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Aydin T, Namli Kalem M, Bakirarar B, Aygun EG, Kalem Z. Comparing the success rate of natural cycle and modified natural cycle protocols for frozen-thawed embryo transfer. Gynecol Endocrinol 2022; 38:1073-1078. [PMID: 36220075 DOI: 10.1080/09513590.2022.2128747] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Objective: The aim of the present study is to compare the effects of Natural Cycle and modified Natural Cycle protocols for frozen-thawed embryo transfer on clinical pregnancy rate and live birth rate. Methods: This prospective randomized controlled trial comprised 145 patients scheduled for frozen-thawed embryo transfer and was conducted at a university hospital between 2019 and 2021. The Natural Cycle protocol was administered to 73 patients and the modified Natural Cycle protocol to 72 patients and the clinical outcome was compared between the groups. The main outcome measure was live birth rate. Results: Baseline characteristics and cycle parameters were similar in both groups. There was no difference in clinical pregnancy rate (58.9% and 54.2%, respectively; p = .565) and live birth rate between the Natural Cycle and modified Natural Cycle groups (49.3% and 48.6% respectively; p = .932). Conclusion: This study established that clinical pregnancy and live birth rates were not affected by natural cycle ovulation being spontaneous or hCG-triggered among patients undergoing frozen-thawed embryo transfer. Thus, the protocol for natural cycle frozen-thawed embryo transfers should be chosen according to the priorities of the patient and the physician.
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Affiliation(s)
- Turgut Aydin
- Department of IVF, Acıbadem University Atakent Hospital, Istanbul, Turkey
| | - Muberra Namli Kalem
- Department of IVF, Istinye University Liv Bahcesehir Hospital, Istanbul, Turkey
| | - Batuhan Bakirarar
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Elif Ganime Aygun
- Department of IVF, Acıbadem University Atakent Hospital, Istanbul, Turkey
| | - Ziya Kalem
- Department of IVF, Istinye University Liv Bahcesehir Hospital, Istanbul, Turkey
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Lin H, Li Y, Ou S, Jiao X, Wang W, Haahr T, Humaidan P, Zhang Q. The relationship of total progressive motile sperm count with the outcome of IUI? An analysis of 5171 cycles. Gynecol Endocrinol 2022; 38:954-959. [PMID: 36271782 DOI: 10.1080/09513590.2022.2126453] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: The role of motile sperm count in intrauterine insemination (IUI) success rate is controversial. This retrospective cohort study performed among unselected infertile couples undergoing IUI was to explore the association between the total progressive motile sperm count (TPMSC) and the live birth rate (LBR) following IUI.Methods: The total cohort of 5363 cycles, 2666 infertile couples between January 2015 and December 2018 and finally 5171 cycles, 2647 couples were included for analysis in Sun Yat-sen memorial hospital of Sun Yat-sen University. The primary outcome was LBR per cycle. And the secondary outcome measure was clinical pregnancy rate (CPR) per cycle.Results: From the receiver operating characteristic (ROC) analysis of female age predicting live birth, female age cutoff was defined as 28 years. With a female age of ≤28 years, the CPRs were 11.5%, 14.9%, 16.1%, and 15.8% in quartile groups of pre-wash TPMSC, respectively. For the LBRs the values were 9.4%, 12.9%, 14.4%, and 11.3%, and there were also no significant differences in quartile groups of pre-wash TPMSC with ≤24 million (M), [24M-50M], [50M-97M], >97M. No statistically significant differences in the CPRs (p = .051) and LBRs (p = .088) were also observed in the quartiles groups of post-wash TPMSC. With a female age of >28 years, the CPR in couples with post-wash TPMSC ≤22.32 M was significantly lower than with post-wash TPMSC >81.0 M (p = .007). There was an obvious trend in which CPRs and LBRs increased with the post-wash TPMSC during the <81 M interval in women >28 years.Conclusions: The optimal female age cutoff for live birth was 28 years in IUI cycles. Pre-wash and post-wash TPMSC were not significantly associated with CPR and LBR per cycle. When female age >28 years, there was a better outcome with post-wash TPMSC >22.32 million.
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Affiliation(s)
- Haiyan Lin
- Reproductive Center, Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yu Li
- Reproductive Center, Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Songbang Ou
- Reproductive Center, Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuedan Jiao
- Reproductive Center, Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wenjun Wang
- Reproductive Center, Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Thor Haahr
- The Fertility Clinic, Skive Regional Hospital, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Qingxue Zhang
- Reproductive Center, Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
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Zhang S, Xu H, Chen J, Zhang Y, Sun Z, Luo L, Wang X, Jiang X, Jiang C, Deng K, Zhang C. Higher baseline alanine aminotransferase level is associated with lower live birth rate after freeze-thawed embryo transfer. Gynecol Endocrinol 2022; 38:949-953. [PMID: 36097348 DOI: 10.1080/09513590.2022.2122430] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The aim of this retrospective analysis was to explore whether an elevated ALT level before pregnancy is associated with a reduction in live birth rate after IVF-FET. DESIGN Retrospective observational study. SETTING Shiyan People's Hospital, China between January 2019 and December 2019. PATIENTS Women aged ≤ 40 years. INTERVENTION(S) Freeze-thawed embryo transfer (FET). MAIN OUTCOME MEASURE(S) The live birth rate, which was defined as the delivery of a live baby after 24 weeks of gestation. RESULTS The analysis included 365 FET cycles. There was a significant difference between groups in the live birth rate (p < .05), which was highest for the low ALT tertile and lowest for the high ALT tertile. Multiple regression analysis with adjustment for multiple potential confounders revealed that the odds of live birth were decreased for each one standard deviation increase in ALT (OR = 0.56, 95%CI = 0.42-0.75, p < .0001) and lower for the high ALT tertile than for the low ALT tertile (OR = 0.38, 95%CI = 0.19-0.75, p = .0055). Smooth curve fitting showed an inverse relationship between ALT and live birth rate. CONCLUSION Our findings indicate that relatively small elevations in baseline serum ALT level can have a clinically relevant impact on the success of FET.
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Affiliation(s)
- Shuping Zhang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Hongyi Xu
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Juan Chen
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Ying Zhang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Zhifeng Sun
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Lijuan Luo
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Xiaoning Wang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Xing Jiang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Chenglong Jiang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Kai Deng
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Changjun Zhang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
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Tulek F, Kahraman A, Demirel LC. Dual trigger with gonadotropin releasing hormone agonist and human chorionic gonadotropin improves live birth rates in POSEIDON group 3 and 4 expected poor responders. Gynecol Endocrinol 2022; 38:731-735. [PMID: 35856433 DOI: 10.1080/09513590.2022.2101635] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Aim of this study was to evaluate the effects of dual triggering with gonadotropin releasing hormone agonist and human chorionic gonadotropin (hCG) on outcomes of fresh embryo transfers following gonadotropin antagonist cycles in POSEIDON group 3 and group 4 low prognosis women and to compare the outcomes with hCG-only triggering. METHODS This study was conducted by retrospective analysis of patients with expected poor ovarian response (POSEIDON group 3 and 4) that underwent fresh embryo transfers following in-vitro fertilization/intracytoplasmic sperm injection cycles with either dual triggering or hCG-only triggering between January 2010 and April 2020. A total of 1068 women that underwent dual triggering and 1931 that underwent hCG-only triggering were included in the study. RESULTS Number of retrieved oocytes, M2 oocytes, oocyte maturation rate, fertilization rate, obtained 2PN embryos, implantation rate, clinical pregnancy rate and live birth delivery rates were found significantly higher in dual-triggering group in comparison to hCG-only group (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.02, p < 0.001 respectively). CONCLUSION Dual trigger with concomitant injections of GnRH agonist and hCG in GnRH antagonist cycles appears to improve IVF outcomes, increase quality of embryos, reduce miscarriage rates and consequently increase live birth delivery rates in POSEIDON groups 3/4 poor responders.
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Affiliation(s)
- Firat Tulek
- Faculty of Health Sciences, Department of Midwifery, Uskudar University, Istanbul, Turkey
- Department of Obstetrics and Gynecology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Alper Kahraman
- Department of Obstetrics and Gynecology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Lutfi Cem Demirel
- Department of Obstetrics and Gynecology, Memorial Atasehir Hospital, Istanbul, Turkey
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Liu J, Li TC, Wang J, Wang W, Hou Z, Liu J. The impact of ovarian stimulation on the outcome of intrauterine insemination treatment: an analysis of 8893 cycles. BJOG 2018; 123 Suppl 3:70-5. [PMID: 27627603 DOI: 10.1111/1471-0528.14020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 03/02/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the impact of ovarian stimulation on the outcome of intrauterine insemination (IUI). DESIGN Retrospective analysis. SETTING A single university-based centre. POPULATION A total of 5109 couples with 8893 cycles. METHODS The outcome of IUI with different protocols for ovarian stimulation was examined. MAIN OUTCOME MEASURES The live birth rate (LBR), twin pregnancy rate and ovarian hyperstimulation syndrome (OHSS). RESULTS In ovulatory women without ovarian stimulation, the LBR was 7.6%. Stimulation with clomifene citrate (CC), letrozole (LE), human menopausal gonadotrophin (HMG), CC or LE combined with HMG achieved LBRs of 6.1, 5, 7.9, 8 and 12.2%, respectively. LE combined with HMG achieved a significantly improved LBR compared with no stimulation. HMG stimulation was associated with a higher rate of twins (7.4%) than no stimulation (0%, P < 0.01). In ovulatory women, the LBR appeared lower in CC and LE compared with no stimulation (P > 0.05). In anovulatory women, ovarian stimulation with CC, LE, HMG, CC or LE combined with HMG achieved LBRs of 11.3, 5.1, 11.8, 12.6 and 13.6%, respectively. No significant difference was observed. There were no triplet pregnancies or OHSS in stimulated cycles. CONCLUSIONS In ovulatory women, ovarian stimulation with LE combined with HMG achieved a significantly improved live birth rate. HMG stimulation resulted in a high risk for twins. TWEETABLE ABSTRACT In ovulatory women, ovarian stimulation with letrozole and HMG resulted in a significantly improved LBR.
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Affiliation(s)
- Jinyong Liu
- The State Key Laboratory of Reproductive Medicine, Clinical Centre of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Hong Kong, China
| | - Tin-Chiu Li
- Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Hong Kong, China
| | - Jing Wang
- The State Key Laboratory of Reproductive Medicine, Clinical Centre of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Hong Kong, China
| | - Wei Wang
- The State Key Laboratory of Reproductive Medicine, Clinical Centre of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Hong Kong, China
| | - Zhen Hou
- The State Key Laboratory of Reproductive Medicine, Clinical Centre of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Hong Kong, China
| | - Jiayin Liu
- The State Key Laboratory of Reproductive Medicine, Clinical Centre of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Hong Kong, China.
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