1
|
Liu YL, Lee CI, Liu CH, Cheng EH, Yang SF, Tsai HY, Lee MS, Lee TH. Association between Leukemia Inhibitory Factor Gene Polymorphism and Clinical Outcomes among Young Women with Poor Ovarian Response to Assisted Reproductive Technology. J Clin Med 2023; 12:jcm12030796. [PMID: 36769444 PMCID: PMC9917712 DOI: 10.3390/jcm12030796] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Does the presence of single-nucleotide polymorphisms (SNPs) in the leukemia inhibitory factor (LIF) gene affect ovarian response in infertile young women? METHODS This was a case-control study recruiting 1744 infertile women between January 2014 to December 2015. The 1084 eligible patients were stratified into four groups using the POSEIDON criteria. The gonadotropin-releasing hormone receptor (GnRHR), follicle-stimulating hormone receptor (FSHR), anti-Müllerian hormone (AMH), and LIF SNP genotypes were compared among the groups. The distributions of LIF and FSHR among younger and older patients were compared. Clinical outcomes were also compared. RESULTS The four groups of poor responders had different distributions of SNP in LIF. The prevalence of LIF genotypes among young poor ovarian responders differed from those of normal responders. Genetic model analyses in infertile young women revealed that the TG or GG genotype in the LIF resulted in fewer oocytes retrieved and fewer mature oocytes relative to the TT genotypes. In older women, the FSHR SNP genotype contributed to fewer numbers of mature oocytes. CONCLUSIONS LIF and FSHR SNP genotypes were associated with a statistically significant reduction in ovarian response to controlled ovarian hyperstimulation in younger and older women with an adequate ovarian reserve, respectively.
Collapse
Affiliation(s)
- Yung-Liang Liu
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei 11490, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Chun-I Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
| | - Chung-Hsien Liu
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - En-Hui Cheng
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Hsueh-Yu Tsai
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
| | - Maw-Sheng Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Tsung-Hsien Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Correspondence:
| |
Collapse
|
2
|
Wang K, Guan Y, Zhang Y, Jia R, Wu S, Yao Z, Zhang M, Li Z. Analysis of cumulative outcomes and influencing factors of patients with discrepancies between age and AMH levels in the early follicular phase prolonged protocol. Front Endocrinol (Lausanne) 2023; 14:1098131. [PMID: 36967754 PMCID: PMC10031014 DOI: 10.3389/fendo.2023.1098131] [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: 11/14/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE To explore the cumulative outcomes and influencing factors of patients with discrepancies between age and Anti-Müllerian hormone (AMH) levels in the early follicular phase prolonged protocol. METHODS A total of 1282 cycles of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) assisted pregnancy with the early follicular phase prolonged protocol in the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from September 2015 to December 2020 were retrospectively analyzed. They were divided into the young low-AMH group (n=1076) and the older high-AMH group (n=206). The primary outcomes included cumulative clinical pregnancy rate (CCPR) and cumulative live birth rate (CLBR). Secondary outcomes included the number of oocytes retrieved, number of available embryos, clinical pregnancy rate (CPR), live birth rate (LBR), miscarriage rate (MR), pregnancy complications, and neonatal outcomes. RESULTS The CPR (68.7% vs. 59.4%) and the LBR (60.7% vs. 43.1%) in the young low-AMH group were higher than those in the older high-AMH group. In contrast, the number of oocytes retrieved (11 vs. 17), number of available embryos (5 vs. 8), and MR (10.6% vs. 18.3%) in the young low-AMH group were lower. There was no significant difference between the two groups in the CCPR, CLBR, pregnancy complications, and neonatal outcomes. Logistic regression analysis showed that infertility duration, basal follicle-stimulating hormone (FSH), and antral follicle count (AFC) correlated with CCPR, while maternal age, type of infertility, basal FSH, AFC, and infertility duration correlated with CLBR. The area under the receiver operating characteristic curves (ROC) curve for the combined model of infertility duration, AFC, and basal FSH to predict cumulative pregnancy was 0.629 (95%CI:0.592-0.666), while the combined model of maternal age, AFC, basal FSH, infertility duration, and type of infertility to predict cumulative live birth was 0.649 (95%CI:0.615-0.682). CONCLUSION Although AMH levels are low by contrast, young patients have a favorable outcome after IVF/ICSI. In patients with discrepancies between age and AMH levels in the early follicular phase prolonged protocol, maternal age correlates better with cumulative live birth. The model that combines maternal age and other factors can help predict cumulative live birth, but its value is limited.
Collapse
|
3
|
Lin R, Zhou H, Wang C, Chen H, Shu J, Gan X, Xu K, Zhao X. Does longer storage of blastocysts with equal grades in a cryopreserved state affect the perinatal outcomes? Cryobiology 2021; 103:87-91. [PMID: 34520741 DOI: 10.1016/j.cryobiol.2021.09.003] [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: 07/06/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022]
Abstract
AIM Although mammalian embryos could be preserved in liquid nitrogen for thousands of years in theoretical models, the viability of cryopreserved blastocyst with varying grades remains to be speculated. In this study, we aimed to determine whether the longer storage time of blastocysts with equal grades could negatively affect the perinatal outcomes. MATERIALS AND METHODS Single vitrified-warmed blastocyst was divided into four grades (AA, AB/BA, BB, BC/CB) according to the blastocyst score when freezing, and each grade of blastocyst was categorized into four storage duration categories: 28 days-1 year, 1-3 years, 3-5 years, and ≥5 years. Then the perinatal outcomes with different storage time were analyzed. RESULTS Our results revealed that for blastocysts with the same grade, the length of storage time had no statistical effect on blastocyst survival rate, clinical pregnancy/implantation rate, live birth rate, and abortion rate. In addition, more advanced developmental blastocyst could obtain better pregnancy outcomes regardless of the cryopreservation length. Similar neonatal outcomes were obtained over time. CONCLUSIONS Cryopreservation time could not negatively affect the perinatal outcomes of blastocysts with equal grades. Efficient blastocyst cryopreservation technology by vitrification can help older women obtain high-quality embryos at a young age.
Collapse
Affiliation(s)
- Ruoyun Lin
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Hong Zhou
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Caizhu Wang
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Huanhua Chen
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China.
| | - Jinhui Shu
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Xianyou Gan
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Kongrong Xu
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| | - Xin Zhao
- Reproductive Medicine Center, Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, PR China
| |
Collapse
|
4
|
Yang R, Niu ZR, Chen LX, Liu P, Li R, Qiao J. Analysis of related factors affecting cumulative live birth rates of the first ovarian hyperstimulation in vitro fertilization or intracytoplasmic sperm injection cycle: a population-based study from 17,978 women in China. Chin Med J (Engl) 2021; 134:1405-1415. [PMID: 34091521 PMCID: PMC8213303 DOI: 10.1097/cm9.0000000000001586] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND More and more scholars have called for the cumulative live birth rate (CLBR) of a complete ovarian stimulation cycle as a key indicator for assisted reproductive technology. This research aims to study the CLBR of the first ovarian hyperstimulation cycles and analyze the related prognosis factors that might affect the CLBR. METHODS Our retrospective study included first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles performed between January 2013 to December 2014. A total of 17,978 couples of first ovarian hyperstimulation IVF/ICSI cycles were included. The study was followed up for 4 years to observe the CLBR. The multivariable logistic regression model was used to analyze the prognosis factor, P value of <0.05 was considered statistically significant. RESULTS The cumulative pregnancy rate was 58.14% (10,452/17,978), and the CLBR was 49.66% (8928/17,978). The female age was younger in the live birth group when compared with the non-live birth group (30.81 ± 4.05 vs. 33.09 ± 5.13, P < 0.001). The average duration of infertility was shorter than the non-live birth cohort (4.22 ± 3.11 vs. 5.06 ± 4.08, P < 0.001). The preliminary gonadotropin used and the total number of gonadotropin used were lower in the live birth group when compared with the non-live birth group (both P < 0.001). Meanwhile, the number of oocytes retrieved and transferrable embryos were both significantly higher in the live birth group (15.35 ± 7.98 vs. 11.35 ± 7.60, P < 0.001; 6.66 ± 5.19 vs. 3.62 ± 3.51, P < 0.001, respectively). CONCLUSIONS The women's age, body mass index, duration of infertility years, infertility factors, controlled ovarian hyperstimulation protocol, the number of acquired oocytes, and number of transferrable embryos are the prognosis factors that significantly affected the CLBR.
Collapse
Affiliation(s)
- Rui Yang
- Center for Reproductive Medicine, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Zi-Ru Niu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Li-Xue Chen
- Center for Reproductive Medicine, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Ping Liu
- Center for Reproductive Medicine, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Rong Li
- Center for Reproductive Medicine, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Jie Qiao
- Center for Reproductive Medicine, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| |
Collapse
|
5
|
Mitsuhata S, Endo Y, Hayashi M, Fujii Y, Motoyama H. Effect on clinical and neonatal outcomes of blastocelic microsuction prior to vitrification. Reprod Med Biol 2019; 18:284-289. [PMID: 31312108 PMCID: PMC6613010 DOI: 10.1002/rmb2.12273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 04/10/2019] [Accepted: 04/15/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Microsuction (MS) is a technique for mechanically emptying fluid from blastocele using a microneedle. In this study, we evaluated the improvement in clinical and neonatal outcomes of vitrified blastocyst transfer programs when MS of blastocelic fluid was used before vitrification. METHODS This was a retrospective study based on data collected between March 2014 and August 2016. A total of 317 blastocysts obtained from 211 patients were analyzed. The blastocelic fluid of expanded blastocysts was aspirated completely, and blastocysts were collapsed prior to vitrification. Clinical and neonatal outcomes of warmed blastocysts were compared. RESULTS The survival rate of the MS blastocyst was significantly higher compared with the nontreatment control (98.7% vs 89.3%, OR: 9.34, 95% CI: 2.35-36.8, P < 0.01). The rates of implantation and live birth were higher in the MS group than in the control group, but the differences were not significant. There were no differences in gestational age, birthweight, proportion of male babies, rates of cesarean section, and congenital abnormalities. CONCLUSION The MS procedure improved blastocyst survival and had little effect on further embryo development after warming.
Collapse
Affiliation(s)
| | - Yuji Endo
- IVF CenterKurashiki Medical ClinicKurashikiJapan
| | | | | | | |
Collapse
|
6
|
Wu CH, Lee TH, Yang SF, Tsao HM, Chang YJ, Chou CH, Lee MS. Interleukin-3 Polymorphism is Associated with Miscarriage of Fresh in Vitro Fertilization Cycles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060995. [PMID: 30893922 PMCID: PMC6466610 DOI: 10.3390/ijerph16060995] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/05/2019] [Accepted: 03/17/2019] [Indexed: 11/21/2022]
Abstract
The aim of this study was to examine the association between interleukin (IL) genes polymorphisms and in vitro fertilization (IVF) outcome. A prospective cohort analysis was performed at a Women’s Hospital IVF centre of 1015 female patients undergoing fresh non-donor IVF cycles. The effects of the following six single nucleotide polymorphisms (SNPs) in five IL genes on IVF outcomes were explored: IL-1α (rs1800587 C/T), IL-3 (rs40401 C/T), IL-6 (rs1800795 C/G), IL-15 (rs3806798 A/T), IL-18 (rs187238 C/G) and IL-18 (rs1946518 G/T). The main outcome measures included clinical pregnancy, embryo implantation, abortion and live birth rates. There were no statistically significant differences in clinical pregnancy, embryo implantation and live birth rates in the analysis of 1015 patients attempting their first cycle of IVF. Infertile women with IL-3 homozygous major genotype had a higher abortion rate than those with heterozygous and homozygous minor genotype (16.5% vs. 7.9%, P = 0.025). In conclusion, our results indicated that the IL-3 rs40401 polymorphism is associated with increased risk of abortion of IVF patients. Future studies with inclusion of other ethnic populations must be conducted to confirm the findings of this study.
Collapse
Affiliation(s)
- Cheng-Hsuan Wu
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Women's Health Research Laboratory, Changhua Christian Hospital, Changhua 50006, Taiwan.
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Hui-Mei Tsao
- Division of Infertility Clinic, Lee Womens' Hospital, Taichung 406, Taiwan.
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua 50006, Taiwan.
| | - Chia-Hsuan Chou
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
- Division of Infertility Clinic, Lee Womens' Hospital, Taichung 406, Taiwan.
| |
Collapse
|
7
|
Wu CH, Yang SF, Tsao HM, Chang YJ, Lee TH, Lee MS. Anti-Müllerian Hormone Gene Polymorphism is Associated with Clinical Pregnancy of Fresh IVF Cycles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050841. [PMID: 30857124 PMCID: PMC6427679 DOI: 10.3390/ijerph16050841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/27/2019] [Accepted: 03/05/2019] [Indexed: 12/11/2022]
Abstract
The aim of this study was to examine the effects of single-nucleotide polymorphisms (SNPs) in the anti-Müllerian hormone (AMH) and AMH type II receptor (AMHRII) genes on in vitro fertilization (IVF) outcomes. In this prospective cohort study, we genotyped the AMH 146 T > G, AMHRII −482 A > G and AMHRII IVS1 +149 T > A variants in 635 women undergoing their first cycle of controlled ovarian stimulation for IVF. DNA was extracted from the peripheral blood of all participants, and the SNPs were genotyped by real-time polymerase chain reaction. The distributions, frequencies of genes, and correlation with clinical pregnancy of IVF were analyzed. The AMH 146 T > G G/G genotype in women was associated with a lower clinical pregnancy rate (T/T: 55.0%, T/G: 51.8%, G/G: 40.0%; p < 0.05). Women with the AMH 146 T > G GG genotype were half as likely to have a clinical pregnancy compared with women with TT genotypes (OR = 0.55, 95% CI: 0.34–0.88, p = 0.014). With multivariate analysis, the AMH 146 T > G GG genotype remains as a significant independent factor to predict clinical pregnancy (p = 0.014). No significant difference was found between AMHRII polymorphisms and clinical pregnancy outcomes of IVF. In conclusion, our results show that AMH 146 T > G seems to be a susceptibility biomarker capable of predicting IVF pregnancy outcomes. Further studies should focus on the mechanism of these associations and the inclusion of other ethnic populations to confirm the findings of this study.
Collapse
Affiliation(s)
- Cheng-Hsuan Wu
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Women's Health Research Laboratory, Changhua Christian Hospital, Changhua 50006, Taiwan.
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Hui-Mei Tsao
- Division of Infertility Clinic, Lee Womens' Hospital, Taichung 406, Taiwan.
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua 50006, Taiwan.
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Division of Infertility Clinic, Lee Womens' Hospital, Taichung 406, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| |
Collapse
|
8
|
Hwang JL, Chen SU, Chen HJ, Chen HF, Yang YS, Chang CH, Seow KM, Tzeng CR, Lin YH. Feasibility of corifollitropin alfa/GnRH antagonist protocol combined with GnRH agonist triggering and freeze-all strategy in polycystic ovary syndrome patients. J Formos Med Assoc 2018; 117:535-540. [DOI: 10.1016/j.jfma.2017.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/26/2017] [Accepted: 05/15/2017] [Indexed: 02/02/2023] Open
|
9
|
Zhou J, Wang B, Hu Y, Sun H. Association between the number of oocytes retrieved and cumulative live birth rate in women aged 35-40 years undergoing long GnRH agonist IVF/ICSI cycles. Arch Gynecol Obstet 2017; 296:1005-1012. [PMID: 28879481 DOI: 10.1007/s00404-017-4503-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 08/23/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE To study the association between the numbers of oocytes retrieved and the cumulative live birth rates (LBR) in women aged 35-40 years undergoing long GnRH agonist IVF/ICSI cycles. METHODS A total of 931 women aged 35-40 years who underwent their first cycle of IVF/ICSI treatment between January 2010 and December 2013 at Nanjing Drum Tower Hospital were identified and reviewed. The main endpoint of this study was the cumulative LBR after one complete oocyte retrieval, which included fresh and all subsequent frozen-thaw embryo transfer cycles. Odds ratios (OR) and 95% confidence interval (CI) for live birth were estimated by multivariate logistic regression analysis. Furthermore, all the women were divided into four groups based on the number of oocytes retrieved: 0-4, 5-9, 10-14 or ≥15 oocytes group. Variables were then compared among groups. RESULTS We found that 634 out of the 931 patients (68.1%) achieved at least one live birth. The number of oocytes retrieved was an independent predictive factor for live birth, with OR 1.20 (95% CI 1.15-1.26) when adjusted for age (years), duration of infertility and Gn (gonadotrophin) doses. The cumulative LBR in the four different oocyte groups was 35.6, 68.8, 83.4 and 89.2%, respectively. When the 1-4 oocytes group was issued as a reference, the ORs for cumulative LBR gradually increased to 3.66, 6.74 and 11.77 in other three oocytes groups, respectively. The moderate-severe ovarian hyperstimulation syndrome (OHSS) rate was dramatically increased in the ≥15 oocytes group (6.9%) when compared to that in the 10-14 oocytes group (0.8%), while the cumulative LBR only increased 5.8% (from 83.4 to 89.2%). CONCLUSIONS The ideal number of oocytes retrieved in women aged 35-40 years is 10-14 oocytes, which achieves a high cumulative LBR while maintaining an acceptable low OHSS rate.
Collapse
Affiliation(s)
- Jianjun Zhou
- Centre for Reproductive Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan North Road 53, Nanjing, 210008, China
| | - Bin Wang
- Centre for Reproductive Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan North Road 53, Nanjing, 210008, China
| | - Yali Hu
- Centre for Reproductive Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan North Road 53, Nanjing, 210008, China
| | - Haixiang Sun
- Centre for Reproductive Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan North Road 53, Nanjing, 210008, China.
| |
Collapse
|
10
|
Associations between male reproductive characteristics and the outcome of assisted reproductive technology (ART). Biosci Rep 2017; 37:BSR20170095. [PMID: 28515223 PMCID: PMC6434081 DOI: 10.1042/bsr20170095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/11/2017] [Accepted: 05/16/2017] [Indexed: 01/29/2023] Open
Abstract
The present study was designed to investigate the relationships between indicators of male body mass index (BMI), age, reproductive hormone levels, semen parameters, and the outcomes of assisted reproductive technology (ART). The clinical data were collected from 636 couples who underwent ART between January, 2013 and December, 2015 at the reproductive center involved in our study. Pearson’s correlation or Spearman rank correlation was applied to establish the relevant correlation coefficients. The correlation between influence factors’ and pregnancy outcomes was analyzed using the Logistic regression model. Analyses were conducted using SPSS software. Male BMI was found to be negatively correlated with testosterone (T) (P<0.05), while follicle-stimulating hormone (FSH) was negatively correlated with semen parameters (P<0.05). Luteinizing hormone (LH) was found to be negatively correlated with total sperm count, normal sperm morphology, and abortion (all P<0.05). Clinical pregnancy was related to sperm concentration and female age (P<0.05), and live birth was found to be associated only with female age (P<0.05). Male BMI was associated with the secretion of reproductive hormones, but had no effect on sperm parameters or ART outcome. A higher male age was also negatively connected with the outcome of clinical pregnancy. Reproductive hormones were not associated with ART outcome. Sperm concentration and female age were important factors influencing ART clinical pregnancy, while the only significant factor influencing live birth was female age. Levels of obesity-related inflammatory indicators (i.e. free fatty acid (FFA), glutathione peroxidase (GSH-Px), human inhibin-B (IHNB), interleukin-1 (IL-1), insulin-like growth factor-1 (IGF-1), and reactive oxygen species (ROS)) also varied with degrees of BMI. The present study provides information on the associations between male reproductive characteristics and the outcome of ART, which may contribute to improved strategies to help couples achieve better pregnancy outcomes.
Collapse
|
11
|
Wang C, Feng G, Zhang B, Zhou H, Shu J, Lin R, Chen H, Wu Z. Effect of different artificial shrinkage methods, when applied before blastocyst vitrification, on perinatal outcomes. Reprod Biol Endocrinol 2017; 15:32. [PMID: 28446183 PMCID: PMC5406977 DOI: 10.1186/s12958-017-0252-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 04/20/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In recent years, single blastocyst transfer combined with vitrification has been applied widely, which can maximize the cumulative pregnancy rate in per oocyte retrieval cycles and minimize the multiple pregnancy rate. Thus, the guarantee for these is the effectiveness of vitrified blastocyst. Studies has shown that AS of the blastocoel cavity prior to vitrification can reduce injuries, increase the thawed blastocyst survival rate and implantation rate. Several AS methods have been established. However, only a few studies have compared the effectiveness and safety of these AS methods. In this study, we aimed to compare the clinical outcomes and neonatal outcomes in FET cycles with single blastocyst that were artificially shrunk before vitrification by either LAS or MNAS method. METHODS A retrospective comparative study of FET cycles in infertile patients which were at our clinic between January 2013 and December 2014. These FET cycles were divided into two groups by the shrinking methods used before vitrification and the clinical and neonatal outcomes were assessed. RESULTS There were no statistically differences in blastocyst survival rates (95.40% vs 94.05%, P > 0.05) between the LAS and MNAS groups. However, compared with MNAS, LAS improved the warmed blastocyst implantation/clinical pregnancy rate (60.82% vs 54.37%, P < 0.05), live birth rate (50.43% vs 45.22%, P < 0.05) and also increased the monozygotic twin rate (4.07% vs 1.73%, P < 0.05). There were no differences in the average gestational weeks (38.83 ± 1.57 vs 38.74 ± 1.75), premature birth rate (0.30% vs 0.49%), average birth weight (3217.89 ± 489.98 g vs 3150.88 ± 524.03 g), low birth weight rate (5.60% vs 8.63%) and malformation rate (0.59% vs 0.48%) (P > 0.05). CONCLUSIONS No significant differences in neonatal outcomes were observed, while in clinical outcomes, LAS improved the warmed blastocyst implantation/clinical pregnancy rate and live birth rate markedly, there was also an increased risk of monozygotic twin pregnancies.
Collapse
Affiliation(s)
- Caizhu Wang
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| | - Guixue Feng
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| | - Bo Zhang
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| | - Hong Zhou
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| | - Jinhui Shu
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| | - Ruoyun Lin
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| | - Huanhua Chen
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| | - Zhulian Wu
- grid.410649.eCenter of Reproductive Medicine, Guangxi Maternal and Child Health Hospital, Nanning, Guangxi 530003 China
| |
Collapse
|
12
|
Milone M, Sosa Fernandez LM, Sosa Fernandez LV, Manigrasso M, Elmore U, De Palma GD, Musella M, Milone F. Does Bariatric Surgery Improve Assisted Reproductive Technology Outcomes in Obese Infertile Women? Obes Surg 2017; 27:2106-2112. [PMID: 28233264 DOI: 10.1007/s11695-017-2614-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
13
|
Fitzgerald HC, Salamonsen LA, Rombauts LJR, Vollenhoven BJ, Edgell TA. The proliferative phase underpins endometrial development: Altered cytokine profiles in uterine lavage fluid of women with idiopathic infertility. Cytokine 2016; 88:12-19. [PMID: 27525354 DOI: 10.1016/j.cyto.2016.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/16/2016] [Accepted: 08/02/2016] [Indexed: 10/21/2022]
Abstract
Endometrial gland development occurs during the proliferative phase of a woman's menstrual cycle, laying the foundation for the subsequent receptive, secretory phase when pregnancy is established. Idiopathic infertility has been rarely investigated with respect to the proliferative phase endometrium. We investigated whether gland development and/or altered secretion of cytokines during the proliferative phase is associated with infertility. Area of the glandular epithelium (GE) was measured in proliferative phase endometrial tissue collected from fertile (n=18) and infertile (n=14) women. Cytokines were measured in proliferative phase uterine lavage of fertile (n=15) and infertile (n=15) women. Immunohistochemistry determined cellular localisation of transforming growth factor alpha (TGFα) and interferon gamma (IFNγ) in proliferative phase endometrial tissue. For statistical analysis the cohort was divided into women <35years and ⩾35years. There were no significant differences in GE area of infertile and fertile women. C-C motif chemokine 11 (P=0.048), TGFα (P=0.049), IFNγ (P=0.033) and interleukin-1 alpha (P=0.047) were significantly elevated in uterine lavage from infertile women <35years compared to fertile but not in women ⩾35years. TGFα and IFNγ localised predominantly to GE in both the fertile and infertile endometrium. The potential impact of this altered proliferative phase environment on subsequent receptivity is discussed.
Collapse
Affiliation(s)
- Harriet C Fitzgerald
- Centre for Reproductive Health, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton 3168, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton 3168, Victoria, Australia.
| | - Lois A Salamonsen
- Centre for Reproductive Health, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton 3168, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton 3168, Victoria, Australia
| | - Luk J R Rombauts
- Centre for Reproductive Health, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton 3168, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton 3168, Victoria, Australia; Monash IVF, Clayton 3168, Victoria, Australia
| | - Beverley J Vollenhoven
- Centre for Reproductive Health, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton 3168, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton 3168, Victoria, Australia; Monash IVF, Clayton 3168, Victoria, Australia
| | - Tracey A Edgell
- Centre for Reproductive Health, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton 3168, Victoria, Australia; Monash University, Clayton 3168, Victoria, Australia
| |
Collapse
|