Assisted hatching and intracytoplasmic sperm injection are not associated with improved outcomes in assisted reproduction cycles for diminished ovarian reserve: an analysis of cycles in the United States from 2004 to 2011

Abstract

Objective To investigate the impact of intracytoplasmic sperm injection (ICSI) and assisted hatching (AH) on ART outcomes in cycles with diminished ovarian reserve (DOR) as the primary diagnosis. Design Retrospective cohort study of cycles from the SART-CORS database. Setting NA. Patient(s) A total of 422,949 fresh, non-donor, initial ART cycles of which 8,597 were diagnosed with only elevated FSH and 38,926 were diagnosed with only DOR according to the SART DOR categorization. Intervention(s) None. Main Outcome Measure(s) Live birth and clinical pregnancy rates. Result(s) ICSI and AH were associated with diminished odds of live birth in SART DOR only cycles (AOR, 95% CI 0.88, 0.81–0.96 for ICSI; AOR, 95% CI 0.77 0.71–0.84 for AH). No association between either ICSI or AH in Elevated FSH only cycles was observed. The combination of ICSI and AH resulted in significantly lower odds of live birth in SART DOR only cycles but not in Elevated FSH only cycles. Conclusion(s) In initial ART cycles for which the only indication relates to a diagnosis of diminished ovarian reserve, assisted hatching and ICSI are not associated with improved live birth rates.

Diminished ovarian reserve in the United States assisted reproductive technology population: diagnostic trends among 181,536 cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System

“…Both basal FSH alone and FSH combined with age had higher PPV and specificity for predicting POR than did clinical DOR assignment. If, as we believe to be the case, the primary purpose of DOR assignment is to allow for better patient counseling that autologous ART is relatively less likely to result in success (1, 32, 33) and that alternative therapies should be considered, PPV and sensitivity of DOR are its most relevant predictive parameters.…”

Cytoskeletal alterations associated with donor age and culture interval for equine oocytes and potential zygotes that failed to cleave after intracytoplasmic sperm injection

“…ICSI has been successfully applied to equine and human oocytes when fertilization needs to be improved and for cases of infertility (Squires et al 2003; Butts et al 2014). At the Colorado State University’s Equine Reproduction Laboratory, cleavage rates after experimental equine ICSI have ranged from 61% to 85%, but a percentage of sperm-injected equine oocytes will fail to complete fertilization and cleave (Altermatt et al 2009; Sessions-Bresnahan et al 2014).…”

“…The association of maternal aging with reduced fertility has been well documented in mares and women (Carnevale et al 1993; Carnevale 2008; Butts et al 2014; Stoop et al 2014). Aging-related changes in chromosome and cytoskeletal organization in the oocyte can contribute to failure of fertilization and fusion of the two gametes in the woman (Mau-Holzmann 2005).…”

Impact of the HIV-1 genetic background and HIV-1 population size on the evolution of raltegravir resistance

“…The resulting dominant variants were aligned using MAFFT [ 57 ] and distance matrices were estimated using the R library ape [ 58 ] under a F84 substitution model (the choice of substitution model had no effect on the subsequent analyses). The R library sna [ 59 ] was used to construct minimum spanning trees (MSTs) based on the distance matrices of patient’s HIV population. Nodes were scaled according to both viral load and the relative abundance of each detected variant at time of sampling.…”