ISRCTN43430382.

No abstract

Women's choice to delay fertility due to various reasons is making subfertility a growing problem and increased use of IVF as a last resort. Despite advances in the technology, IVF success remains low, especially in older women. Hence, many of these women need to undergo several cycles of IVF and are faced with unprecedented anxiety and frustration. In desperation, they resort to anything that might increase the success of their IVF treatment. Acupuncture has gained popularity among the various complementary medicines available and many go privately to have acupuncture while undergoing IVF. Since 1999, in spite of multiple trials and systematic reviews, the beneficial effect of acupuncture in improving the success of IVF remains unproven and debatable. As clinicians, we face the dilemma of what to suggest to our patients when asked about having acupuncture during IVF, given that different meta-analyses have come to different conclusions. Hence, this review is conducted with the aim to summarise the available literature and provide a better insight into this complex and controversial topic.

To review the cumulative outcome of pre-implantation genetic diagnosis (PGD) cycles performed for prevention of sickle cell disease (SCD). Couples referred for PGD for SCD between April 2012 and October 2017 were included. Ovarian stimulation was performed using a short gonadotrophinreleasing hormone (GnRH) antagonist protocol and follicle-stimulating hormone injections. The GnRH agonist was used to trigger oocyte maturation. Oocytes were fertilised using intracytoplasmic sperm injection. Trophectoderm biopsy was performed on day 5 or 6 followed by vitrification. Genetic testing was done using pre-implantation genetic haplotyping. A total of 60 couples started 70 fresh PGD cycles (mean 1Á2 cycles/couple) and underwent a total of 74 frozen-embryo-transfer (FET) cycles (mean 1Á3 FET/couple). The mean (SD) female age was 33 (4Á4) years and the mean (SD) anti-m€ ullerian hormone level was 22Á9 (2Á8) pmol/l. The cumulative live-birth rate was 54%/PGD cycle started and 63%/couple embarking on PGD. The rate of multiple births was 8%. The cumulative outcome of PGD treatment for prevention of SCD transmission is high and PGD treatment should be offered to all at-risk couples.