Effect of embryo quality on pregnancy outcome following single embryo transfer in women with a diminished egg reserve

Check, Jerome H.; Summers-Chase, D; Wei, Yuan; Horwath, D; Wilson, C.

doi:10.1016/j.fertnstert.2006.11.001

Cited by 39 publications

(38 citation statements)

References 40 publications

(42 reference statements)

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“…These observations agree with previous reports, that showed that a high Gn dose is effective in getting more oocytes [8,24] and avoiding cycle cancellation [8], but does not improve IVF results [6][7][8]24]. This could be due to a negative impact of high Gn dose on endometrial quality [25] or, alternatively, to the fact that a high dose of exogenous Gn could force the recruitment of "resistant" follicles, hosting oocytes of poor quality from which poor competence embryos derive [26].…”

Section: Discussionsupporting

confidence: 91%

“Mild” vs. “long” protocol for controlled ovarian hyperstimulation in patients with expected poor ovarian responsiveness undergoing in vitro fertilization (IVF): a large prospective randomized trial

Revelli

Chiadò

Dalmasso³

et al. 2014

J Assist Reprod Genet

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Background This large prospective, randomized study was designed to compare the "mild" protocol with clomiphene citrate, low-dose gonadotropins and a GnRH-antagonist (CC/Gn/GnRH-ant protocol) with the "long" protocol with a GnRH-agonist and high-dose Gn for the controlled ovarian hyperstimulation (COH) of patients with expected poor ovarian responsiveness undergoing IVF. Materials and Methods A total of 695 women with clinical, endocrine and ultrasound characteristics suggesting a low ovarian reserve and a poor responsiveness to COH were recruited and randomly assigned to receive the CC/Gn/ GnRH-ant "mild" protocol (mild group, n=355) or the "long" protocol with high-dose Gn (long group, n=340). Results The "mild" stimulation led to significantly shorter follicular phase, lower consumption of exogenous Gn and lower peak estradiol level than the "long" regimen. With the "long" protocol, significantly less cycles were cancelled due to the lack of ovarian response; further, it obtained significantly more oocytes, more mature oocytes, more embryos, and a thicker endometrium. As for the final IVF outcome, however, the two stimulation regimens obtained comparable implantation rate, clinical pregnancy rate, and ongoing pregnancy rate at 12 weeks. Conclusions In conclusion, the "mild" CC/Gn/GnRH-ant stimulation protocol is a valid alternative to the long protocol with high Gn dose as it obtains a comparable success rate and requires significantly less medications, with an obvious economical advantage.

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Section: Discussionsupporting

confidence: 91%

“Mild” vs. “long” protocol for controlled ovarian hyperstimulation in patients with expected poor ovarian responsiveness undergoing in vitro fertilization (IVF): a large prospective randomized trial

Revelli

Chiadò

Dalmasso³

et al. 2014

J Assist Reprod Genet

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“…This ratio was significantly higher in the D1-hCG treatment group compared to Controls. Yet, several studies consider top quality embryos those with higher implantation ability [33], Check et al [34] analyzed a single embryo transfer data basis and reported that six, seven or eight-cell embryos produces similar pregnancy rates. Consequently, the translation of D1-hCG's better quality embryos into a significantly improved biochemical pregnancy rate, implantation rate, and on-going pregnancy rate per transfer might still under debate and scientific testing.…”

Section: Discussionmentioning

confidence: 99%

Human choriogonadotropin prior to controlled ovarian stimulation and in vitro fertilization improves implantation, and pregnancy rates

Motta

Smith

Serafini

et al. 2009

J Assist Reprod Genet

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Purpose Our purpose was to retrospectively compare controlled ovarian stimulation(COH) in IVF cycles with administration of hCG on the day of menses (D1-hCG) with women not receiving hCG at day 1 of menses (Control). Methods Data on maternal age, endocrine profile, amount of rFSH required, embryo characteristics, implantation and pregnancy rates were recorded for comparison between D1-hCG (n=36) and Control (n=64). Results Dose of rFSH required to accomplish COH was significantly lower in D1-hCG. Following ICSI, more topquality embryos were available for transfer per patient in the D1-hCG and biochemical pregnancy rates per transfer were significantly higher in the D1-hCG. Significantly higher implantation and on-going pregnancy rates per embryo transfer were observed in D1-hCG (64%) compared to Control (41%). Conclusions Administration of D1-hCG prior to COH reduces rFSH use and enhances oocyte developmental competence to obtain top quality embryos, and improves implantation and on-going pregnancy rates. At present it is not clear if the benefit is related to producing an embryo that more likely to implant or a more receptive uterus, or merely fortuitous and related to the relatively small power of the study.

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“…Roberts et al's study showed that any age women who ever once had a serum FSH more than 15mIU/mL can not achieve a live pregnancy even if they stimulate adequately and have morphologically normal embryos (45). Their hypothesis suggested that high serum FSH results in a loss of best oocytes and the remaining ones have poor quality similar to >45 year old woman (45), but the fact that live delivered babies have been achieved despite the extreme of oocyte depletion suggests Roberts et al's hypothesis is incorrect (45,46,57).…”

Section: Minimal and Natural Stimulations For Ivf 29mentioning

confidence: 99%

“…Recently, a study evaluated the relative effect of blastomere number and fragmentation indices of day 3 embryos on pregnancy and implantation rates by undergoing IVF women with a markedly decreased egg reserve and >15 mIU/mL serum FSH levels (57). The study consisted of only women having a single embryo transfer.…”

Section: Minimal and Natural Stimulations For Ivf 29mentioning

confidence: 99%

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Minimal and Natural Stimulations for IVF

Check¹

2012

Advances in Embryo Transfer

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Effect of embryo quality on pregnancy outcome following single embryo transfer in women with a diminished egg reserve

Cited by 39 publications

References 40 publications

“Mild” vs. “long” protocol for controlled ovarian hyperstimulation in patients with expected poor ovarian responsiveness undergoing in vitro fertilization (IVF): a large prospective randomized trial

“Mild” vs. “long” protocol for controlled ovarian hyperstimulation in patients with expected poor ovarian responsiveness undergoing in vitro fertilization (IVF): a large prospective randomized trial

Human choriogonadotropin prior to controlled ovarian stimulation and in vitro fertilization improves implantation, and pregnancy rates

Minimal and Natural Stimulations for IVF

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