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Peitsidis N, Tsakiridis I, Najdecki R, Michos G, Chouliara F, Timotheou E, Chartomatsidou T, Athanasiadis A, Papanikolaou E. Diagnostic hysteroscopy with endometrial fundal incision may improve reproductive outcomes in oocyte recipients after implantation failure. JBRA Assist Reprod 2023. [PMID: 37962971 DOI: 10.5935/1518-0557.20230037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVE This study aimed to investigate whether hysteroscopy plus endometrial fundal incision (EFI) with endoscopic scissors can improve reproductive outcomes in oocyte recipients who have failed in their first egg donation cycle. METHODS This was a prospective study (2014-2022) conducted in Assisting Nature Centre Reproduction and Genetics, Thessaloniki Greece, IVF Unit. The study population consisted of oocyte recipients with implantation failure in their first embryo transfer (ET) with donor eggs. All the recipients underwent routine evaluation during their early follicular phase, 1-3 months before the start of a new cycle with donor oocytes and were eligible to undergo EFI. RESULTS During the study period, 218 egg recipients underwent egg donation; 126 out of 218 oocyte recipients (57.8%) did not achieve a live birth at the 1st ET. 109 of them had surplus embryos cryopreserved and underwent a second ET; 50 women consented for EFI. Both groups were similar in terms of age, years of infertility, duration of estrogen replacement protocol and number of transferred blastocysts (p>0.05). In the EFI group, 60% had normal intrauterine cavity, while 40% had minor anomalies. The pregnancy test was positive in 46% (n=23/50) in the EFI group compared with 27.1% (n=16/59) in the control group (p=0.04). Moreover, live birth rates were higher in the EFI group compared to the control group (38.0% vs. 20.3%; p=0.04). CONCLUSIONS The findings of our study indicate that in oocyte recipients after implantation failure, diagnostic hysteroscopy plus EFI prior to subsequent ETmay increase pregnancy and live birth rates.
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Affiliation(s)
- Nikolaos Peitsidis
- Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, Greece
| | - Ioannis Tsakiridis
- Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Robert Najdecki
- Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, Greece
| | - Georgios Michos
- Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Foteini Chouliara
- Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, Greece
| | - Evi Timotheou
- Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, Greece
| | | | - Apostolos Athanasiadis
- Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Evangelos Papanikolaou
- Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, Greece
- Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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Peitsidis N, Tsakiridis I, Najdecki R, Michos G, Chouliara F, Zachomitros F, Kalogiannidis I, Athanasiadis A, Papanikolaou E. Hysteroscopic Identification of Intrauterine Pathology in Oocyte Donation Cycles: A Retrospective Study. Cureus 2023; 15:e37470. [PMID: 37187651 PMCID: PMC10176530 DOI: 10.7759/cureus.37470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Hysteroscopy remains the gold standard for the diagnosis and treatment of intracavitary uterine anomalies. As for recipients where oocyte donation is mandatory, accurate evaluation of previously missed intrauterine pathology may be an important step to optimize implantation process. The aim of this study was to hysteroscopically assess the incidence of unidentified intrauterine pathology prior to embryo transfer in an oocyte recipient population. METHODS A retrospective descriptive study was conducted between 2013 and 2022 at Assisting Nature In Vitro Fertilization (IVF) Centre in Thessaloniki, Greece. The study population consisted of oocyte recipient women who underwent hysteroscopy one-three months before embryo transfer. Furthermore, oocyte recipients after repeated implantation failure were investigated as a subgroup. Any identified pathology was treated accordingly. RESULTS In total, 180 women underwent diagnostic hysteroscopy prior to embryo transfer with donor oocytes. The mean maternal age at the time of intervention was 38.9 (+5.2) years, while the mean duration of infertility was 6.03 (+1.23) years. Additionally, 21.7% (n=39) of the study population had abnormal hysteroscopic findings. In particular, congenital uterine anomalies (U1a: 1.1% {n=2}, U2a: 5.6% {n=10}, U2b: 2.2% {n=4}) and polyps (n=16) were the main findings in the sample population. Furthermore, 2.8% (n=5) had submucous fibroids and 1.1% (n=2) were diagnosed with intrauterine adhesions. Notably, in recipients after repeated implantation failure intrauterine pathology rates were even higher (39.5%). CONCLUSIONS Oocyte recipients and especially those with repeated implantation failures probably have high rates of previously undiagnosed intrauterine pathology so, hysteroscopy would be justified in these subfertile populations.
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Affiliation(s)
- Nikolaos Peitsidis
- Private In Vitro Fertilization (IVF) Unit, Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, GRC
| | - Ioannis Tsakiridis
- Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Robert Najdecki
- Private In Vitro Fertilization (IVF) Unit, Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, GRC
| | - Georgios Michos
- Private In Vitro Fertilization (IVF) Unit, Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, GRC
- Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Foteini Chouliara
- Private In Vitro Fertilization (IVF) Unit, Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, GRC
| | - Fotios Zachomitros
- Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Ioannis Kalogiannidis
- Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Apostolos Athanasiadis
- Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Evangelos Papanikolaou
- Private In Vitro Fertilization (IVF) Unit, Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, GRC
- Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Kostoglou K, Chartomatsidou T, Papa E, Chouliara F, Kallintzi M, Timologou A, Papanikolaou E, Najdecki R, Timotheou E. P-245 Cumulative live birth rates in egg donation regarding the origin of oocytes (fresh or cryopreserved oocytes) in unsynchronized cycles. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is there a difference in cumulative live birth rates between the two groups of fresh or cryopreserved donor oocytes?
Summary answer
In egg donation cumulative live birth rates achieved with fresh donor oocytes are similar to those with cryopreserved donor oocytes.
What is known already
The improvement techniques of cryopreservation of gametes and embryos with vitrification has played an important role in ART and Oocyte Donation Programs. Oocyte donation is a worldwide established method for women with premature ovarian failure, those with repeated (IVF) failure, or those who have inherited genetic abnormalities. The increasing use of Oocyte cryopreservation has improved the outcomes and the success rates. However, cryopreserved-donated oocytes have been still achieved lower live birth rates in comparison to fresh donor oocytes.
Study design, size, duration
This study was carried out in Assisting Nature IVF Unit from January 2015 to December 2020. 191 recipient’s cycles were examined for the cumulative live birth outcomes according to the origin of oocytes. Group A include cycles with fresh donor oocytes from the retrieval day and Group B include cycles with cryopreserved donor oocytes.
Participants/materials, setting, methods
191 recipient cycles participated in the study. Group A (n = 133) received fresh donor eggs in which the formed blastocysts were cryopreserved and then were thawed for the first embryotransfer (ET). Acceptors in Group B (n = 58) received cryopreserved donor eggs and carried out a fresh embryotransfer. The rest of formed blastocysts were cryopreserved and thawed in the next ET. All acceptors transferred at most two embryos and they occurred maximum 3 embryotransfers in egg donation.
Main results and the role of chance
In Group A 755 fresh donor oocytes were utilized when in Group B were 269 cryopreserved oocytes. Fertilization (87% Group A, 84% Group B) and blastulation rates (70% Group A and 65% Group B) were similar between two groups. Cumulatively the live birth rate in Group A was 61% (1st ET: 51,1%, 2nd ET: 9%, 3rd ET: 0,9%). Acceptors with a failure in the first ET carried out a second ET or in the third ET with cryopreserved blastocysts. In Group B acceptors achieved 59% live birth rates (1st ET: 50%, 2nd ET: 9%). Some acceptors after the failure of the first ET carried out a second ET and delivered a healthy baby. There was not observed significant difference in live birth rate between two groups. The vitrification and warming stages in oocyte cryopreservation has been dramatically improved in recent years and therefore in our study seems to have equal live birth rates as in the fresh oocytes in egg donation program.
Limitations, reasons for caution
Large scale studies are required with further investigation with more equal number of studied patients between groups. Moreover, information regarding sperm quality parameters, embryos quality or endometrium should be considered.
Wider implications of the findings
Acceptors should be reassured that the origin of oocytes does not have impact in the likelihood of becoming pregnant.
Trial registration number
NONE
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Affiliation(s)
- K Kostoglou
- ASSISTING NATURE, EMBRYOLOGY , THESSALONIKI, Greece
| | | | - E Papa
- ASSISTING NATURE, EMBRYOLOGY , THESSALONIKI, Greece
| | - F Chouliara
- Assisting Nature, Gynaecology , Thessaloniki, Greece
| | - M Kallintzi
- Assisting Nature, Gynaecology , Thessaloniki, Greece
| | - A Timologou
- Assisting Nature, Gynaecology , Thessaloniki, Greece
| | | | - R Najdecki
- Assisting Nature, Gynaecology , Thessaloniki, Greece
| | - E Timotheou
- ASSISTING NATURE, EMBRYOLOGY , THESSALONIKI, Greece
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Najdecki R, Michos G, Peitsidis N, Timotheou E, Chartomatsidou T, Kakanis S, Chouliara F, Mamopoulos A, Papanikolaou E. Agonist triggering in oocyte donation programs-Mini review. Front Endocrinol (Lausanne) 2022; 13:838236. [PMID: 36093096 PMCID: PMC9462512 DOI: 10.3389/fendo.2022.838236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Oocyte donation programs involve young and healthy women undergoing heavy ovarian stimulation protocols in order to yield good-quality oocytes for their respective recipient couples. These stimulation cycles were for many years beset by a serious and potentially lethal complication known as ovarian hyperstimulation syndrome (OHSS). The use of the short antagonist protocol not only is patient-friendly but also has halved the need for hospitalization due to OHSS sequelae. Moreover, the replacement of beta-human chorionic gonadotropin (b-hCG) with gonadotropin-releasing hormone agonist (GnRH-a) triggering has reduced OHSS occurrence significantly, almost eliminating its moderate to severe presentations. Despite differences in the dosage and type of GnRH-a used across different studies, a comparable number of mature oocytes retrieved, fertilization, blastulation, and pregnancy rates in egg recipients are seen when compared to hCG-triggered cycles. Nowadays, GnRH-a tend to be the triggering agents of choice in oocyte donation cycles, as they are effective and safe and reduce OHSS incidence. However, as GnRH-a triggering does not eliminate OHSS altogether, caution should be practiced in order to avoid unnecessary lengthy and heavy ovarian stimulation that could potentially compromise both the donor's wellbeing and the treatment's efficacy.
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Affiliation(s)
- Robert Najdecki
- Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
- *Correspondence: Robert Najdecki,
| | - Georgios Michos
- Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
| | - Nikos Peitsidis
- Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
| | - Evangelia Timotheou
- Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
| | | | - Stelios Kakanis
- 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Foteini Chouliara
- Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
| | - Apostolos Mamopoulos
- 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelos Papanikolaou
- Assisting Nature, Centre of Assisted Reproduction and Genetics, Thessaloniki, Greece
- 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Chartomatsidou T, Najdecki R, Chouliara F, Timotheou E, Tatsi P, Asouchidou E, Βouchlariotou S, Mbambas E, Karagiannidis LK, Nikolettos N, Papanikolaou E. A single injection of long acting gnrh-antagonist -degarelix- downregulates hypophysis during ovarian stimulation. A randomized controlled trial. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dagklis T, Tsakiridis I, Chouliara F, Mamopoulos A, Rousso D, Athanasiadis A, Papazisis G. Antenatal depression among women hospitalized due to threatened preterm labor in a high-risk pregnancy unit in Greece. J Matern Fetal Neonatal Med 2017; 31:919-925. [DOI: 10.1080/14767058.2017.1301926] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Themistoklis Dagklis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Ioannis Tsakiridis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Foteini Chouliara
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Mamopoulos
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - David Rousso
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Athanasiadis
- Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
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Dagklis T, Papazisis G, Tsakiridis I, Chouliara F, Mamopoulos A, Rousso D. Prevalence of antenatal depression and associated factors among pregnant women hospitalized in a high-risk pregnancy unit in Greece. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1025-31. [PMID: 27138949 DOI: 10.1007/s00127-016-1230-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/26/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE Women who face pregnancy complications may require hospitalization in a high-risk pregnancy unit (HRPU), and this may have a negative impact on the pregnant woman's mental health. The purpose of this study was to screen for depressive symptoms in pregnant women admitted in a high-risk pregnancy unit and also to investigate associated risk factors. METHODS This was a cross-sectional study that enrolled pregnant women admitted at ≥24 gestational weeks in a university hospital HRPU, between September 2014 and November 2015. The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms on admission. A cutoff score ≥13 was considered as indicative of depression. Test results were then correlated with the reasons that led to the women's admission as well as socio-demographic characteristics. RESULTS Overall, 157 of the women admitted in the HRPU during the study period were eligible for the study and agreed to complete the questionnaire. The mean age of the pregnant women was 30 ± 6 years, and the mean gestational week at admission was 32 ± 3 weeks. The prevalence of antenatal depression (score ≥13) was 28 % (44/157). In the multivariate analysis, antenatal depression was significantly correlated with smoking (OR = 2.681, 95 % CI 1.089-6.601) and the existence of thoughts for pregnancy termination (OR = 3.624, 95 % CI 1.149-11.427). CONCLUSIONS Approximately one quarter of pregnant women hospitalized in the HRPU may show signs of depression at the time of admission. Smoking and an unwanted pregnancy were found to be independently associated with antenatal depression, whereas no association was found with any obstetric parameters.
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Affiliation(s)
- Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynaecology, Hippokrateion Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynaecology, Hippokrateion Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Foteini Chouliara
- 3rd Department of Obstetrics and Gynaecology, Hippokrateion Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Mamopoulos
- 3rd Department of Obstetrics and Gynaecology, Hippokrateion Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - David Rousso
- 3rd Department of Obstetrics and Gynaecology, Hippokrateion Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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