Retrospective Study to Compare Frozen-Thawed Embryo Transfer with Fresh Embryo Transfer on Pregnancy Outcome Following Intracytoplasmic Sperm Injection for Male Infertility

The natural cycle protocol of endometrial preparation for frozen embryo transfer decreases the miscarriage rate in women with recurrent pregnancy loss

OBJECTIVE

To investigate whether different endometrial preparation methods lead to different results.

DESIGN

Retrospective cohort study.

PATIENTS

Women with recurrent pregnancy loss undergoing frozen embryo transfer (FET).

INTERVENTIONS

Natural cycle (NC) protocol (n = 111) with no drug or human chorionic gonadotropin (HCG) used for endometrial preparation, vs. the hormone replacement therapy (HRT) protocol (n = 797) with estrogen or gonadotropin releasing hormone agonist (GnRH-a) plus estrogen used for endometrial preparation.

MAIN OUTCOME MEASURES

Miscarriage rate and live birth rate (LBR).

RESULTS

Compared to women in the HRT protocol, women undergoing NCs had fewer previous FET cycles, lower antral follicle counts (AFCs), fewer oocytes retrieved and a thicker endometrium on the day of progesterone administration. Women in the HRT group had a higher miscarriage rate (29.4% vs. 17.2%) and a lower LBR (37% vs. 46.9%) than the rates of women in the NC group. Univariate analysis showed that female age also had a negative association with the miscarriage rate. Logistic regression indicated that endometrial preparation using the NC protocol was linked to a decreased likelihood of miscarriage.

CONCLUSIONS

The NC protocol decreased the miscarriage rate and increased the LBR for patients with recurrent pregnancy loss compared with the HRT protocol.

Early Spontaneous Twinning Recorded By Time-Lapse

Monozygotic twins (MZT) are 2.5 times more frequent in ART than in natural conceptions. A number of ART-related mechanisms have been probably linked with MZT. Studies that retrospectively analyze the time-lapse (TL) records resulting in MZT suggest that some morphokinetic traits of the inner cell mass and the trophectoderm could be predictors of MZT, but results are controversial. We present the complete TL record of one case of MZT that split itself at the very moment of the division into two cells, with one of the cells coming out through a hole in the zona pellucida (ZP). Both resulting embryos developed normally, and were vitrified. It is suggested that the hole in the ZP may facilitate the extrusion of some cells of the Collapse

Key Words

• Blastocyst
• cleavage–stage embryo
• embryo splitting
• embryonic development
• monozygotic twins
• time-lapse recording

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MESH Headings

• Humans
• Retrospective Studies
• Time-Lapse Imaging
• Blastocyst
• Fertilization
• Inhibition, Psychological

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Affiliation(s)

Roberto Matorras IVI Bilbao, Lejona, Spain Obstetrics and Gynecology Department, Department of Medical-Surgical Specialties, Cruces University Hospital, Basque Country University, Baracaldo, Spain Biocruces Bizkaia Health Research Institute, Baracaldo, Spain
Alberto Vendrell Biocruces Bizkaia Health Research Institute, Baracaldo, Spain
Marcos Ferrando IVI Bilbao, Lejona, Spain
Zaloa Larreategui IVI Bilbao, Lejona, Spain

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Effect of Superovulation Treatment on Oocyte's DNA Methylation

Controlled ovarian stimulation is a necessary step in some assisted reproductive procedures allowing a higher collection of female gametes. However, consequences of this stimulation for the gamete or the offspring have been shown in several mammals. Most studies used comparisons between oocytes from different donors, which may contribute to different responses. In this work, we use the bovine model in which each animal serves as its own control. DNA methylation profiles were obtained by single-cell whole-genome bisulfite sequencing of oocytes from pre-ovulatory unstimulated follicles compared to oocytes from stimulated follicles. Results show that the global percentage of methylation was similar between groups, but the percentage of methylation was lower for non-stimulated oocytes in the imprinted genes APEG3, MEG3, and MEG9 and higher in TSSC4 when compared to stimulated oocytes. Differences were also found in CGI of imprinted genes: higher methylation was found among non-stimulated oocytes in MEST (PEG1), IGF2R, GNAS (SCG6), KvDMR1 ICR UMD, and IGF2. In another region around IGF2, the methylation percentage was lower for non-stimulated oocytes when compared to stimulated oocytes. Data drawn from this study might help to understand the molecular reasons for the appearance of certain syndromes in assisted reproductive technologies-derived offspring.

Predicting clinical pregnancy using clinical features and machine learning algorithms in in vitro fertilization

INTRODUCTION

Assisted reproductive technology has been proposed for women with infertility. Moreover, in vitro fertilization (IVF) cycles are increasing. Factors contributing to successful pregnancy have been widely explored. In this study, we used machine learning algorithms to construct prediction models for clinical pregnancies in IVF.

MATERIALS AND METHODS

A total of 24,730 patients entered IVF and intracytoplasmic sperm injection cycles with clinical pregnancy outcomes at Taipei Medical University Hospital. Data used included patient characteristics and treatment. We used machine learning methods to develop prediction models for clinical pregnancy and explored how each variable affects the outcome of interest using partial dependence plots.

RESULTS

Experimental results showed that the random forest algorithm outperforms logistic regression in terms of areas under the receiver operating characteristics curve. The ovarian stimulation protocol is the most important factor affecting pregnancy outcomes. Long and ultra-long protocols have shown positive effects on clinical pregnancy among all protocols. Furthermore, total frozen and transferred embryos are positive for a clinical pregnancy, but female age and duration of infertility have negative effects on clinical pregnancy.

CONCLUSION

Our findings show the importance of variables and propensity of each variable by random forest algorithm for clinical pregnancy in the assisted reproductive technology cycle. This study provides a ranking of variables affecting clinical pregnancy and explores the effects of each treatment on successful pregnancy. Our study has the potential to help clinicians evaluate the success of IVF in patients.

IVF-conceived children outcome from birth to 3 years at a single IVF center in Indonesia: frozen versus fresh embryo transfer

Background

Frozen embryo transfer procedure is becoming more common in assisted reproduction technology. The effect of this technology is still not yet well studied in developing countries with limited resources, including Indonesia. This study explores the clinical outcomes between frozen and fresh embryo transfer-conceived children aged 0–3 years in Indonesia.

Results

The participants were divided into frozen embryo (n = 30) and fresh embryo (n = 30) transfer groups. There were no differences in growth and development. However, in vitro fertilization (IVF) children with frozen embryo transfer had a lower risk of developing low birth weight compared to the fresh embryo group with an OR of 0.17 (95% CI: 0.03–0.85). All children, both in the fresh and frozen embryos, have normal development.

Conclusions

Frozen versus fresh embryo transfer does not affect child growth and development.

Pregnancy outcomes of the first thawing cycle in "freeze-all" strategy of infertility patients with fever during oocyte recruitment: a matched-pair study

Background:

It is currently unknown whether patients with a fever after controlled ovulation during egg retrieval could increase the risk of pelvic infection or not, and fever itself may affect endometrial receptivity or embryo quality with poor pregnancy outcomes. The aim of this study was to analyze the outcomes of patients with fever during oocyte retrieval after the first frozen-thawed embryo transfer (FET) cycle.

Methods:

This was a 1:3 retrospective paired study matched for age. In this study, 58 infertility patients (Group 1) had a fever during the control ovulation, and the time of the oocyte retrieval was within 72 hours, they underwent ovum pick up and whole embryo freezing (“freeze-all” strategy). The control subjects (Group 2) are 174 patients matched for age who underwent whole embryo freezing for other reasons. The baseline characteristics, clinical data of ovarian stimulation, and outcomes, such as the clinical pregnancy rate, ongoing clinical pregnancy rate were compared between the two groups in the subsequent FET cycle.

Results:

All patients had no pelvic inflammatory disease after oocyte retrieval. Anti-Mullerian hormone (AMH) levels (4.2 vs. 2.2, P <0.001) were higher in group 2, and the number of oocytes retrieved, and fertilization rate were lower in group 1 (P < 0.001), but the endometrial thickness, the number of embryo transfers, and the type of luteal support supplementation were similar between the two groups. Regarding pregnancy outcomes in the subsequent FET cycle, the implantation rate, clinical pregnancy rate, early spontaneous rate, ectopic pregnancy rate, and ongoing pregnancy rate were all not significantly different. Further regression analyses showed that the clinical pregnancy rate and ongoing pregnancy rate were also not significantly different.

Conclusions:

Transvaginal ultrasound-guided follicular puncture for oocyte retrieval is a safe and minimally invasive method for patients with fever. Moreover, the fever had almost no effect on embryo quality.