Predictive value of the number of frozen blastocysts in live birth rates of the transferred fresh embryos

Song, Junxian; Duan, Cuicui; Cai, Wei-Xiong; Xu, Jian

doi:10.1186/s13048-021-00838-5

Cited by 8 publications

(3 citation statements)

References 27 publications

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“…And the result from 2,226 patients of US suggested that the pregnancy rate was higher when the retrieved oocytes number was ≥ 15 [ 22 ]. A recent study of 8676 cycles of first fresh embryo transfer in the Chinese population detected that the optimal ovarian response for retrieved oocytes was ≥ 10 [ 23 ]. Our results suggest that an oocyte yield of 9 ~ 17 is ideal, giving the highest LBR per OPU cycle (54.0%-60.3%), as well as moderating the risk of OHSS.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of GnRH-a prolonged protocol for in vitro fertilization in 18,272 cycles in China

Tian

Xia²,

Wu³

2022

J Ovarian Res

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Background This large-cohort, retrospective study investigates the relationship between the number of oocytes retrieved and the clinical outcomes for patients receiving the GnRH-a prolonged protocol (mGnRH-a protocol) for fertilization in vitro or intracytoplasmic sperm injection–embryo transfer (IVF/ICSI-ET) treatment. Results We categorized 18,272 cycles into three groups by the number of oocytes retrieved (1–8, 9–17, and ≥ 18) during IVF with the GnRH-a prolonged protocol at the Reproductive Medical Center of Jiangxi Maternal and Child Health Hospital from January 2014 to December 2018 (excluding oocyte donation cycles), analyzing the associations among oocyte number and live birth rates (LBRs) or cumulative LBRs (CLBRs), as well as the rate of moderate-to-severe ovarian hyperstimulation syndrome (OHSS). We defined the primary outcome as LBR and the secondary outcome to include the rate of patients at high risk for OHSS. The LBR (with fresh ET) per cycle of oocyte pick-up increased as the number of retrieved oocytes increased from 1 to ~ 8, plateaued between 9 ~ 17, and steadily decreased thereafter. However, the CLBR per cycle continued to increase as the oocyte number increased, as did the incidence of moderate-to-severe OHSS. Conclusions Our results show a strong relationship between the number of oocytes retrieved and the CLBR following IVF treatment. The balance between treatment success and the risk of complications, especially OHSS, should be investigated further. We recommend a fresh-ET strategy for the GnRH-a prolonged protocol because the endometrial receptivity in the fresh cycles was better than those in the frozen cycles.

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Section: Discussionmentioning

confidence: 99%

Retrospective analysis of GnRH-a prolonged protocol for in vitro fertilization in 18,272 cycles in China

Tian

Xia²,

Wu³

2022

J Ovarian Res

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“…Additionally, abnormal fertilization (triploidy with ICSI) lowers the IRs of the entire normally fertilized cohort, again suggesting an oocyte issue in the cohort (30). Another aspect of the cohort is the presence of excess embryos for freezing and whether transfer was at the cleavage (31) or blastocyst stage (32,33). Availability of excess embryos was associated with higher IRs even with equivalent embryo grade at transfer.…”

Section: Putative Causes Underlying Rif Oocyte Cohort Effectmentioning

confidence: 97%

Recurrent Implantation Failure: Reality or a Statistical Mirage?: Consensus Statement From the July 1, 2022 Lugano Workshop on Recurrent Implantation Failure

Pirtea

Cedars

Devine

et al. 2023

Obstetrical &Amp; Gynecological Survey

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Despite advancements in assisted reproductive technologies over the past few decades, a 35% failure rate is still observed for unexplained reasons when transferring euploid embryos to an anatomically normal uterus. Recurrent implantation failure (RIF) is defined based on cumulative ART cycles failing; however, there is an absence in consensus on the diagnostic criteria, which leads to the risk of overdiagnosing and overtreating the condition. This consensus statement by the Lugano RIF Workshop aimed to merge variation in the clinical concept and management of RIF, focusing primarily on euploid blastocyst transfers in hormone replacement-primed cycles. The workshop comprised a panel of 27 international experts selected on the basis of overall research activities and publications on the subject. A literature search as conducted for all relevant titles and abstracts published between January 2015 and May 2022 for review. Consensus conclusions were based on the literature search and expert opinions. Consideration of an RIF diagnosis was determined to focus on failure to achieve sustained implantation (defined as a gestational sac identified on ultrasound). Historically, RIF was defined as the failed transfer of >10 embryos; however, today, a common number used is 3, which is also similar to the rate of failure based on a 95% confidence interval. Based on large clinical data sets, approximately 2%–5% of patients pursuing ART treatment may have RIF, and the decline in future implantation rate with each cycle fits more to an exponential delay curve than a linear decrease. The diagnosis of RIF should not be considered based on a single cohort of embryos, but rather on the number of euploid blastocyst transferred adjusted to patient’s age. In the absence of abnormal uterine bleeding and normal uterine size, further evaluation of asymptomatic adenomyosis is not warranted. Testing for biomarkers of endometrial receptivity and the endometrial microbiome have not been validated using RCTs and should not be used. The role of chronic inflammation in RIF remains unclear, but evidence suggests chronic endometritis does not directly play a role in ART outcome as assessed by sustained implantation rate after euploid embryo transfer. Substantial evidence exists that is low progesterone on the day of embryo transfer results in worse ART outcomes, and that IM progesterone may be superior to vaginal progesterone. There are no effective treatments for RIF currently, and immunomodulatory treatments that may be offered including glucocorticoids, IVIG, and GCSF have a lack of comprehensive data. This consensus document finds that RIF is likely present in fewer than 5% of patients undergoing ART and has been overdiagnosed and overtreated without sufficient critical evaluation of the presumed condition. It also highlights areas where future research is needed, both in the pathophysiologic cause of RIF and hypothetical treatment modalities.

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“…Генетичні порушення в сперматозоїдах, зокрема фрагментація ДНК, можуть бути причиною зниження чоловічої фертильності. Важливим питанням є визначення здатності сперми низької якості до нормального запліднення ооцитів і подальшого розвитку ембріонів з високим імплантаційним потенціалом [4,5]. Один із головних критеріїв нормального розвитку ембріона -формування бластоцисти на п'яту добу культивування.…”

Section: вступunclassified

The effect of preparatory therapy with myo-inositol on the outcome of infertility treatment by ART in men with low reproductive function

Feskov¹,

Zhylkova²,

Nesteruk³

et al. 2021

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Research objective: to study the effect of myo-inositol (MI), folic acid (FA) and cyanocobalamin in mono- and complex therapy on the classical fertility rates and the level of DNA fragmentation in sperm in men with low reproductive function, and on the results of the in vitro fertilization (IVF) programs performed in these patients.Materials and methods. A retrospective study of 133 patients aged 32 to 40 years was carried out for the period 2020–2021. All patients were divided into three groups: group 1 – 44 men who took MI, FA and cyanocobalamin daily as monotherapy for 3 months; group 2 – 42 patients who followed a diet to improve spermatogenesis for 3 months; group 3 – 47 men, for whom complex therapy was applied for 3 months: MI, FA, cyanocobalamin and diet.Results. The increase of sperm concentration in ejaculate, improvement of progressively motility of spermatozoa, and increase of the percent of spermatozoa with normal morphology in men with failures of reproductive function after the complex preparatory therapy are defined. The preparatory therapy for men with MI in preparation for IVF helps to improve the quality of embryos and increase the pregnancy rates in couples with male infertility due to the assisted reproductive technologies. The positive effect of preparatory complex therapy in patients with poor spermatogenesis on the blastocyst formation rates in IVF programs is shown.Conclusions. The positive effect of MI on the normal functioning of the reproductive system in men has been proven. The increase pregnancy rates in the IVF program after preparatory treatment of men with MI can be explained by its positive effect on reducing the level of DNA fragmentation of sperm.

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Predictive value of the number of frozen blastocysts in live birth rates of the transferred fresh embryos

Cited by 8 publications

References 27 publications

Retrospective analysis of GnRH-a prolonged protocol for in vitro fertilization in 18,272 cycles in China

Retrospective analysis of GnRH-a prolonged protocol for in vitro fertilization in 18,272 cycles in China

Recurrent Implantation Failure: Reality or a Statistical Mirage?: Consensus Statement From the July 1, 2022 Lugano Workshop on Recurrent Implantation Failure

The effect of preparatory therapy with myo-inositol on the outcome of infertility treatment by ART in men with low reproductive function

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