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Fazilet Kübra Boynukalin Remzi Abalı Meral Gultomruk Zalihe Yarkiner Aylin Mutlu Mustafa Bahceci 《Reproductive biomedicine online》2021,42(6):1187-1195
Research questionWhich parameters affect the likelihood of miscarriage after single euploid frozen–thawed blastocyst transfer (FBT)?DesignIn this retrospective study, clinical and laboratory data from 1051 single euploid FBTs were evaluated. Exclusion criteria were endocrine or systemic pathologies, uterine anomalies or pathologies, unilateral or bilateral hydrosalpinx, karyotypic abnormalities (either maternal or paternal) or thrombophilia. Patients were divided into two groups according to pregnancy outcome: live birth and miscarriage.ResultsBody mass index (BMI) (25.98 ± 0.5 versus 24.36 ± 0.21, P = 0.019), duration of infertility (6.62 ± 0.54 versus 4.92 ± 0.18, P = 0.006) and number of previous miscarriages (1.36 ± 0.13 versus 0.79 ± 0.05, P < 0.001) were significantly higher in the miscarriage group (n = 100) than in the live birth group (n = 589). Although the trophectoderm and inner cell mass (ICM) percentage scores were not statistically different among the miscarriage and live birth groups, the percentage of day-6 biopsied embryos was significantly higher in the miscarriage group. Binary logistic regression analysis revealed that BMI (OR 1.083, 95% CI 1.013 to 1.158, P = 0.02) and number of previous miscarriages (OR 1.279, 95% CI 1.013 to 1.158, P = 0.038) were independent factors for miscarriage. Patients with elevated BMI and a higher number of miscarriages were at increased risk of miscarriage.ConclusionAfter a single euploid FBT, BMI and number of previous miscarriages are predictors of miscarriage. Lifestyle interventions before FBT may decrease miscarriage rates. 相似文献
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Hizkiyahu Ranit Suarthana Eva Kadour Peero Einav Feferkorn Ido Buckett William 《Journal of assisted reproduction and genetics》2022,39(5):1081-1085
Journal of Assisted Reproduction and Genetics - To assess the effect of increasing estrogen doses during hormone therapy frozen embryo transfer (HT-FET) cycles on endometrial thickness and success... 相似文献
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Manuel Alvarez Francisca Martínez Filipe M Bourroul Nikolaos P Polyzos Miquel Solé Mónica Parriego Ignacio Rodríguez Pedro N Barri Buenaventura Coroleu 《Reproductive biomedicine online》2019,38(6):940-946
Research questionThe aim of this study was to investigate the relationship between the different manoeuvres employed or degrees of difficulty during embryo transfer and live birth rate (LBR) in frozen euploid (blastocyst) embryo transfer (FEET).DesignA retrospective, observational study of women undergoing FEET was performed. If the catheter encountered any resistance in its passage through the cervix, a stepwise approach was used. Easy embryo transfer was defined as a direct embryo transfer or use of the outer sheath of the catheter. Difficult embryo transfer was defined as when the process required the use of a Wallace Malleable Stylet (Smiths Medical International Ltd., UK) without or with additional instrumentation such as a tenaculum or uterine sound.ResultsThe analysis involved 370 FEET. LBR was significantly lower in difficult FEET procedures compared with easy ones (54.5% versus 40.5%, P = 0.026) but significance was lost after adjustment for confounders. Use of the outer sheath use did not affect LBR. Although LBR was significantly lower when the stylet, without or with a tenaculum, was required (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.34–0.93; P < 0.05), no statistically significant reduction was observed after adjustment for confounders (OR 0.81, 95% CI 0.45–1.47).ConclusionsNo significant reduction in LBR was observed after adjustment for confounders between difficult and easy FEET, or when use of stylet without or with a tenaculum was required for embryo transfer. The lack of significance may be due to factors such as the sample size or the use of array comparative genomic hybridization analysis. Further studies are needed to confirm these results. 相似文献
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The main aim was to investigate whether or not day-3 embryo grade could predict day-5 blastocyst transfer outcomes in patients with good prognosis. This study included 233 elective single blastocyst transfers (eSBT) by D5 selection with conventional morphology (CM) and 121 elective single blastocyst transfers (eSBT) by D5 selection with time-lapse monitoring system (TL) from October 2016 to October 2017. All the patients were submitted to controlled ovarian stimulation (COS) with long-term protocol and transferred for the first time. The main outcome measures were clinical pregnancy rates (CPR) and ongoing pregnancy (OPR). Our results suggested that CPR (58.04 versus 57.89 versus 55.56%; p?=?.957) and OPR (66.07 versus 65.79 versus 64.44%; p?=?.981) were comparable among day 3 grades I, grades II, and grades III groups. We also observed that the TL group showed a slightly better CPR and OPR than CM group (p?>?.05). Our findings suggested that good or poor embryos at day-3 were not predictive of the outcomes of good-quality blastocysts in a good-prognosis population. It needed to be emphasized that time-lapse monitoring might be useful for elective single blastocyst transfer. 相似文献
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Katarzyna Litwicka Cecilia Mencacci Cristiana Arrivi Maria Teresa Varricchio Alina Caragia Maria Giulia Minasi Ermanno Greco 《Journal of assisted reproduction and genetics》2018,35(3):449-455
Purpose
The aim of the present study was to evaluate whether in a modified natural cycle (modified-NC) for a frozen-thawed single euploid blastocyst transfer, a critical LH value, above which human chorionic gonadotropin (hCG) administration should be avoided, may be defined.Methods
One hundred and sixty-seven patients underwent modified natural cycle in order to transfer a single frozen-thawed euploid blastocyst. All embryos were obtained by intracytoplasmic sperm injection and were biopsied at the blastocyst stage and analyzed by means of array comparative genomic hybridization (aCGH). Ovulation was induced using 10.000 IU hCG when the mean follicle diameter was at least of 17 mm, independently from LH values. The primary end points were the hCG-positive test and clinical pregnancy. The interim analysis showed that LH value ≥?13 mIU/ml on the day of hCG injection may negatively influence the clinical results, suggesting that in this condition, it should be advisable waiting for spontaneous ovulation.Results
Among patients who received hCG for ovulation induction, the hCG-positive test and clinical pregnancy rates in modified-NC were significantly lower in cycles with LH?≥?13 mIU/ml in respect to those with LH?<?13 mIU/ml (45.4 vs 73.3 and 36.4 vs 65.9%, in LH?≥?13 and LH?<?13 groups, respectively). In patients with LH value ≥?13 mIU/ml, hCG administration led to significantly lower rates of hCG-positive test (45.4 vs 74.5% in hCG administration and spontaneous ovulation groups, respectively) and clinical pregnancy (36.4 vs 64.7% in hCG administration and spontaneous ovulation groups, respectively). The baseline patient characteristics were comparable in all groups.Conclusions
The findings of this study highlight that LH elevation ≥?13 mIU/ml prior to hCG administration may negatively affect clinical pregnancy rates in modified-NC for single euploid blastocyst transfer. The LH determination should be routinely performed during follicular monitoring. In the presence of LH level ≥?13 mIU/ml, hCG administration should be avoided, and the embryo transfer should be planned only after spontaneous follicular rupture.8.
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The timing of a mock embryo transfer does not affect in vitro fertilization implantation or pregnancy rates. Performing a mock embryo transfer at the time of oocyte retrieval, 3 to 5 days before embryo transfer, does not have a deleterious effect on the endometrium. 相似文献
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Singleton pregnancies following in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are associated with increased risks of abnormal placentation, pre-eclampsia and preterm birth. These risks might partly be a consequence of the number of transferred embryos. In this commentary we summarize the results of three observational studies and one randomized study with 1052 pregnancies following single embryo transfer (SET). An increased age- and parity-adjusted risk of gestational hypertension and placenta previa in the SET pregnancies as compared to the spontaneously conceiving controls was reported in one of the studies. Preterm births occurred in 6-12% of SET pregnancies and 4-6% of the newborns were of low birth weight (LBW). The frequency of preterm birth and LBW after SET were considered either lower than or similar to those after double embryo transfer (DET) but higher than after spontaneous conception. Comparison of SET and DET pregnancies thus shows heterogeneous results. Still, it seems that not even a transfer of one good-quality embryo at a time diminishes all the previously identified increased risks of certain obstetric complications and preterm births in singleton pregnancies following IVF or ICSI. 相似文献
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Peter Drakakis Dimitris Loutradis Eleftheria Vomvolaki Erasmia Kiapekou Elli Anagnostou 《Gynecological endocrinology》2013,29(11):645-652
Objective. To evaluate the effect of estradiol addition to progesterone supplementation during the luteal phase on pregnancy and implantation rates in patients undergoing in vitro fertilization/intracytoplasmic sperm injection–embryo transfer (IVF/ICSI-ET) cycles.Methods. In this prospective, randomized study, carried out in an IVF unit of a university hospital, we studied patients who were undergoing IVF/ICSI with controlled ovarian hyperstimulation using a gonadotropin-releasing hormone agonist/human recombinant gonadotropin long protocol. The main outcome measures were the pregnancy and implantation rates measured in the two groups.Results. Our results suggest higher pregnancy and implantation rates in IVF/ICSI-ET cycles that were supplemented with estradiol in the luteal phase.Conclusions. Estradiol supplementation during the luteal phase in women undergoing IVF/ICSI-ET has a beneficial effect on the outcome without (at least, as seems from this study) having any adverse effects. 相似文献
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Orvieto R Saar-Ryss B Morgante G Gemer O Anteby EY Meltcer S 《Fertility and sterility》2011,(5):1842-1844
In a study on the influence of salpingectomy on the same patient ipsilateral ovarian response, 15 patients who were admitted to our department with the diagnosis of uni- or bilateral hydrosalpinges and who were successfully treated by laparoscopic salpingectomy were evaluated. The observed significant decrease in the ipsilateral ovarian response after salgingectomy, as reflected by the quantity of developing follicles during controlled ovarian hyperstimulation for IVF, should be presented to patients during the decision-making process, before offering salpingectomy for the treatment of hydrosalpinx. 相似文献
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Keliang Wu Haibin Zhao Hui Liu Mei Li Shuiying Ma Cheng Li Chang Liu Zi-Jiang Chen 《Journal of assisted reproduction and genetics》2014,31(3):275-278
Purpose
To compare the clinical outcomes after day 3 embryo transfer, day 5 single blastocyst transfer (SBT) and frozen-thawed embryo transfer (FET) in high responder patients (>15 retrieved oocytes) undergoing IVF/ICSI treatment.Methods
A retrospective analysis of three embryo transfer strategies for the high responder patients in IVF/ICSI cycles. The 1041 high responder patients diagnosed as primary infertility with more than 15 oocytes retrieved were recruited in Day 3 ET group, 308 patients with more than 15 oocytes retrieved first transferred with one blastocyst in SBT group and 425 patients with more than 15 oocytes retrieved in fresh cycle, first transferred with one frozen-thawed blastocyst were assigned in FET group.Results
In the high responder patients, the clinical pregnancy rate after day 5 SBT was significantly lower than that of day 3 ET (43.18 % VS 57.16 %, p < 0.05). In addition, the clinical pregnant rate and implantation rate of FET cycles were significantly higher than SBT cycles (59.06 % vs. 43.18 % and 64.70 % vs. 47.40 %, p < 0.05). The multiple pregnancy rate in FET cycles was markedly lower than that of day 3 ET (2.35 % VS 34.97 %, p < 0.05).Conclusions
FET was the preferable strategy for the high responder patients in IVF/ICSI cycles to obtain both desirable clinical outcome and lower multiple pregnancy rates. 相似文献16.
Study objective
Frozen-thawed embryo transfer (FET) avoids the nightmare of developing ovarian hyperstimulation syndrome in PCOS patients during IVF. Ideal protocols of Endometrium preparation in PCOS patients are lacking and need further declaration.Design
This was a retrospective study of frozen-thawed ET of PCOS Patients who had previously undergone ICSI with cryopreservation.Materials and methods
We compared the pregnancy outcomes from two separate protocols for endometrial preparation in PCOS patients. Cases had pituitary downregulation prior to hormone replacement (n?=?37 cycles or patients), and patients hormone replacement without prior downregulation (n?=?58 cycles or patients controls).Main outcome measures
Chemical pregnancy rate for downregulation was 56.8% and that of the hormone replacement rate was 55.2%. The clinical pregnancy rate for downregulation was 51.4% vs 50.0% for hormone replacement with no statistically different.Conclusions
In PCOS patients, GnRH downregulation before artificial hormonal treatment in FET didn’t increase the chemical pregnancy and clinical pregnancy, however, this need to be validated in larger prospective randomized studies. 相似文献17.
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Dimitra Kyrou Human M. Fatemi Biljana Popovic-Todorovic Etienne Van den Abbeel Michel Camus Paul Devroey 《European journal of obstetrics, gynecology, and reproductive biology》2010
Objective
The purpose of this study is to assess the effect of luteal phase supplementation (LPS) on pregnancy rates in human chorionic gonadotropin (hCG)-induced natural frozen–thawed (FET) cycles.Study design
All performed hCG-induced natural FET cycles from January 2006 until August 2007 were retrospectively identified. The study group consisted of 452 cycles: 243 supplemented with progesterone administration (600 mg natural micronized progesterone in three separate doses) and 209 without progesterone. Analysis was limited to cycles where embryos were cryopreserved on day 3. Final oocyte maturation was achieved by hCG when endometrial thickness of ≥7 mm and a follicle of 17 mm were present on ultrasound.Results
No statistically significant differences were observed in ongoing pregnancy rate between the two groups (22% versus 21%, p = 0.8; difference +1%; 95% confidence interval (CI): −6.5 to +8.7). The non-significant effect of the presence or not of luteal support on pregnancy rate was confirmed by logistic regression (odds ratio (OR): 0.9, 95% CI: 0.54–1.47, P = 0.64). A previous pregnancy following fresh embryo transfer (OR: 6.04, 95% CI: 3.63–10.02, P = 0.001) and increased endometrial thickness (OR: 1.25, 95% CI: 1.11–1.41, P = 0.001) significantly affected the achievement of ongoing pregnancy, whereas the association between embryo score and achievement of pregnancy was marginally significant (OR:0.28, 95% CI: 0.08–0.97, P = 0.05).Conclusion
There is no convincing evidence to support the use of LPS in hCG-induced natural FET cycles, since there is no luteal phase defect. Further prospective randomized studies are necessary to confirm these findings. 相似文献19.
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