scholarly journals Efficacy of dual progesterone administration (intramuscular and vaginal) for luteal support in fresh day 3 or day 4 embryo transfer cycles

2020 ◽  
Vol 47 (3) ◽  
pp. 227-232
Author(s):  
Eun Jee Nho ◽  
Yeon Hee Hong ◽  
Ju Hee Park ◽  
Seul Ki Kim ◽  
Jung Ryeol Lee ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Implantation Rate ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Luteal Support ◽  
Vitro Fertilization ◽  
Embryo Score

Objective: The aim of this study was to compare in vitro fertilization outcomes between fresh day 3 or day 4 embryo transfer cycles with dual progesterone (P) administration (intramuscular and vaginal) and cycles with single intramuscular P administration for luteal support.Methods: We selected 124 cycles from 100 women (under age 40 years) who underwent oocyte pick-up (number of trials ≤ 3, 4–14 oocytes obtained) and transfer of two or three day 3 or day 4 embryos at two infertility centers from January 2014 to June 2019. Dual P (intramuscular P [50 mg] daily+vaginal P) was used in 52 cycles and a single intramuscular administration of P (50 mg daily) was used in 72 cycles.Results: Women’s age, infertility factors, number of oocytes retrieved, number of transferred embryos, and mean embryo score were similar between the dual P group and the single P group. Although the number of trial cycles was significantly higher (1.9 vs. 1.5), and the mean endometrial thickness on the trigger day (10.0 mm vs. 11.0 mm) was significantly lower in the dual P group, the implantation rate, clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate for both day 3 and day 4 transfers were similar between the two groups.Conclusion: In fresh day 3 or day 4 embryo transfer cycles, dual P administration did not demonstrate any clinical advantages. Intramuscular P alone appears to be sufficient for luteal support.

scholarly journals Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Alessio Paffoni ◽  
Marco Reschini ◽  
Valerio Pisaturo ◽  
Cristina Guarneri ◽  
Simone Palini ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Fertilization Failure ◽  
Vitro Fertilization ◽  
Rescue Icsi

Abstract Background Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18–24 h from conventional insemination on oocytes that show no signs of fertilization. This treatment has however been reported to be associated with a low success rate until recent observations that embryos derived from late rescue ICSI may be transferred after cryopreservation in a frozen-thawed cycle with improved results. The aim of the present study was to assess whether frozen embryos deriving from rescue ICSI performed about 24 h after conventional IVF may represent a valuable option for couples experiencing fertilization failure. Methods A systematic review on the efficacy of late rescue ICSI was performed consulting PUBMED and EMBASE. Results Including twenty-two original studies, we showed that clinical pregnancy rate per embryo transfer and implantation rate obtainable with fresh embryo transfers after rescue ICSI are not satisfactory being equal to 10 and 5%, respectively. The transfer of cryopreserved rescue ICSI embryos seems to offer a substantial improvement of success rates, with pregnancy rate per embryo transfer and implantation rate equal to 36 and 18%, respectively. Coupling rescue ICSI with frozen embryo transfer may ameliorate the clinical pregnancy rate for embryo transfer with an Odds Ratio = 4.7 (95% CI:2.6–8.6). Conclusion Results of the present review support the idea that r-ICSI coupled with frozen embryo transfer may overcome most of the technical and biological issues associated with fresh transfer after late r-ICSI, thus possibly representing an efficient procedure for couples experiencing fertilization failure following conventional IVF cycles. Trial registration Prospero registration ID: CRD42021239026.

scholarly journals Estimating the causal effect of embryo transfer day on clinical in vitro fertilization outcomes using propensity score matching

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Han-Chih Hsieh ◽  
Chun-I Lee ◽  
En-Yu Lai ◽  
Jia-Ying Su ◽  
Yi-Ting Huang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Day 5 Transfer

Abstract Background For women undergoing in vitro fertilization (IVF), the clinical benefit of embryo transfer at the blastocyst stage (Day 5) versus cleavage stage (Day 3) remains controversial. The purpose of this study is to compare the implantation rate, clinical pregnancy rate and odds of live birth of Day 3 and Day 5 embryo transfer, and more importantly, to address the issue that patients were chosen to receive either transfer protocol due to their underlying clinical characteristics, i.e., confounding by indication. Methods We conducted a retrospective cohort study of 9,090 IVF cycles collected by Lee Women’s Hospital in Taichung, Taiwan from 1998 to 2014. We utilized the method of propensity score matching to mimic a randomized controlled trial (RCT) where each patient with Day 5 transfer was matched by another patient with Day 3 transfer with respect to other clinical characteristics. Implantation rate, clinical pregnancy rate, and odds of live birth were compared for women underwent Day 5 transfer and Day 3 transfer to estimate the causal effects. We further investigated the causal effects in subgroups by stratifying age and anti-Mullerian hormone (AMH). Results Our analyses uncovered an evidence of a significant difference in implantation rate (p=0.04) favoring Day 5 transfer, and showed that Day 3 and Day 5 transfers made no difference in both odds of live birth (p=0.27) and clinical pregnancy rate (p=0.11). With the increase of gestational age, the trend toward non-significance of embryo transfer day in our result appeared to be consistent for subgroups stratified by age and AMH, while all analyses stratified by age and AMH were not statistically significant. Conclusions We conclude that for women without strong indications for Day 3 or Day 5 transfer, there is a small significant difference in implantation rate in favor of Day 5 transfer. However, the two protocols have indistinguishable outcomes on odds of live birth and clinical pregnancy rate.

P–415 Clinical and In Vitro Fertilization laboratory parameters that contribute to clinical miscarriage after single euploid embryo transfer

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M D C Nogale. Barrios ◽  
J A García-Velasco ◽  
M Cruz ◽  
S D Frutos ◽  
E M Martínez ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Maternal Age ◽  
Pregnancy Loss ◽  
Endometrial Thickness ◽  
Miscarriage Rate ◽  
Vitro Fertilization ◽  
Endometrial Preparation ◽  
Euploid Embryo

Abstract Study question To investigate which factors, excluding embryo aneuploidies, are associated with miscarriage in patients who have undergone a single euploid blastocyst transfer. Summary answer Miscarriage was related to the body mass index (BMI), the type of cycle and the thickness of the endometrium. What is known already Preimplantation genetic testing for aneuploidies (PGT-A) is widely used in-vitro fertilization (IVF) to select euploid embryos. Several studies have shown that embryo aneuploidy is the main contributing factor for IVF failure, reinforcing the relevance of PGT-A as a method to select chromosomally normal embryos. A recent meta-analysis confirmed that patients undergoing PGT-A have a lower miscarriage rate than women that conceived naturally (9% vs 28%, respectively). Even though most of the studies show that PGT-A significantly reduces miscarriage rate, still some women do lose their pregnancies. We investigated which other reasons may be related to this early pregnancy loss. Study design, size, duration Retrospective, observational, and multicenter study of 6910 patients undergoing single euploid blastocyst transfer after PGT-A from January 2017 to December 2019 in our institution. Several laboratory and clinic variables were analyzed to study the effect of these variables on the miscarriage rate Participants/materials, setting, methods Indications for PGT-A were advanced maternal age, implantation failure, recurrent pregnancy loss and male factor. Embryos were cultured 5% O2 concentration and 6.5% CO2 concentration. Trophectoderm biopsy was performed on day 5/6 of development and analyzed through Next Generation Sequencing (NGS); embryos were vitrified until transfer was performed. Single euploid embryo transfer was performed in all cases. We performed a multivariate regression analysis to compare the different variables and search for there are significant differences. Main results and the role of chance We studied a total of 6910 patients undergoing PGT-A to describe which factors, excluding embryo aneuploidies, were correlated with miscarriage in patients who underwent single thawed euploid embryo transfer. When considering embryo morphology (embryo grading, quality of inner cell and quality of trophectoderm), we did not find differences in miscarriage rate among groups (high quality= 15.9%; normal quality= 14.3%; low quality= 15.0%; poor quality= 14.8%) p = 0.833. BMI was significantly associated with miscarriage rate (odds ratio [OD] 1.04; 95% confidence interval [CI], 1.012–1–076 p = 0.006) and miscarriage rate. We observed a weak association between endometrial thickness and miscarriage rate ([OD] 0.65; 95%, 0.528–0.778 p = 0.04) and also between type of endometrial preparation (natural cycle or hormone replacement cycle) ([OD] 0.77; 95%, 0.528–0.778) p = 0.04. Body mass index, according to our findings, was the main variable correlated with miscarriage rate. We did not find any association with the other variables studied (biopsy day, maternal age, male age, duration infertility, cycle length, previous miscarriage, previous live birth, previous cycles IVF, endometrial pattern and diagnosis). Limitations, reasons for caution The retrospective study design limits the generalization of our results but offers a good insight to be validated in prospective trials. Wider implications of the findings: According to our findings, BMI, endometrial thickness the day of the embryo transfer, and the type of endometrial preparation should be considered when transferring an euploid blastocyst. Trial registration number NO APLICA

scholarly journals The efficacy of tamoxifen in the treatment of thin endometrium in frozen-thawed embryo transfer cycle

2020 ◽  
Author(s):  
Jingjuan Ji ◽  
Lihua Luo ◽  
Lingli Huang
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Hormone Replacement ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Tamoxifen Treatment ◽  
Induction Agent ◽  
Ongoing Pregnancy Rate ◽  
Thin Endometrium

Abstract Background: Thin endometrium is known to adversely affect reproductive performance. There is no agreement about a consensus treatment on thin endometrium. Tamoxifen(TAM) has a positive effect on endometrium when used as ovulation induction agent. Little information is available regarding its use in patients with thin endometrium during frozen-thaw embryo transfer (FET) cycles. This study was designed to evaluate the effectiveness of TAM on women with thin endometrium in frozen-thaw embryo transfer cycles. Methods: A total of 345 thin endometrium women were retrospectively analyzed during their FET cycles. Among them 190 received TAM protocol (TAM 20 mg per day for 5 days) and 155 hormone replacement therapy (HRT) protocol (estradiol val­erate 6 mg/d for 14 to 21days). Endometrial thickness and pregnancy outcome were compared between the two groups. Result(s): The endometrial thickness in TAM group was significantly higher compared with HRT group. The clinical pregnancy rate, implantation rate, ongoing pregnancy rate and live birth rate were significantly higher in TAM group than HRT group. Conclusion(s): In patients of recurrent thin endometrium, tamoxifen treatment in endometrium preparation may be a successful alternative approach

scholarly journals Impact of Transitory Hyperprolactinemia on Clinical Outcome of In Vitro Fertilization and Embryo Transfer

2012 ◽  
Vol 31 (1) ◽  
pp. 27-33
Author(s):  
Yi-ping Zhong ◽  
Xiao-ting Shen ◽  
Ying Ying ◽  
Hai-tao Wu ◽  
Jin Li ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Serum Prolactin ◽  
Close Monitoring ◽  
Vitro Fertilization ◽  
The Impact ◽  
Ivf Et

Impact of Transitory Hyperprolactinemia on Clinical Outcome of In Vitro Fertilization and Embryo Transfer This study aimed to evaluate the impact of serum prolactin concentration at the day of human chorionic gonadotropin (HCG) administration on the clinical outcome of in vitro fertilization and embryo transfer (IVF-ET). A total of 184 patients receiving the IVF-ET/ICSI-ET from October 2005 to March 2008 were retrospectively analyzed. Subjects were divided into four groups according to the serum prolactin concentration [<30 ng/mL (A), 30-60 ng/mL (B), 60-90 ng/mL (C), ≥90 ng/mL (D)] on the day of HCG administration during controlled ovarian stimulation (COS). In the Groups A, B, C and D, the implantation rate was 11.76%, 19.71%, 12.72% and 2.22%, respectively, and the pregnancy rate (PR) was 25.00%, 42.70%, 27.30% and 5.88%, respectively. The implantation rate and PR in the Group D were markedly lower than those in the remaining groups (P=0.011 and 0.009). During the COS, the serum prolactin concentration was dramatically elevated when compared with the baseline level leading to transient hyperprolactinemia. In addition, the implantation rate and pregnancy rate were significantly markedly decreased when the serum prolactin concentration was remarkably increased (≥90 ng/mL). To improve the clinical pregnancy rate of IVF-ET, close monitoring and appropriate intervention are needed for patients with an abnormal prolactin level during the COS.

scholarly journals The correlation between endometrial thickness and pregnancy outcomes in fresh ART cycles with different age groups: a retrospective study

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Maryam Eftekhar ◽  
Sara Zare Mehrjardi ◽  
Behnaz Molaei ◽  
Fatemeh Taheri ◽  
Esmat Mangoli
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Endometrial Thickness ◽  
Age Groups ◽  
Invasive Technique ◽  
Main Role ◽  
Ongoing Pregnancy Rate ◽  
Vitro Fertilization ◽  
The Impact

Abstract Background In assisted reproductive technology (ART) cycles in addition to embryo quality, the receptivity of the endometrium plays the main role in clinical outcomes. Endometrial receptivity is necessary to implantation of an embryo, and ultrasound has been established as an appreciated, simple, and non-invasive technique in the evaluation of the endometrial preparation before embryo transfer in fresh in vitro fertilization (IVF) cycles. Debate on the predictive value measuring endometrial thickness before administering human chorionic gonadotropin (HCG) for ovulation triggering in ART is ongoing. In order to explore the impact of endometrial thickness on triggering day on ongoing pregnancy rate (OPR) in ART cycles, we retrospectively analyzed data from 1000 patients undergoing IVF/ICSI cycles. Results The data showed pregnancy rate was increased in the endometrial thickness of 8 mm to 11 mm then decreased, and in endometrial thickness (Ent) > 14 mm, pregnancy rate was zero. There were significant differences in endometrial thickness and pregnancy outcomes between different age groups. The pregnancy rate was higher (32%) in 23–30 years old women, and the range of Ent in this group was 6–12 mm. Also, the data showed a positive correlation between Ent with AMH and estradiol levels and the number of COC and MII oocytes and a negative correlation between female age with Ent. Conclusion The result showed that Ent on hCG administration day is associated with pregnancy outcomes in fresh IVF/ICSI cycles with different age groups, although some of the clinical parameters may have an effect on Ent. Large studies are needed to make a definitive conclusion.

scholarly journals Endometrial thickness and frozen thaw embryo transfer: A prospective study

2020 ◽  
Vol 3 (2) ◽  
pp. 132-135
Author(s):  
S Mahalakshmi ◽  
A Sakthi ◽  
L Saravanan ◽  
Nidhi Sharma
Keyword(s):  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Implantation Rate ◽  
Primary Objective ◽  
Ongoing Pregnancy ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Study Population ◽  
The Mean ◽  
A Prospective Study

Aim and objectives: Endometrial Window of Implantation (WOI) is open in the midsecretory phase wherein the markers of invasion and cell adhesion are manifested .The primary objective was to find out the predictive value of Endometrial thickness and profile as a prognostic factors for embryo transfers during ART. Materials and Methods: Endometrial thickness assessment was performed with grey scale ultrasound on the day of transfer just before thawing the embryos in patients undergoing Frozen embryo transfer cycle after endometrial preparation. Results: The mean age and standard deviation of study population was is 33.26+5.95.Out of 69 patients there was clinical pregnancy in 33 patients , miscarriage in 10 patients and ongoing pregnacy in 23 patients. So the implantation rate was 47.83% (33/69), early miscarriage rate (pregnancy ending before 12 weeks) was 14.49%(10/69) and the ongoing pregnancy rate was 33.33% (23/69). Endometrial thickness < 6 mm had comparable implantation rates but low ongoing pregnancy rates. Conclusion: The ultrasound morphological and vascular grading of endometrial thickness and vascularity is useful to synchronise Day 5 embryo transfer and window and implantation thereby minimizing the loss of good embryos in nonreceptive endometrium.

scholarly journals Evaluation of the Role of Hysteroscopic Endometrial Injury and Its Timing Prior to in vitro Fertilization Treatment

2016 ◽  
Vol 7 (2) ◽  
pp. 52-57 ◽  
Author(s):  
KK Gopinathan ◽  
Avani Pillai ◽  
G Parasuram ◽  
Fessy L Thalakottoor
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Pregnancy Rates ◽  
Fertility Treatment ◽  
Vitro Fertilization ◽  
Endometrial Injury ◽  
Group I

ABSTRACT Aim To evaluate the role of hysteroscopic endometrial injury and its timing prior to embryo transfer in patients undergoing IVF (in vitro fertilization) treatment. Materials and methods A total of 133 patients who underwent hysteroscopy at CIMAR Fertility Centre at Kochi, between January 2013 and December 2014, and had normal hysteroscopic findings were enrolled for the study. These women subsequently underwent IVF treatment and were evaluated in three groups based on the timing of hysteroscopy before embryo transfer: Group I – hysteroscopy performed 50 days or less before embryo transfer (n = 54), group II – hysteroscopy performed between 51 days and 6 months of embryo transfer (n = 45), and group III – hysteroscopy performed more than 6 months before embryo transfer (n = 34). Results The implantation rates were 21.8, 22.6, and 21.6% in groups I, II, and III respectively. Overall pregnancy rates were 44.4, 48.9, and 44.1%. Clinical pregnancy rates (CPR) were 40.7, 46.7, and 44.1% and live birth rates (LBR) were 30, 29, and 26% in groups I, II, and III respectively. Thus the implantation rate, overall pregnancy rate, and CPR were not significantly different in the three groups. Conclusion Hysteroscopic endometrial injury prior to IVF does not improve the pregnancy rate in patients with normal hysteroscopic findings. Clinical significance Due to the lack of definitive evidence regarding the role of hysteroscopic endometrial injury, ideal technique, and its timing prior to embryo transfer, it is necessary to evaluate the role of endometrial injury as a fertility treatment in women undergoing assisted reproductive technology (ART) cycles, as well as to present it in a way that supports clinical practice. At this stage, there is little evidence to support hysteroscopic endometrial injury prior to embryo transfer as a standard of care, and its use should be limited to selected cases after careful deliberation between the medical team and patient. How to cite this article Pillai A, Parasuram G, Thalakottoor FL, Gopinathan KK. Evaluation of the Role of Hysteroscopic Endometrial Injury and Its Timing Prior to in vitro Fertilization Treatment. Int J Infertil Fetal Med 2016;7(2):52-57.

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