Optimum number of oocytes for a successful first IVF treatment cycle

Purpose Morphological evaluation is currently considered the single most important predictive measure for assessing embryo quality. The aim of this study was to investigate whether cycles with at least one non-cleaved embryo (i.e., a 1-cell embryo on day 3) have different outcomes compared with cycles in which all embryos had cleaved by day 3. Methods All autologous IVF/ICSI cycles with a fresh day 3 transfer and without using a gestational carrier performed at our center between 1/1/2010 and 12/31/2011 were analyzed retrospectively. Those cycles with at least one non-cleaved embryo on day 3 were compared with all other autologous cycles that had l00 % cleaved embryos performed during the study period. Results Eight hundred and forty two cycles were included. Of them, 144 cycles comprised the non-cleaved group, and 698 cycles comprised the cleaved group. Cycles in the non-cleaved group had more oocytes retrieved (15.4±7.1 vs. 12.5±7.1, p<0.001), more zygotes obtained (10.0±5.3 vs. 7.9±5.2, p= <0.001), but the embryos exhibited lower cleavage rates and higher rates of fragmentation and asymmetry compared with controls (p<0.001). However, spontaneous abortion rates, ectopic pregnancies rates as well as delivery rates were similar between the two groups.Conclusions Our results show that the presence of a noncleaved embryo on day 3 is associated with a more exuberant response to controlled ovarian stimulation as reflected by more oocytes retrieved. Despite the significant decrease in quality of the whole cohort in the non-cleaved group, implantation, delivery rates and number of embryos frozen were not adversely affected by the presence of a non-cleaved embryo.

Section: Discussioncontrasting

confidence: 62%

Is the presence of a non-cleaved embryo on day 3 associated with poorer quality of the remaining embryos in the cohort?

Machtinger

Bormann

Ginsburg

et al. 2015

“…There were some differences in the number of retrieved oocytes when comparing the groups with a P/F ratio≤.075 with those with a ratio>.075, with a lower number of oocytes noted in the latter group. However, according to the literature [8,24], both groups of patients have been found to exhibit good prognoses considering the number of retrieved oocytes. When between 6 and 15 oocytes are retrieved, the pregnancy rates for one fresh ET are similar, and when oocyte numbers are either below or above that range, outcomes are compromised [25].…”

Section: Discussionmentioning

confidence: 98%

Ratio of progesterone-to-number of follicles as a prognostic tool for in vitro fertilization cycles

Roque

Valle

Sampaio

et al. 2015

Purpose To establish a ratio of the P level to the number of follicles (P/F ratio) on the day of human chorionic gonadotropin (hCG) administration and to evaluate whether this ratio is associated with in vitro fertilization (IVF) outcome. Methods This study was conducted between January 2012 and June 2013. A total of 337 patients with cleavage-stage day-3 fresh embryo transfer with P levels ≤1.5 ng/mL on the day of hCG administration were included in the study. The main outcome was ongoing pregnancy rate. Result(s) The P/F ratio was calculated according to the equation (P[ng/mL]/number of follicles) on the day of final oocyte maturation. Using ROC, we established a cut-off level of 0.075 for the P/F ratio. The area under the curve (AUC) (0.756; 95 % confidence interval [CI]: 0.704-0.807) indicated that it was a good prognostic test. In group 1 (patients under 36 years old), the ongoing pregnancy rates were 57 and 30 % for patients with P/F ratios≤.075 and>.075, respectively, (p= 0.003). In group 2 (patients between 36 and 39 years old), the ongoing pregnancy rates were 58 % and 17 % (p=0.001) for patients with P/F ratios ≤.075 and>.075, respectively. In group 3 (patients≥40 years old), the ongoing pregnancy rates were 41.7 and 10.9 % (p=0.001) for patients with P/F ratios≤.075 and>.075, respectively. Conclusions The P/F ratio is a good prognostic test for predicting IVF outcome that can correlate the P level with ovarian response.

“…In the case of equal ovarian assessment, other parameters could influence pregnancy rate, for example age [18][19][20][21], which is the most important predictive variable of live birth in IVF. Globally, women who are poor responders have a lower pregnancy rate than normally responding women [19,[22][23][24]. Even in young poor responders IVF results are low but acceptable [25].…”

Section: Introductionmentioning

confidence: 99%

Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study

Marca

Grisendi

Giulini

et al. 2015

Purpose to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. Methods database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. Results There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. Conclusion The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.