Predicting live birth outcomes after <i>in vitro</i> fertilisation

Nelson, Scott M.; Lawlor, Debbie A.

doi:10.1111/j.1471-0528.2012.03508.x

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…The number of embryos created is positively correlated with outcome as expected from previous analyses of UK national data (Hirst et al, 2011;Nelson and Lawlor, 2012;Templeton et al, 1996). Interestingly however, this is mediated not just through embryo viability, as previously assumed, as more embryos are available for selection, but also women who generate more embryos are more receptive.…”

Section: Discussionsupporting

confidence: 69%

Factors affecting embryo viability and uterine receptivity: insights from an analysis of the UK registry data

Roberts

Hann

Brison

2016

Reproductive BioMedicine Online

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Many studies have identified prognostic factors for IVF treatment outcome; however, little information is available on the mechanism of their action. Embryo-uterus models have the potential to distinguish between factors acting on the embryo directly and those acting through the uterine environment. Here we apply embryo-uterus models to comprehensive UK registry data from two periods, 2000-2005 and 2007-2011, containing 139,444 and 226,542 embryo transfer cycles, respectively. Given this large dataset, the embryo-uterus model is capable of distinguishing between uterine and embryo effects. Maternal age is the predominant predictor of live birth and acts on both the embryo and uterine components, but with larger effects on the embryo. Prolonged embryo culture is associated with greater embryo viability, reflecting the greater degree of selection, but is also associated with greater uterine receptivity. Cryopreserved embryos are less viable and were associated with poorer uterine receptivity. This work suggests that, in addition to the direct effects of in-vitro culture on the embryonic environment during the first few days of the embryo's life, the delay in transfer after extended culture or cryopreservation can lead to an altered uterine environment for the embryo after transfer.

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Section: Discussionsupporting

confidence: 69%

Factors affecting embryo viability and uterine receptivity: insights from an analysis of the UK registry data

Roberts

Hann

Brison

2016

Reproductive BioMedicine Online

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“…If one has 2 embryos, and the choice is to transfer 2 in 1 cycle, or 1 each in 2 cycles, data have shown that the overall pregnancy rate is actually higher with 2 in 1 cycle [126][127][128] . There is the potential for DCDA twins and rarely dichorionic-triamniotic triplets.…”

Section: Discussionmentioning

confidence: 99%

Re-Thinking Elective Single Embryo Transfer: Increased Risk of Monochorionic Twinning - A Systematic Review

Dziadosz

Evans²

2017

Fetal Diagn Ther

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Background/Objectives: Multiple pregnancies have tripled in the United States over the past 3 decades. Attributed to increasing maternal age at delivery but more so assisted reproductive technological advances, an effort has been made to decrease twinning through elective single embryo transfer. We sought to review and evaluate risks of monochorionic twinning as a predictable consequence of increasing utilization of elective single embryo transfer on perinatal outcomes. Primary outcomes included twinning rates, fetal anomalies, growth, preterm birth, and mortality. Secondary outcomes included neurological and pulmonary disability, intrauterine growth restriction, and congenital cardiac anomalies and twin-twin transfusion syndrome. Data sources: PubMed and Embase. Results: A total of 106 studies identified by systematic search met the inclusion criteria. The trend for lower numbers of embryos transferred has inadvertently led to an increase in monochorionic twinning. This is associated with worse outcomes compared to dichorionic twinning and singleton gestations for all outcomes studied. Discussion: Of great concern for monochorionic twins is the risk profile of significant morbidity and mortality. Transfer of 2 embryos should be considered to avoid higher risks inherent to the shared placental phenomena related to monochorionic twins.

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“…We read with interest the article by van den Boogaard et al 1 that intends to perform an individual patient data (IPD) meta-analysis of subfertile couples and treatment outcomes using the Templeton model to estimate the chance of pregnancy after in vitro fertilisation (IVF). The model of Templeton et al analysed 36 961 treatment cycles undertaken in the UK between 1991 and 1994, and was validated in a population of 1253 couples receiving IVF treatment in the Netherlands between 1991 and 1999.…”

Section: Sirmentioning

confidence: 99%

“…Sir, We thank Prof Nelson and colleagues 1 for their interest in our individual patient data (IPD) analysis, and for informing us about their prediction model to estimate the chance of pregnancy after in vitro fertilisation (IVF). The aim of our IPD analysis was to evaluate whether prognosis as predicted by a validated prediction model could be used for treatment selection in untreated couples with unexplained or mild male subfertility, i.e.…”

Section: Authors' Replymentioning

confidence: 99%

“…The existing prediction models all focus upon predicting the outcome of a specific treatment strategy (expectant management; 2 IUI, with or without OS 3 or IVF 4,5 ), and do not focus on treatment selection for the individual couple. The aim of our analysis was to evaluate if one of the existing models has the capacity to select the best treatment strategy based on the prognosis for the individual couple.…”

Section: Authors’ Replymentioning

confidence: 99%

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Authors' response to: Predicting live birth outcomes after in vitro fertilisation

Boogaard¹,

Rengerink²,

Loendersloot³

et al. 2012

BJOG

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Predicting live birth outcomes after in vitro fertilisation

Cited by 4 publications

References 4 publications

Factors affecting embryo viability and uterine receptivity: insights from an analysis of the UK registry data

Factors affecting embryo viability and uterine receptivity: insights from an analysis of the UK registry data

Re-Thinking Elective Single Embryo Transfer: Increased Risk of Monochorionic Twinning - A Systematic Review

Authors' response to: Predicting live birth outcomes after in vitro fertilisation

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