associate with mean blastocyst euploidy rate (m-ER) per patient and live birth rate (LBR) after vitrified-warmed euploid single embryo transfer (SET)? DESIGN Observational study conducted between April 2013 and March 2020 at a private IVF clinic, involving 1811 Caucasian women undergoing trophectoderm biopsy and comprehensive chromosome testing. The outcomes of 1125 first vitrified-warmed euploid SET were also analysed. Patients were clustered as normal weight (BMI 18.5-25; n = 1392 performing 859 SET), underweight (BMI <18.5; n = 160 performing 112 SET) and overweight (BMI >25; n = 259 performing 154 SET). m-ER per patient was the primary outcome. The secondary outcomes were all clinical outcomes per euploid SET. All data were adjusted for confounders through regression analyses. RESULTS The m-ER per patient decreases as maternal BMI increases from 17 up to 22-23 before reaching a plateau. A linear regression adjusted for maternal age confirmed this moderate association (unstandardized coefficient B: -0.6%, 95% confidence interval [CI]: -1.1 to -0.1%, P = 0.02). All clinical outcomes were similar between normal weight and underweight women. Overweight women, instead, showed higher miscarriage rate per clinical pregnancy (n = 20/75, 26.7% versus n = 67/461, 14.5%; odds ratio [OR] adjusted for blastocyst quality and day of full blastulation: 2.0, 95% CI: 1.1-3.6, P = 0.01) and lower LBR per SET (n = 55/154, 35.7% versus n = 388/859, 45.2%; OR adjusted for blastocyst quality and day of full blastulation: 0.67, 95% CI: 0.46-0.96, P = 0.03). CONCLUSION These data indicate a need for future research on more sensitive metrics to assess body fat mass and distribution, as well as on the mechanisms leading to lipotoxicity, thereby impairing embryo competence and/or endometrial receptivity. Overweight women should be informed of their higher risk for miscarriage and, whenever possible, encouraged to lose weight, especially before transfer.
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Pataia V, Nair S, Wolska M, Linara-Demakakou E, Shah T, Lamanna G, Macklon N, Ahuja KK. Factors predicting clinical outcomes from 494 vitrified oocyte donation cycles at a UK-regulated egg bank. Reprod Biomed Online 2021; 43:453-465. [PMID: 34326005 DOI: 10.1016/j.rbmo.2021.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/07/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022]
Abstract
RESEARCH QUESTION Do donor age, AMH, AFC, BMI and reproductive history predict response to ovarian stimulation? Do donor and recipient clinical markers and embryology parameters predict recipient pregnancy and live birth? DESIGN Retrospective cohort study of 494 altruistic oocyte donors aged 18-35 years; 340 were matched to 559 recipients. Predictors of donor total oocyte yield and total mature oocyte yield were identified. Total and mature oocyte number were compared according to stratified donor AMH and age. Donor, recipient and embryology parameters predictive of recipient primary outcomes (clinical pregnancy and live birth) were identified. RESULTS Donor age and AMH predicted total oocyte yield (P = 0.030 and P < 0.001)) and total mature oocyte yield (P = 0.011 and P < 0.001). Donors aged 30-35 years with AMH 15-29.9 pmol/l had lower total oocyte yield (P = 0.004) and mature oocyte yield (P < 0.001) than donors aged 18-24 years. Up to an AMH threshold of 39.9 pmol/l, increasing AMH levels predicted higher total oocyte yield (<15 pmol/l versus 15-29.9 pmol/l, P = 0.001; 15-29.9 pmol/l versus 30-39.9 pmol/l, P < 0.001; 30-39.9pmol/l versus ≥ 40 pmol/l, P = 1.0) and mature oocyte yield (<15 pmol/l versus 15-29.9 pmol/l, P = 0.005; 15-29.9 pmol/l versus 30-39.9 pmol/l, P = 0.006; 30-39.9 pmol/l versus ≥40 pmol/l, P = 1.0). In recipients, the rate of transferrable embryos per oocytes received, fertilized and number of embryo transfers needed to achieve the primary outcome were predictors of cumulative clinical pregnancy (P = 0.011, P = 0.017 and P < 0.001) and live birth (P = 0.008, P = 0.012 and P < 0.001) rates. Recipient BMI (P = 0.024) and previous miscarriages (P = 0.045) were predictors of cumulative live birth rate. Donor age 18-22 years was associated with a lower incidence of recipient clinical pregnancy (P = 0.004) and live birth (P = 0.001) after the first embryo transfer versus donor age 23-29 years. CONCLUSIONS Donor age and AMH are independent predictors of oocyte yield. Raised recipient BMI and history of miscarriages reduce cumulative live birth rates, which may be increased by selecting donors aged 23-29 years, instead of younger donors.
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Affiliation(s)
- Vanessa Pataia
- London Egg Bank, London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK
| | - Shailaja Nair
- London Egg Bank, London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK
| | - Marta Wolska
- London Egg Bank, London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK
| | | | - Trina Shah
- London Egg Bank, London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK
| | - Giuseppina Lamanna
- London Egg Bank, London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK
| | - Nick Macklon
- London Egg Bank, London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK
| | - Kamal K Ahuja
- London Egg Bank, London Women's Clinic, 113-115 Harley Street, London W1G 6AP, UK.
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Martinez F, Racca A, Rodríguez I, Polyzos NP. Ovarian stimulation for oocyte donation: a systematic review and meta-analysis. Hum Reprod Update 2021; 27:673-696. [PMID: 33742206 DOI: 10.1093/humupd/dmab008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/30/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Since its introduction in the 1980s, oocyte donation (OD) has been largely integrated into ART. Lately, both demand and the indications for OD have increased greatly. Oocyte donors are healthy and potentially fertile women undergoing voluntarily ovarian stimulation (OS). Selection of the optimal type of stimulation is of paramount importance in order to achieve the most favourable outcomes for the oocyte recipients, but most importantly for the safety of the oocyte donors. OBJECTIVE AND RATIONALE This is the first systematic review (SR) with the objective to summarize the current evidence on OS in oocyte donors. The scope of this SR was to evaluate the OD programme by assessing four different aspects: how to assess the ovarian response prior to stimulation; how to plan the OS (gonadotrophins; LH suppression; ovulation trigger; when to start OS); how to control for the risk of ovarian hyperstimulation syndrome (OHSS) and other complications; and the differences between the use of fresh versus vitrified donated oocytes. SEARCH METHODS A systematic literature search was conducted in May 2020, according to PRISMA guidelines in the databases PubMed and Embase, using a string that combined synonyms for oocytes, donation, banking, freezing, complications and reproductive outcomes. Studies reporting on the safety and/or efficacy of OS in oocyte donors were identified. The quality of the included studies was assessed using ROBINS-I and ROB2. Meta-analysis was performed where appropriate. Data were combined to calculate mean differences (MD) for continuous variables and odd ratios (OR) for binary data with their corresponding 95% CIs. Heterogeneity between the included studies was assessed using I2 and tau statistics. OUTCOMES In total, 57 manuscripts were selected for the review, out of 191 citations identified. Antral follicle count and anti-Müllerian hormone levels correlate with ovarian response to OS in OD but have limited value to discriminate donors who are likely to show either impaired or excessive response. Five randomized controlled trials compared different type of gonadotrophins as part of OS in oocyte donors; owing to high heterogeneity, meta-analysis was precluded. When comparing different types of LH control, namely GnRH antagonist versus agonist, the studies showed no differences in ovarian response. Use of progesterone primed ovarian stimulation protocols has been evaluated in seven studies: the evidence has shown little or no difference, compared to GnRH antagonist protocols, in mean number of retrieved oocytes (MD 0.23, [95% CI 0.58-1.05], n = 2147; 6 studies; I2 = 13%, P = 0.33) and in clinical pregnancy rates among recipients (OR 0.87 [95% CI 0.60-1.26], n = 2260, I2 = 72%, P < 0.01). There is insufficient evidence on long-term safety for babies born. GnRH agonist triggering is the gold standard and should be used in all oocyte donors, given the excellent oocyte retrieval rates, the practical elimination of OHSS and no differences in pregnancy rates in recipients (four studies, OR 0.86, 95%CI 0.58-1.26; I2 = 0%). OS in OD is a safe procedure with a low rate of hospitalization after oocyte retrieval. The use of a levonorgestrel intrauterine device or a progestin contraceptive pill during OS does not impact the number of oocytes retrieved or the clinical pregnancy rate in recipients. Ultrasound monitoring seems enough for an adequate follow up of the stimulation cycle in OD. Use of fresh versus vitrified donated oocytes yielded similar pregnancy outcomes. WIDER IMPLICATIONS This update will be helpful in the clinical management of OS in OD based on the most recent knowledge and recommendations, and possibly in the management of women under 35 years undergoing oocyte vitrification for social freezing, owing to the population similarities. More clinical research is needed on OS protocols that are specifically designed for OD, especially in term of the long-term safety for newborns, effective contraception during OS, and treatment satisfaction.
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Affiliation(s)
- Francisca Martinez
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Hospital Universitario Dexeus, Barcelona, Spain
| | - Annalisa Racca
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Hospital Universitario Dexeus, Barcelona, Spain
| | - Ignacio Rodríguez
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Hospital Universitario Dexeus, Barcelona, Spain
| | - Nikolaos P Polyzos
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Hospital Universitario Dexeus, Barcelona, Spain
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Jin H, Shen X, Song W, Liu Y, Qi L, Zhang F. The Development of Nomograms to Predict Blastulation Rate Following Cycles of In Vitro Fertilization in Patients With Tubal Factor Infertility, Polycystic Ovary Syndrome, or Endometriosis. Front Endocrinol (Lausanne) 2021; 12:751373. [PMID: 34803917 PMCID: PMC8595301 DOI: 10.3389/fendo.2021.751373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/11/2021] [Indexed: 12/02/2022] Open
Abstract
It is well known that the transfer of embryos at the blastocyst stage is superior to the transfer of embryos at the cleavage stage in many respects. However, the rate of blastocyst formation remains low in clinical practice. To reduce the possibility of wasting embryos and to accurately predict the possibility of blastocyst formation, we constructed a nomogram based on range of clinical characteristics to predict blastocyst formation rates in patients with different types of infertility. We divided patients into three groups based on female etiology: a tubal factor group, a polycystic ovary syndrome group, and an endometriosis group. Multiple logistic regression was used to analyze the relationship between patient characteristics and blastocyst formation. Each group of patients was divided into a training set and a validation set. The training set was used to construct the nomogram, while the validation set was used to test the performance of the model by using discrimination and calibration. The area under the curve (AUC) for the three groups indicated that the models performed fairly and that calibration was acceptable in each model.
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9
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Neves AR, Devesa M, Martínez F, Garcia-Martinez S, Rodriguez I, Polyzos NP, Coroleu B. What is the clinical impact of the endometrial receptivity array in PGT-A and oocyte donation cycles? J Assist Reprod Genet 2019; 36:1901-1908. [PMID: 31352621 DOI: 10.1007/s10815-019-01535-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To evaluate the influence of the endometrial receptivity array (ERA) test on the implantation rate (IR) and pregnancy rate (PR) in patients with previous failed euploid embryo transfers (Euploid-ET) or oocyte donation embryo transfers (Donor-ET). METHODS Single-center retrospective study of patients with ≥ 1 previous failed Euploi-ET (n = 24) or ≥ 2 failed Donor-ET (n = 32) who underwent an ERA test and a post-ERA Euploid-ET/Donor-ET between 2012 and 2018. Controls were patients with ≥ 1 previously failed Euploid-ET (n = 119) or ≥ 2 failed Donor-ET (n = 158) who underwent Euploid-ET/Donor-ET during the same period without performing an ERA test. Only blastocyst stage embryos were included. IR/PR was compared between the post-ERA ET and the last ET in the control group. RESULTS There was no statistically significant difference regarding IR [55.6% (34.6-76.5%) vs. 65.0% (56.9-73.1%)] nor PR (58.3% vs.70.6%, p = 0.238) in the Euploid-ET ERA vs. Euploid-ET control groups. In the Donor-ET arm, both IR [26.8% (12.3-41.4%) vs. 57.2% (50.1-64.3%)] and PR (34.4% vs. 65.2%, p = 0.001) were significantly lower in the ERA group. Multivariate analysis confirmed that performing an ERA test did not influence the PR in the Euploid-ET arm and was associated with a diminished PR in the Donor-ET arm. In the ERA group, 41.1% patients were non-receptive (NR). No significant difference was found regarding IR/PR in NR vs. receptive patients in both Euploid-ET/Donor-ET arms. CONCLUSIONS In our sample, the performance of an ERA test did not improve pregnancy outcomes. Future prospective studies in larger samples are needed to confirm the role of the ERA test in Euploid-ET/Donor-ET.
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Affiliation(s)
- Ana Raquel Neves
- Department of Obstetrics and Gynecology, Coimbra Hospital and University Centre, Rua Augusta 17, 3000-045, Coimbra, Portugal.
| | - Marta Devesa
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, 08028, Barcelona, Spain
| | - Francisca Martínez
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, 08028, Barcelona, Spain
| | - Sandra Garcia-Martinez
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, 08028, Barcelona, Spain
| | - Ignacio Rodriguez
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, 08028, Barcelona, Spain
| | - Nikolaos P Polyzos
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, 08028, Barcelona, Spain.,Faculty of Medicine and Pharmacy, Department of Surgical and Clinical Science, Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Department of Clinical Medicine, Faculty of Health, Aarhus University, 8000, Aarhus, Denmark
| | - Buenaventura Coroleu
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, 08028, Barcelona, Spain
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