Effect of intrauterine injection of human chorionic gonadotropin before fresh embryo transfer on IVF and ICSI outcomes: a meta-analysis

Purpose

This analysis was performed to evaluate the effects of intrauterine injection of human chorionic gonadotropin (hCG) before fresh embryo transfer (ET) on the outcomes of in vitro fertilization and intracytoplasmic sperm injection.

Methods

Randomized controlled trials (RCTs) were identified by searching electronic databases. The outcomes of live birth, clinical pregnancy, implantation, biochemical pregnancy, ongoing pregnancy, ectopic pregnancy, and miscarriage between groups with and without hCG injections were analyzed. Summary measures were reported as risk ratios (RR) with 95% confidence intervals.

Results

Six RCTs on fresh embryo transfer (ET) were included in the meta-analysis. A total of 2759 women undergoing fresh ET were enrolled (hCG group n?=?1429; control group n?=?1330). Intrauterine injection of hCG significantly increased rates of biochemical pregnancy (RR 1.61) and ongoing pregnancy (RR 1.58) compared to controls. However, there were no significant differences in clinical pregnancy (RR 1.11), implantation (RR 1.17), miscarriage (RR 0.91), ectopic (RR 1.65) or live birth rates (RR 1.13) between the hCG group and control group.

Conclusion

The current evidence for intrauterine injection of hCG before fresh ET does not support its use in an assisted reproduction cycle.

     

Laparoscopic ovarian drilling versus GnRH antagonist combined with cabergoline as a prophylaxis against the re-development of ovarian hyperstimulation syndrome

Objective: The aim of this work was to investigate the value of laparoscopic ovarian drilling (LOD) compared with GnRH antagonist flexible protocol combined with cabergoline (Cb), as a prophylaxis against the re-development of ovarian hyperstimulation syndrome (OHSS) in women with clomiphene citrate-resistant polycystic ovary disease (CCR-PCOD) who had severe OHSS before in a previous ICSI cycle.

Study design: It is a prospective controlled study, where 250 CCR-PCOD women (n?=?250) with a history of severe OHSS before, had been recruited for the study. LOD had been performed for 120 (n?=?120) of the recruited women before ovarian induction, and considered as group A. GnRH antagonist (Cetrotide 0.25?mg) was added when a leading follicle reaches 14–16?mm combined with oral Cb in a dose 0.5?mg a day before hCG, and for 8?d for another 130 (n?=?130) women, and considered as group B. Pregnancy was diagnosed with BhCG level ≥25?IU/L,?±?14?d after embryo transfer, followed with transvaginal ultrasound scanning (TVS) 2 weeks later to confirm intra-uterine pregnancy (IUP). Women were followed up weekly for 3?months for the possible development of any signs and symptoms of OHSS.

Results: None of the participants in group A developed severe OHSS, and only six women (5%) developed mild to moderate OHSS. The incidence of severe OHSS was significantly higher (n?=?3, 15%) in group B compared with group A (p?n?=?17, 13.3%) women in group B developed mild to moderate OHSS. The probability of developing severe OHSS was also significantly higher in group B as well (p?=?.031). Pregnancy rate (PR) was significantly higher in group A more than group B (67% versus 39%, respectively), and all were single intrauterine pregnancies (IUP) and all developed after fresh embryo transfer (ET), compared with frozen embryo transfer (FET) which was performed in 42 cases in group B after postponing ET due to significantly severe OHSS developed.

Conclusion: LOD could be considered a good prophylactic measure against OHSS, in addition to improving the total outcome of IVF cycles in women with CCR-PCOS.     

The impact of single embryo transfer policy on pregnancy outcomes after legislative change

Abstract

We evaluated the effect of mandatory single embryo transfer (SET) on live birth rates and pregnancy outcomes in Turkey. A retrospective study was conducted in Zekai Tahir Burak Women’s Health Education and Research Hospital. Four hundred and four patients undergoing intracytoplasmic sperm injection (ICSI) cycles were included in the study. In Turkey, the number of embryos to be transferred in an assisted cycle was limited to three under normal circumstances until 6 March 2010. After that, new legislation was introduced to promote the application of SET. Outcomes were compared in periods of 1 year before and after the new law. We compared pregnancy outcomes of all assisted reproductive cycles in SET cycles (group 1: n?=?281) with double embryo transfer (DET) cycles (group 2: n?=?123). There were significant differences in oocyte number, multiple pregnancy, gestational age, birth weight and perinatal fetal morbidity between the groups (p?=?0.023, 0.001, 0.001, 0.001, 0.001, respectively). But there were no differences in age, baseline FSH, infertility period, stimulation protocol, stimulation day, gonadotrophin dose, clinical pregnancy rate, abortion rate, live birth rate and cesarean rate (p?>?0.05). These results suggest that under the new legislation multiple pregnancy rates and perinatal complications are significantly reduced without causing a significant decline in the pregnancy rates.     

宫腔灌注绒毛膜促性腺激素对反复着床失败后冻融胚胎移植妊娠结局的作用

目的:探讨胚胎反复着床失败(RIF)后冻融胚胎移植(FET)时行宫腔内灌注基因重组人绒毛膜促性腺激素(rh CG)对妊娠结局的影响。方法:选择既往胚胎RIF再次行FET的208个周期的患者资料进行回顾性分析。将其中FET日宫腔内灌注rh CG为研究组,另按1∶1选择匹配(年龄、既往ET失败次数、不孕类型)对照组。分析比较着床率、自然流产率、生化妊娠率、临床妊娠率、多胎妊娠率。结果:研究组着床率(22.92%)、生化妊娠率(5.77%)、自然流产率(17.78%)均略高于对照组(分别为16.88%、1.92%、16.13%),多胎妊娠率略低于对照组(15.56%vs 19.35%),但差异均无统计学意义(P0.05)。研究组和对照组均未观察到异位妊娠病例,研究组临床妊娠率显著高于对照组(43.27%vs 29.82%),差异有统计学意义(P0.05)。结论:FET日行宫腔内灌注rh CG可以提高RIF患者的临床妊娠率。     

Does luteal phase support by human chorionic gonadotropin improve pregnancy outcomes in frozen-thawed embryo transfer cycles?

Objective

The present study was aimed to investigation the effect of human chorionic gonadotropin (hCG) administration on the implantation and pregnancy outcomes in the frozen-thawed embryo transfer (FET) cycles.

全胚冷冻再行解冻胚胎移植周期的临床结局分析

目的:探讨新鲜移植周期与冻融胚胎移植(FET)周期妊娠结局的差异。方法:回顾性分析本中心刺激周期行新鲜胚移植(190例)和全部胚胎冷冻后再行FET(97例)周期的临床妊娠率、种植率以及流产率。结果:190例刺激周期新鲜胚胎种植后的妊娠率、种植率、流产率分别为47.4%(90/190)、30.2%(103/341)、10.0%(9/90),97例全部胚胎冷冻后行FET后的妊娠率、种植率、流产率分别为60.8%(59/97)、47.0%(86/183)、10.2%(6/59),组间妊娠率与种植率均有统计学差异(P<0.05),流产率无统计学差异(P>0.05)。结论:对于有OHSS风险等不适宜进行新鲜胚胎移植的患者,选择全部胚胎冷冻并择期进行FET,并不降低胚胎种植率和临床妊娠率,从而预防迟发型OHSS的发生,可获得更为理想的妊娠结局。     

The addition of single dose GnRH agonist to luteal phase support in artificial cycle frozen embryo transfer: a randomized clinical trial

This prospective randomized clinical trial (RCT) was to evaluate the effect of single-dose gonadotrophin-releasing hormone agonist (GnRHa) in artificial cycle frozen-embryo transfer (AC-FET). A total of 868 FET cycles were included and randomized into two groups: Group A (n?=?434) received GnRHa 0.1?mg subcutaneous injection on day 3 after embryo transfer (ET); Group B (n?=?434) did not receive GnRHa. The demographic characteristics, primary endpoint (implantation rate) and secondary endpoints (chemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate) were compared between two groups and subgroups (aged <35?years and 35-37?years). There were no significant differences in terms of the rates of implantation, clinical pregnancy, ongoing pregnancy, and miscarriage between two groups. While, the subgroups analysis showed the implantation rate was significantly increased in advanced age women (35–37?years) in GnRHa group compared with control group (45.3% vs. 27.8%, p?=?.03). In conclusion, single dose of GnRHa (0.1?mg triptorelin acetate) supplementation 3?days after ET in AC-FET cycles did not show significant benefit on pregnancy outcomes as a whole. However, in ageing women subgroup, the implantation rate was increasing by adding up GnRHa in peri-implantation periods, and this tendency needs to be further demonstrated by RCT with larger sample size.     

薄型子宫内膜新鲜胚胎和冻融胚胎移植妊娠结局比较

目的探讨在薄型子宫内膜患者中新鲜胚胎移植与冻融胚胎移植(FET)妊娠结局的差异。方法回顾性分析接受体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)治疗采用长方案胚胎移植h CG注射日与冻融周期胚胎移植内膜转化日的内膜厚度≤7 mm的患者共592个周期的临床资料。将移植周期按胚胎是否冻融分为新鲜胚胎移植组(n=173)和FET组(n=419)。比较组间的胚胎种植率、临床妊娠率、流产率、多胎率和异位妊娠率有无差异。结果新鲜胚胎移植组患者平均移植胚胎(2.1±0.4)枚,与FET组患者平均移植胚胎(2.1±0.5)枚比较,组间有统计学差异(P0.05);按照移植胚胎数分为3个亚组,新鲜胚胎移植组1枚胚胎者,妊娠率为7.7%,2枚者为30.2%,3枚者为23.8%;FET组1枚胚胎者15.6%,2枚者为34.9%,3枚者为41.6%,新鲜胚胎移植组与FET组间差异均无统计学意义(P0.05)。组间着床率、流产率、异位妊娠率等结果也均无统计学差异(P0.05)。移植3枚胚胎新鲜组多胎率(80.0%)高于FET组(29.7%)(P0.05)。新鲜胚胎移植组多胎率3个亚组间有统计学差异(P0.05),FET组妊娠率和流产率3个亚组间均有统计学差异(P0.05)。将移植胚胎数作为协变量,纳入Logistics回归模型对结果变量进行分析,说明周期类型与临床妊娠率间无显著相关性(OR=0.726,95%CI=0.504~1.104)。结论子宫内膜厚度≤7 mm的薄型内膜患者新鲜胚胎移植和FET妊娠结局相似,选择新鲜周期移植不影响妊娠结局并可缩短治疗周期,降低总费用。     

Effect of empiric intravenous intralipid therapy on pregnancy outcome in women with unexplained recurrent implantation failure undergoing intracytoplasmic sperm injection-embryo transfer cycle: a randomized controlled trial

Abstract

To evaluate the effect of empiric intralipid infusion therapy on pregnancy outcomes for patients with unexplained recurrent implantation failure (RIF) undergoing intracytoplasmic sperm injection (ICSI). A total of 142 patients with a history of unexplained RIF (3 or more cycles) were included in this randomized controlled trial. Patients were randomized into two groups, study group (n?=?71) and control group (n?=?71). The study group received intralipid 20% infusion on the day of embryo transfer (ET) and a second dose on the day of pregnancy test. The clinical pregnancy rate in the study group was 36.6% (n?=?26) compared to 28.2% (n?=?20) in the control group (OR 1.47, CI 0.72–2.98, p?=?.282). The live birth rate in the study group was 18.3% (n?=?13) and 14.1% (n?=?10) in the control group (OR 1.37, CI 0.55–3.36, p=.49). No side effects of intralipid therapy were reported in the study period. There was improvement in the pregnancy rate among women with unexplained RIF who received empiric intralipid infusion therapy; however, this improvement did not reach statistical significance.     

Efficacy of cryopreservation of embryos generated by intracytoplasmic sperm injection with spermatozoa from frozen testicular tissue

Purpose

To evaluate the viability of frozen embryos generated by intracytoplasmic sperm injection (ICSI) with frozen testicular spermatozoa.

Methods

A total of 68 fresh embryo transfer (ET) cycles and 85 subsequent frozen-thawed ET (FET) cycles were grouped according to the source of spermatozoa: fresh testicular spermatozoa (TESE) or frozen-thawed testicular spermatozoa (t-TESE).

Results

There were no significant differences in the age of female patients, number of oocytes, or fertilization rates in fresh ET cycles with TESE (TESE-fresh ET) versus t-TESE (t-TESE-fresh ET). The rate of embryo survival after thawing (95.7 % vs. 94.0 %) was similar in frozen ET cycles (FET) with TESE (TESE-FET) and with t-TESE (t-TESE-FET). While there were significant differences in the proportion of good quality embryos, no statistical differences were found in the pregnancy or clinical abortion rates between the two groups. Moreover, delivery rates were not significantly different.

Conclusions

Although the proportion of good quality embryos was affected by cryopreservation of testicular tissue, embryo survival rate was not. As well, subsequent pregnancy could be achieved successfully via t-TESE-FET cycles. Therefore, FET is not affected by the cryopreservation of testicular tissue, and avoids further oocyte retrieval and TESE procedures.     

The impact of unilateral salpingectomy on antral follicle count and ovarian response in ICSI cycles: comparison of contralateral side

Objective: To determine the impact of salpingectomy on the ovarian reserve. Comparisons are made with the contralateral side in patients with unilateral salpingectomy undergoing intracytoplasmic sperm injection (ICSI) cycles.

Study design: Patients under 40 with unilateral salpingectomy and without history of ovarian surgery were selected for the multicentre retrospective study. Women with bilateral salpingectomy and history of endometriosis were excluded from the study. Antral follicle count, controlled ovarian hyperstimulation (COH) parameters and number of collected oocytes were the main outcome measures of the study.

Results: A total of 56 patients were eligible for this study. The mean age of the patients was 31.6?±?4.7 years. The reasons for the salpingectomy were hydrosalpinx (39.3%, n?=?22) and ruptured ectopic pregnancy (60.7%, n?=?34). The ongoing pregnancy rate per embryo transfer was 30.6%. There was no statistically significant difference between the operated and non-operated sides in antral follicle count (AFC), follicles ≥?17?mm and 10–17?mm on day of human chorionic gonadotrophin (hCG), or number of aspirated oocytes. In the subgroup analysis, AFC, number of growing follicles on day of hCG and number of collected oocytes were comparable between the ectopic pregnancy group and hydrosalpinx group.

Conclusion: The study suggests that salpingectomy is not associated with detrimental effects on AFC and ovarian response.     

Should intrauterine human chorionic gonadotropin infusions ever be used prior to embryo transfer?

Purpose

The aim of this study was to explore the factors that influence the outcome of intrauterine human chorionic gonadotropin (hCG) infusion at the time of embryo transfer (ET), in particular, the effect of hCG infusions on fresh and frozen embryo transfers (FETs) and whether prior recurrent implantation failure (RIF) impacts upon outcomes.

Method

This was a case-control study based on a standardized database from a multi-site in vitro fertilization clinic. The analysis contains 458 cases and 749 matched controls, with an intervention group of those given intrauterine hCG prior to ET and a control group of patients receiving no hCG infusion. Outcomes were defined as clinical pregnancy and live birth rates. Two analyses were performed. The first separated FETs (cases n = 224, controls n = 325) and fresh ETs (cases n = 234, controls n = 424), with outcomes calculated in each group. The second analysis divided patients into those with RIF (cases n = 149, controls n = 200) and those without (cases n = 309, controls n = 549).

Results

Results in fresh ETs demonstrated a 5.8% reduction (adjusted odds ratio (AOR) = 0.60, p = 0.041) in clinical pregnancy rates with the use of intrauterine hCG. In those without defined RIF, clinical pregnancy rates were reduced by 8.1% (AOR = 0.61, p = 0.023) and live birth rates by 7.2% (AOR = 0.56, p = 0.32) with intrauterine hCG use. There were no significant differences in outcomes in FETs and in the RIF cohort.

Conclusion

Intrauterine hCG at the time of ET not only seems to have no benefit, but rather a negative effect in fresh ETs and those without RIF.

     

Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome: a prospective,controlled, randomized trial

Object?ve: The aim of the study is to investigate the effect of myo-inositol (MYO) on pregnancy rates of patients diagnosed with polycystic ovary syndrome (PCOS) who undergone controlled ovulation induction and intrauterine insemination (IUI).

Methods: A total of 196 infertile patients diagnosed with PCOS and admitted to Dokuz Eylul University Faculty of Medicine were included in the study between March 2013 and May 2016. The patients in group 1 (n?=?98) were given 4?g MYO and 400?μg folic acid before and during ovulation induction. The patients undergone controlled ovarian hyperstimulation (COH) with recombinant FSH and IUI. The patients in group 2 (n?=?98), were given recombinant FSH directly and 400?μg folic acid. The primary outcome measure of this study was the clinical pregnancy rate.

Results: In group 1, 9 patients conceived spontaneous pregnancy. During COH?+?IUI treatment three cycles were canceled in group 1 and 8 cycles in group 2. Total rFSH dose and cycle duration were significantly lower and clinical pregnancy rates were higher in group 1. The pregnancy rate for group 1 was %18.6 and for group 2 was %12.2.

Conclus?ons: This study shows that MYO should be considered in the treatment of infertile PCOS patients. MYO administration increases clinical pregnancy rates, lowers total rFSH dose and the duration of the ovulation induction.     

Concomitant use of FSH and low-dose recombinant hCG during the late follicular phase versus conventional controlled ovarian stimulation for intracytoplasmic sperm injection cycles

The objective of this study was to investigate the effects of low-dose hCG supplementation on ICSI outcomes and controlled ovarian stimulation (COS) cost. Three hundred and thirty patients undergoing ICSI were split into groups according to the COS protocol: (i) control group (n?=?178), including patients undergoing conventional COS treatment; and (ii) low-dose hCG group (n?=?152), including patients undergoing COS with low-dose hCG supplementation. Lower mean total doses of FSH administered and higher mean oestradiol level and mature oocyte rates were observed in the low-dose hCG group. A significantly higher fertilization rate, high-quality embryo rate and blastocyst formation rate were observed in the low-dose hCG group as compared to the control group. The miscarriage rate was significantly higher in the control group compared to the low-dose hCG group. A significantly lower incidence of OHSS was observed in the low-dose hCG group. There was also a significantly lower gonadotropin cost in the low-dose hCG group as compared to the control group ($1235.0?±?239.0×$1763.0?±?405.3, p?相似文献   

Serum estradiol and progesterone in the mid-luteal phase predict clinical pregnancy outcome in IVF/ICSI cycles

Abstract

In this prospective study, we tested the hypothesis if E2 and P serum levels significantly differ during the luteal phase following in vitro-fertilization/intracytoplasmic sperm injection (IVF/ICSI) therapy in conception (CC) versus non-conception (NC) cycles, and their potential in the prediction of pregnancy at the earliest point in time. Serum was sampled from the day of embryo transfer (ET) and throughout the luteal phase until ET?+?14 from patients consecutively enrolling for IVF/ICSI therapy. The luteal phase was supported by vaginal P suppositories only, clinical pregnancies were detected by ultrasound and followed up until the 20th week. Overall pregnancy rate was 30.9% constituting the two study groups of CC (n?=?22) and NC cycles (n?=?49). Significantly, higher E2 (3326?±?804 versus 1072?±?233?pmol/l, p?=?0.014) and P (244?±?68 versus 73?±?10?nmol/l, p?=?0.023) were present in CC versus NC from as early as ET?+?7. In the CC group, patients with ongoing pregnancies (CC-OG) as compared with miscarriages (CC-MC) had significantly higher E2 and P from ET?+?7, predicting ongoing pregnancy in receiver operator characteristics analysis.     

Preimplantation genetic testing and frozen embryo transfer synergistically decrease very pre-term birth in patients undergoing in vitro fertilization with elective single embryo transfer

Purpose

To study the effects of frozen embryo transfer (FET) and FET post-PGT on pre-term and very pre-term births in patients undergoing in vitro fertilization (IVF).

Materials and methods

A study was conducted using the SART National Summary Report from 2014 to 2017. Cycle inclusion criteria were eSET, fresh embryo transfers (ET), frozen embryo transfers without PGT (FET), and frozen embryo transfers with PGT (FET/PGT). Exclusion criteria were use of gestational carriers and donor eggs. Pregnancy outcomes included live births and gestational age at birth.

Results

A total of 161,550 eSETs were analyzed for the effect of FET and FET/PGT on IVF outcome and pre-term births including 43,618 ET, 58,812 FET, and 59,120 FET/PGT cycles. Live birth rates in patients with FET/PGT were significantly higher than those in ET (52.9% vs 46.4%, P < 0.0001) and FET (52.9% vs 43.1%, P < 0.0001). Patients with FET had a significantly lower live birth rate compared with that of ET (43.1% vs 46.4%, P < 0.0001). Both FET and FET/PGT significantly decreased total pre-term births compared with ET (10.8% and 10.5% vs 11.5%, P < 0.05 and < 0.001). FET/PGT significantly reduced very pre-term births when compared with ET and FET (1.5% vs 2.0%, P < 0.0001 and 1.5% vs 1.9%, P = 0.0002).

Conclusion

This study demonstrates that PGT significantly improves IVF outcome. Moreover, patients undergoing FET/PGT had significantly decreased total pre-term births. More importantly, patients with FET/PGT had significantly lower very pre-term births.

     

Progesterone change in the late follicular phase affects pregnancy rates both agonist and antagonist protocols in normoresponders: a case-controlled study in ICSI cycles

Objective: The aim of the presented study is to investigate the impact of progesterone change in the late follicular phase on the pregnancy rates of both agonist and antagonist protocols in normoresponders.

Study design: A total of 201 normoresponder patients, who underwent embryo transfer were consecutively selected. 118 patients were stimulated using a long luteal GnRH agonist protocol and 83 using a flexible antagonist protocol. The level of change in late follicular phase progesterone was calculated according to the progesterone levels on the hCG day and pre-hCG day (1 or 2 days prior to hCG day) measurement.

Results: Clinical pregnancy rates were comparable between long luteal and antagonist group (35.6 and 41%, respectively). The incidence of progesterone elevation on the hCG day was 11% in long luteal and 18% in antagonist group (p?=?0.16). In pregnant cycles, p levels both on the hCG day and pre-hCG day measurement were significantly higher in antagonist than agonist cycles (p?=?0.029, p?=?0.038, respectively). The change of p level was statistically significant in non-pregnant cycles both for the agonist (-0.17?±?0.07; 95% CI:??0.29 to??0.37) and antagonist groups (?0.18?±?0.07; 95%CI:??0.31 to??0.04).

Conclusions: Late follicular phase progesterone levels were stable during the cycles of pregnant patients irrespective of the protocols and were shown to be higher in pregnant patients in antagonist cycles when compared to agonist cycles.     

Evaluation of granulocyte colony-stimulating factor on the treatment of thin endometrium during frozen-thawed embryo transfer cycles: a retrospective cohort study

Abstract

The aim of this study was to evaluate the effect of granulocyte colony-stimulating factor (G-CSF) on thin endometrium (≤7?mm) in women undergoing frozen-thawed embryo transfer (FET). This retrospective cohort study includes 271 infertile patients with thin endometrium. 117 patients who received intrauterine perfusion of G-CSF before the day of administration of progesterone were defined as G-CSF group, whereas 154 patients who refused to use G-CSF treatment were defined as control group. In the G-CSF group, significantly higher endometrial thickness was observed after G-CSF perfusion (p?<?.001). When we divided the G-CSF group into two subgroups according to whether they conceived, the endometrial thickness increased from 6.02?±?0.92?mm to 6.98?±?1.20?mm in the conception group (p?<?.001) and from 6.21?±?0.96?mm to 6.87?±?1.16?mm in the non-conception group (p?<?.001). However, there were no significant differences between the two subgroups in respect to the endometrial thickness both before and after G-CSF perfusion. The implantation rate, hCG positive rate and clinical pregnancy rate were similar between G-CSF group and control group. Thus, our study fails to demonstrate that G-CSF has the potential to improve pregnancy outcome but has the potential to increase endometrial thickness of the women with thin endometrium in FET cycles.     

Association between anti-chlamydial immunity and IVF outcome

Abstract

Background: Elevated antibody titers to Chlamydia trachomatis are detected in up to 70% of women with tubal factor infertility (TFI). In order to evaluate the influence of past chlamydial infection on the results of IVF treatment, a prospective cohort study was performed.

Materials and methods: A total of 242 women with TFI were enrolled in the study. Serum samples (n?=?242) and follicular fluid (n?=?197) were analyzed using enzyme-linked immunosorbent assay for anti-C. trachomatis IgG, IgA, IgM and anti-chlamydial heat shock protein 60?kDa IgG.

Results: “Poor response” to ovarian stimulation was two times more frequent in seropositive subjects (22.9% versus 13.3%, p?=?0.039). Seropositive and seronegative women had similar IVF outcomes, expressed by clinical pregnancy (20.5% versus 25.0%), life birth (13.1% versus 20.0%) and miscarriage rates (36.0% versus 16.7%, p?=?0.092). Incidence of missed abortion after IVF was higher in women with previous exposure to C. trachomatis (28.0%) as compared to those without antibodies (3.3%), p?=?0.018.

Conclusions: Anti-chlamydial antibody detection is not related to oocyte maturity, embryo quality, pregnancy and life birth rates. However, past chlamydial infection in TFI patients is associated with decreased IVF success: “poor response” to ovarian stimulation and missed abortion rate.     

The role of VEGF and its receptors in the etiology of early pregnancy loss

Objective: This study aimed to investigate the role of vascular endothelial growth factor (VEGF) and its receptors (VEGFR1, VEGFR2) in maternal and embryonic tissues in the etiology of early pregnancy loss.

Methods: Immunohistochemistry was used to analyze the expression of VEGF and its receptors in placental and decidual tissues of 80 women with spontaneous incomplete abortion (n?=?20), missed abortion (n?=?20), blighted ovum (n?=?20) and from early terminated pregnancies (n?=?20).

Results: Compared with the controls, all study groups showed weaker VEGF immunoreactivity in cytotrophoblasts and syncytiotrophoblasts of placental villi and endothelial cells of decidua (p?=?0.002, p?=?0.003, p?p?p?p?Conclusion: These results suggest that decreased expression of VEGFR1 in decidua and weaker VEGF and VEGFR2 expression in placental villi and decidua may be associated with early pregnancy loss.