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Morcel K, Merviel P, Pertuisel D, James P, Bouée S, Le Guillou M, Chabaud JJ, Roche S, Drapier H, Perrin A, Beauvillard D. Live Birth Rates in Women Under 38 Years Old with AMH Level < 1.2 ng/ml in the First In Vitro Fertilization + / - Intracytoplasmic Sperm Injection: Retrospective Study and Arguments for Care. Reprod Sci 2023; 30:1133-1142. [PMID: 36175614 DOI: 10.1007/s43032-022-01091-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/16/2022] [Indexed: 10/14/2022]
Abstract
Many studies failed to show a predictive impact of AMH levels on the chances of pregnancy; however, acceptable pregnancy rates for young women with low AMH levels were observed in IVF + / - ICSI. The objectives of this retrospective study were to evaluate the clinical pregnancy and live birth rates in the first IVF + / - ICSI cycle in women under 38 years old with AMH level < 1.2 ng/ml and to determine the arguments for care. We classified the women into three groups: group A: AMH < 0.4 ng/ml (n: 86); group B: AMH: 0.4 to 0.8 ng/ml (n: 90); and group C: AMH > 0.8 to < 1.2 ng/ml (n: 92). We recorded data on the patients' characteristics, stimulation cycles, embryo cultures, and ongoing pregnancies. No difference was observed between the three groups for the number of embryos transferred, the clinical pregnancy, and the live birth rates (LBR) per embryo transfer (LBR/transfer: 24.1% in group A, 25.9% in group B, and 28.1% in group C). The young age of the women reassures about the oocyte quality, but a low level of AMH may raise concerns about a lower quantitative oocyte yield, leading to accelerated management of the couple in IVF + / - ICSI.
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Affiliation(s)
- Karine Morcel
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Philippe Merviel
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France.
| | - Diane Pertuisel
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Pandora James
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Sarah Bouée
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Mathilde Le Guillou
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Jean-Jacques Chabaud
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Sylvie Roche
- Department of Gynecology, Obstetrics and Reproductive Medicine, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Hortense Drapier
- Department of Reproductive Biology, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Aurore Perrin
- Department of Reproductive Biology, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
| | - Damien Beauvillard
- Department of Reproductive Biology, ART Center, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France
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Li M, Su P, Zhou LM. Live births from in vitro fertilization-embryo transfer following the administration of gonadotropin-releasing hormone agonist without gonadotropins: Two case reports. World J Clin Cases 2023; 11:2067-2073. [PMID: 36998947 PMCID: PMC10044950 DOI: 10.12998/wjcc.v11.i9.2067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/31/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The prevalence of female infertility between the ages of 25 and 44 is 3.5% to 16.7% in developed countries and 6.9% to 9.3% in developing countries. This means that infertility affects one in six couples and is recognized by the World Health Organization as the fifth most serious global disability. The International Committee for Monitoring Assisted Reproductive Technology reported that the global total of babies born as a result of assisted reproductive technology procedures and other advanced fertility treatments is more than 8 million. Advancements in controlled ovarian hyperstimulation procedures led to crucial accomplishments in human fertility treatments. The European Society for Human Reproduction and Embryology guideline on ovarian stimulation gave us valuable evidence-based recommendations to optimize ovarian stimulation in assisted reproductive technology. Conventional ovarian stimulation protocols for in vitro fertilization (IVF)–embryo transfer are based upon the administration of gonadotropins combined with gonadotropin-releasing hormone (GnRH) analogues, either GnRH agonists (GnRHa) or antagonists. The development of ovarian cysts requires the combination of GnRHa and gonadotropins for controlled ovarian hyperstimulation. However, in rare cases patients may develop an ovarian hyper response after administration of GnRHa alone.
CASE SUMMARY Here, two case studies were conducted. In the first case, a 33-year-old female diagnosed with polycystic ovary syndrome presented for her first IVF cycle at our reproductive center. Fourteen days after triptorelin acetate was administrated (day 18 of her menstrual cycle), bilateral ovaries presented polycystic manifestations. The patient was given 5000 IU of human chorionic gonadotropin. Twenty-two oocytes were obtained, and eight embryos formed. Two blastospheres were transferred in the frozen-thawed embryo transfer cycle, and the patient was impregnated. In the second case, a 37-year-old woman presented to the reproductive center for her first donor IVF cycle. Fourteen days after GnRHa administration, the transvaginal ultrasound revealed six follicles measuring 17-26 mm in the bilateral ovaries. The patient was given 10000 IU of human chorionic gonadotropin. Three oocytes were obtained, and three embryos formed. Two high-grade embryos were transferred in the frozen-thawed embryo transfer cycle, and the patient was impregnated.
CONCLUSION These two special cases provide valuable knowledge through our experience. We hypothesize that oocyte retrieval can be an alternative to cycle cancellation in these conditions. Considering the high progesterone level in most cases of this situation, we advocate freezing embryos after oocyte retrieval rather than fresh embryo transfer.
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Affiliation(s)
- Mai Li
- Reproductive Center, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
| | - Ping Su
- Reproductive Center, Institution of Reproductive Health, Tongji Medical College, Wuhan 430030, Hubei Province, China
| | - Li-Ming Zhou
- Reproductive Center, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
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Zhang Y, Wang H, Pan X. Live birth in woman with premature ovarian insufficiency and 46, XY karyotype after chemotherapy and bone marrow transplant: a case report. BMC Pregnancy Childbirth 2023; 23:170. [PMID: 36915065 PMCID: PMC10012704 DOI: 10.1186/s12884-023-05464-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/22/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Premature ovarian insufficiency (POI) is a clinical syndrome defined by loss of ovarian function before the age of 40 years, characterized by elevated serum gonadotropin levels and decreased estrogen levels with menstrual disturbance. POI can be natural or iatrogenic such as after chemotherapy, radiotherapy and surgery. CASE PRESENTATION In this study, we describe a successful live birth in a 31-year-old woman with POI and 46, XY Karyotype after being treated with chemotherapy and bone marrow transplant (BMT) for acute non-lymphocytic leukemia when she was 17 years old. With amenorrhea or oligomenorrhea for 11 years, her serum level of FSH was up to 35.0 IU/L and 53.0 IU/L taken 4 weeks apart, which can be diagnosed as POI. After controlled ovarian stimulation treatment for three cycles with different protocols and frozen-thawed embryo transfer (FET), she finally got a successful pregnancy and had a live birth later. CONCLUSIONS This case report serves as a reminder that karyotype of peripheral blood may mislead the diagnosis as disorders of sex development (DSD). It also demonstrates that it is possible for a woman with chemotherapy and bone marrow transplant induced POI can have successful pregnancy and live birth with appropriate therapy. Furthermore, as age may plays a predominant role in fertility rather than residual ovarian reserve, active treatment may be concerned for women with POI at younger age.
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Affiliation(s)
- Yaojia Zhang
- Department of Assisted Reproduction Center, Huzhou Maternity and Child Health Care Hospital, Huzhou, China
| | - Haiyan Wang
- Department of Assisted Reproduction Center, Huzhou Maternity and Child Health Care Hospital, Huzhou, China
| | - Xiaoqin Pan
- Department of Assisted Reproduction Center, Huzhou Maternity and Child Health Care Hospital, Huzhou, China.
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Le Levreur B, Frantz S, Lambert M, Chansel-Debordeaux L, Bernard V, Carriere J, Verdy G, Hocke C. [No improvement in live birth rate after luteal phase support by GnRH agonist]. Gynecol Obstet Fertil Senol 2023; 51:249-255. [PMID: 36871830 DOI: 10.1016/j.gofs.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/20/2023] [Accepted: 02/18/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To evaluate the impact of adding a GnRH agonist (GnRH-a) in luteal phase support (LPS) on live birth rates in IVF/ICSI in antagonist protocols. METHODS In total, 341 IVF/ICSI attempts are analyzed in this retrospective study. Patients were divided into two groups: A f: LPS with progesterone alone (179 attempts) between March 2019 and May 2020; B: LPS with progesterone and an injection of triptorelin (GnRH-a) 0.1mg 6 days after oocyte retrieval (162 attempts) between June 2020 and June 2021. The primary outcome was live birth rate. The secondary outcomes were miscarriage rate, pregnancy rate and ovarian hyperstimulation syndrome rate. RESULTS The baseline characteristic are identical between the two groups except the infertility duration (longer in the group B). There was no significant difference between the two groups in live birth rate (24.1% versus 21.2%), pregnancy rate (33.3% versus 28.1%), miscarriage rate (4.9% versus 3.4%) and no increase the SHSO rate. The multivariate regression analysis after adjustment for age, ovarian reserve and infertility duration did not reveal a significant difference in live birth rate between the two groups. CONCLUSION In this study, the results showed no statistically significant association with the single injection of a GnRH-a in addition to progesterone on live birth rate in luteal phase support.
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Affiliation(s)
- B Le Levreur
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
| | - S Frantz
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Lambert
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - L Chansel-Debordeaux
- Service de biologie de la reproduction-CECOS, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - V Bernard
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - J Carriere
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - G Verdy
- Pôle santé publique, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - C Hocke
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
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Mu F, Huang J, Zeng X, Liu L, Wang F. Efficacy and safety of recombinant human granulocyte colony-stimulating factor in patients with unexplained recurrent spontaneous abortion: A systematic review and meta-analysis. J Reprod Immunol 2023; 156:103830. [PMID: 36821985 DOI: 10.1016/j.jri.2023.103830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION Published data regarding efficacy of intrauterine perfusion of recombinant human granulocyte colony-stimulating factor for patients with unexplained recurrent spontaneous abortion (URSA) is inconclusive. This study aims at evaluating the efficacy and safety of G-CSF in URSA. MATERIALS AND METHODS Electronic databases were searched including Cochrane Library, PubMed, Embase, China Biology Medicine disc, China Science and Technology Journal Database, Wanfang Database and China National Knowledge Infrastructure Database (last search was performed on Sep 10th, 2022). A systematic review and meta-analysis was conducted with R-language software. Combined relative risk (RRs), and 95% confidence intervals (CIs) were calculated to estimate efficacy and safety. RESULTS Compared with placebo, the efficacy of G-CSF in the treatment of URSA patients was significant in conception rate (RR=1.34, 95%CI: 1.03-1.74, P = 0.028), and was none of significance in live birth rate (RR=1.35, 95%CI: 0.99-1.84, P = 0.06). Subgroup analysis showed that the ovulation-period-medication was the protective factor for conception rate, while "Ethnicity Asian" and "ovulation-period medication" were the protective factors for live birth rate. When it comes to the safety of rhG-CSF on URSA, meta-analysis showed that rhG-CSF had no significant effect on the incidence of adverse events (AEs) (RR=1.13, 95% CI: 0.89-1.43, P = 0.322), and subgroup analysis showed that the incidence of AEs in each subgroup did not increase significantly (P > 0.05). CONCLUSION Based on our meta-analysis, intrauterine perfusion of rhG-CSF in ovulation period is an effective and safe way to improve conception rate in URSA.
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Affiliation(s)
- Fangxiang Mu
- Department of Reproductive Medicine, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Jiumei Huang
- Department of Reproductive Medicine, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Xianghui Zeng
- Department of Reproductive Medicine, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Ling Liu
- Department of Reproductive Medicine, Lanzhou University Second Hospital, Lanzhou 730000, China
| | - Fang Wang
- Department of Reproductive Medicine, Lanzhou University Second Hospital, Lanzhou 730000, China.
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Begon E, Lefebvre T, Arbo E, Bouée S, Darné B, Jaffré F, Languille S, Mellouhi D, Pont JC, Rousset N, Fréour T. Does paternal age affect the live birth rate in donor oocyte cycles? A systematic review and meta-analysis. J Assist Reprod Genet 2023; 40:617-626. [PMID: 36652117 PMCID: PMC10033779 DOI: 10.1007/s10815-023-02714-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
PURPOSE While delayed parenthood is increasing worldwide, the effect of paternal age on in vitro fertilization (IVF) outcomes remains unclear. The egg donation model appears to be relevant to studying the independent impact of paternal age on clinical outcome, but the available studies are heterogeneous and contradictory. This systematic review and meta-analysis aimed to assess the relationship between paternal age and live birth rate (LBR) in egg donation cycles. METHODS A systematic search of the literature was conducted in PubMed, Embase, and the Cochrane Library from inception to June 30, 2021. All studies on egg donation cycles where LBR is reported according to male age were included. Study selection, bias assessment, and data extraction were performed by two independent reviewers according to the Cochrane methods. RESULTS Eleven studies involving 10,527 egg donation cycles were finally included. The meta-analysis showed a slight but significant and linear decrease in LBR with increasing paternal age (estimate - 0.0055; 95% CI (- 0.0093; - 0.0016), p = 0.006), with low heterogeneity (I2 = 25%). No specific threshold was identified. A similar trend toward decreased clinical pregnancy rate with advancing paternal age was found but did not reach statistical significance (p = 0.07). CONCLUSION This meta-analysis demonstrates that increasing paternal age is associated with a slight but significant and linear decrease in the live birth rate in egg donation cycles, with no apparent threshold effect. Although this requires further confirmation, this information is important for counseling men who are considering delayed childbearing.
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Affiliation(s)
- Emmanuelle Begon
- Service de chirurgie gynécologique et médecine de la reproduction, CHU Bordeaux, Hôpital Pellegrin, 33000, Bordeaux, France
| | - Tiphaine Lefebvre
- Service de biologie et médecine de la reproduction, CHU de Nantes, CHU Nantes, Nantes Université, 38 Boulevard Jean Monnet, 44093, Nantes, France
| | | | - Sarah Bouée
- Service de biologie et médecine de la reproduction, CHU Brest, Hôpital Morvan, 29200, Brest, France
| | | | - Frédérique Jaffré
- Clinique Mutualiste La Sagesse, 4 place saint Guénolé, 35 000, Rennes, France
| | | | | | | | | | - Thomas Fréour
- Service de biologie et médecine de la reproduction, CHU de Nantes, CHU Nantes, Nantes Université, 38 Boulevard Jean Monnet, 44093, Nantes, France.
- Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, F-44000, Nantes, France.
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.
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Curnow EC, Vannucci B, Muller CH, Herndon CN. Successful Live Birth Outcome Following Assisted Activation of Failed Fertilized Oocytes. Reprod Sci 2023:10.1007/s43032-023-01186-z. [PMID: 36752985 DOI: 10.1007/s43032-023-01186-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/27/2023] [Indexed: 02/09/2023]
Abstract
Here, we report on a rare case of a live birth following assisted oocyte activation of failed fertilized oocytes. A 34-year-old nulliparous woman presenting at a university-based assisted reproductive technology center with multi-factor infertility underwent an IVF cycle using intracytoplasmic sperm injection (ICSI) of frozen/thawed testicular sperm aspiration (TESA) sample and preimplantation genetic testing for aneuploidy (PGT-A). All oocytes displayed failed fertilization at assessment 18 h post-ICSI. Rescue of this cycle was achieved with the use of an assisted oocyte activation (AOA) protocol, whereby oocytes were subjected to AOA with calcium ionophore at 19 h post-ICSI and assessed for blastocyst development. Blastocyst-stage embryos were biopsied for PGT-A analysis with one of the three embryos reporting as genetically normal. This embryo was transferred in a frozen embryo transfer cycle and resulted in a normal pregnancy and term live birth. In conclusion, application of AOA protocols following failed fertilization outcomes can lead to viable, genetically normal embryos capable of resulting in a live birth.
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Affiliation(s)
- Eliza C Curnow
- REI Division, Department of ObGyn, University of Washington, Seattle, WA, 98195, USA.
| | - Bianca Vannucci
- REI Division, Department of ObGyn, University of Washington, Seattle, WA, 98195, USA
| | - Charles H Muller
- Male Fertility Lab, Department of Urology, University of Washington, Seattle, WA, 98195, USA
| | - Christopher N Herndon
- REI Division, Department of ObGyn, University of Washington, Seattle, WA, 98195, USA
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Li HJ, Seifer DB, Tal R. AMH independently predicts aneuploidy but not live birth per transfer in IVF PGT-A cycles. Reprod Biol Endocrinol 2023; 21:19. [PMID: 36739415 PMCID: PMC9898926 DOI: 10.1186/s12958-023-01066-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/21/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While anti-Müllerian hormone (AMH) predicts quantitative IVF outcomes such as oocyte yield, it is not certain whether AMH predicts markers of oocyte quality such as aneuploidy. METHODS Retrospective case-control analysis of the SART-CORS database, 2014-2016, to determine whether anti-Müllerian hormone (AMH) predicts aneuploidy and live birth in IVF cycles utilizing preimplantation genetic testing for aneuploidy (PGT-A). RESULTS Of 51,273 cycles utilizing PGT-A for all embryos, 10,878 cycles were included in the final analysis; of these, 2,100 cycles resulted in canceled transfer due to lack of normal embryos and 8,778 cycles resulted in primary FET. AMH levels of cycles with ≥ 1 euploid embryo were greater than those of cycles with no normal embryos, stratifying by number of embryos biopsied (1-2, 3-4, 5-6, and ≥ 7), P < 0.017 for each stratum. Adjusting for age and number of embryos biopsied, AMH was a significant independent predictor of ≥ 1 euploid embryo for all age groups: < 35 yrs (aOR 1.074; 95%CI 1.005-1.163), 35-37 years (aOR 1.085; 95%CI 1.018-1.165) and ≥ 38 years (aOR 1.055; 95%CI 1.020-1.093). In comparative model analysis, AMH was superior to age as a predictor of ≥ 1 euploid embryo for age groups < 35 years and 35-37 years, but not ≥ 38 years. Across all cycles, age (aOR 0.945, 95% CI 0.935-0.956) and number of embryos (aOR 1.144, 95%CI 1.127-1.162) were associated with live birth per transfer, but AMH was not (aOR 0.995, 95%CI 0.983-1.008). In the subset of cycles resulting in ≥ 1 euploid embryo for transfer, neither age nor AMH were associated with live birth. CONCLUSIONS Adjusting for age and number of embryos biopsied, AMH independently predicted likelihood of obtaining ≥ 1 euploid embryo for transfer in IVF PGT-A cycles. However, neither age nor AMH were predictive of live birth once a euploid embryo was identified by PGT-A for transfer. This analysis suggests a predictive role of AMH for oocyte quality (aneuploidy risk), but not live birth per transfer once a euploid embryo is identified following PGT-A.
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Affiliation(s)
- Howard J Li
- Dept. of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, U.S.A..
| | - David B Seifer
- Dept. of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, U.S.A
| | - Reshef Tal
- Dept. of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, U.S.A
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Zong X, Guo Y, Li H, Li R, Qiao J. Obstetric and perinatal outcomes following frozen and fresh embryo transfer in patients with endometrial hyperplasia and carcinoma: a retrospective study in a high-volume reproductive center. BMC Pregnancy Childbirth 2023; 23:92. [PMID: 36737751 PMCID: PMC9896787 DOI: 10.1186/s12884-023-05418-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There is ongoing debate regarding which embryo transfer procedure can achieve a higher live birth rate. Research has suggested that frozen ET might be beneficial for certain populations, such as hyper-responders. This study aimed to compare outcomes of pregnancies between frozen and fresh embryo transfer cycles in patients with endometrial hyperplasia and carcinoma. METHODS This retrospective cohort study was conducted at a high-volume reproductive center from January 2010 to January 2022. Patients who were diagnosed with endometrial hyperplasia with atypia and endometrial carcinoma were included. They all underwent in vitro fertilization after conservative treatment. The primary outcome was live birth after frozen and fresh embryo transfer cycles, and secondary outcomes included perinatal complications and other pregnancy outcomes. RESULTS Overall, 259 ET cycles (130 fresh and 129 frozen) were included. The rate of live births per embryo transfer cycle of the whole cohort was 20.8% (54/259), and no significant between-group difference was found after adjusting for potential confounding factors (23.8% vs. 17.8%; adjusted OR, 0.47; 95% CI, 0.21-1.06; p=0.068). Compared to fresh embryo transfer group, the incidence of total maternal complications in the frozen embryo transfer group was significantly higher (30.4% vs. 6.5%, p=0.019). Analyzing each complication as a separate entity, patients in the frozen embryo transfer group had a higher incidence of hypertensive disorders of pregnancy (p=0.028). Multiple logistic regression analysis showed that frozen embryo transfer was related with an increased occurrence of maternal complications (OR, 6.68, 95% CI, 1.01-44.19, p=0.040). CONCLUSIONS Among patients with endometrial hyperplasia and carcinoma, the rate of live births was comparable between both embryo transfer procedures, while frozen embryo transfer might be associated with a higher risk of maternal complications compared to that with fresh embryo transfer.
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Affiliation(s)
- Xuan Zong
- grid.411642.40000 0004 0605 3760Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, 100191 China
| | - Yaxing Guo
- grid.411642.40000 0004 0605 3760Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, 100191 China
| | - Hongzhen Li
- grid.411642.40000 0004 0605 3760Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, 100191 China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, 100191 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191 China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191 China
| | - Rong Li
- grid.411642.40000 0004 0605 3760Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, 100191 China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, 100191 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191 China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191 China
| | - Jie Qiao
- grid.411642.40000 0004 0605 3760Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, 100191 China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital), Beijing, 100191 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191 China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191 China
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Vexø LE, Stormlund S, Landersoe SK, Jørgensen HL, Humaidan P, Bergh C, Englund ALM, Klajnbard A, Bogstad JW, Freiesleben NLC, Zedeler A, Prætorius L, Andersen AN, Løssl K, Pinborg A, Nielsen HS. Low-grade inflammation is negatively associated with live birth in women undergoing IVF. Reprod Biomed Online 2023; 46:302-311. [PMID: 36446681 DOI: 10.1016/j.rbmo.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 11/23/2022]
Abstract
RESEARCH QUESTION Is low-grade inflammation, detected by C-reactive protein (CRP), a marker of IVF outcome addressing both blastocyst quality and pregnancy outcome? DESIGN This sub-study of a multicentre randomized controlled trial included 440 women undergoing IVF treatment with a gonadotrophin-releasing hormone (GnRH) antagonist protocol. Serum CRP was measured on cycle day 2-3 (baseline) and on the day of ovulation triggering. The association between CRP concentrations and reproductive outcomes (number of retrieved oocytes, number of good-quality blastocysts, pregnancy, pregnancy loss and live birth), were analysed, adjusting for relevant confounders. RESULTS A negative association was found between higher baseline CRP concentrations and live birth rate (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.62-0.96, P = 0.02) and higher CRP concentrations at baseline were associated with pregnancy loss among women who conceived (OR 1.37, 95% CI 1.07-1.76, P = 0.01). When testing for a specific cut-off, CRP concentrations above 2.34 (the highest quartile) were more likely to be associated with pregnancy loss (P = 0.02) and a lower chance of live birth (P = 0.04) compared with the lowest quartile. No associations were found between CRP concentrations and pregnancy outcomes on the day of ovulation triggering, and there were no associations between CRP concentrations and the number of good-quality blastocysts. CONCLUSIONS Higher CRP concentrations at cycle day 2-3, before starting ovarian stimulation, are negatively associated with chance of live birth, possibly because of an increased risk of pregnancy loss. No association was found between the number of good-quality blastocysts and CRP concentration. More studies are needed to investigate the impact of low-grade inflammation.
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Affiliation(s)
- Laura Emilie Vexø
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
| | - Sacha Stormlund
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Selma Kloeve Landersoe
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Henrik Løvendahl Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Humaidan
- Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University; Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anne Lis Mikkelsen Englund
- Department of Obstetrics and Gynaecology, Fertility Clinic, Region Zealand University Hospital, Koege, Denmark
| | - Anna Klajnbard
- Fertility Clinic, Department of Obstetrics and Gynaecology, Herlev University Hospital, Copenhagen, Denmark
| | - Jeanette Wulff Bogstad
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nina la Cour Freiesleben
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Zedeler
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Lisbeth Prætorius
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Anders Nyboe Andersen
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kristine Løssl
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Venetis CA, Mol BW. Biosimilars versus the originator of follitropin alfa: Randomized controlled trials are still the best way to evaluate their comparative effectiveness in assisted reproduction. Drug Discov Today 2023; 28:103425. [PMID: 36332833 DOI: 10.1016/j.drudis.2022.103425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/11/2022] [Accepted: 10/27/2022] [Indexed: 11/07/2022]
Abstract
Biosimilars of follitropin alfa have been introduced in many countries as more affordable alternatives to the reference product for patients undergoing ovarian stimulation for assisted reproductive technology cycles. A recent meta-analysis, by reviewing available evidence originating from randomised controlled trials, has shown that based on the best available evidence, biosimilars of follitropin alfa are associated with lower live birth, ongoing and clinical pregnancy rates compared to the reference product. A subsequently published opinion paper challenges the methodology and results of this meta-analysis and suggests that these data should be ignored. In the present paper, it is clearly demonstrated why this criticism is largely unfounded and in stark contradiction with basic principles of evidence-based medicine. Furthermore, it is presented why the results of this meta-analysis provide the best available evidence to date and therefore the base that should inform clinical practice and, importantly, stimulate further research.
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Affiliation(s)
- Christos A Venetis
- Centre for Big Data Research in Health & Discipline of Obstetrics and Gynaecology, Faculty of Medicine & Health, University of New South Wales, Sydney 2000, New South Wales, Australia; IVFAustralia, Alexandria 2015, New South Wales, Australia.
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia; Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Wang Z, Cantineau AEP, Hoek A, van Eekelen R, Mol BW, Wang R. Live birth is not the only relevant outcome in research assessing assisted reproductive technology. Best Pract Res Clin Obstet Gynaecol 2023; 86:102306. [PMID: 36642691 DOI: 10.1016/j.bpobgyn.2022.102306] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/30/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022]
Abstract
In assisted reproductive technology (ART) research, live birth has been generally accepted as an important outcome, if not the most important one. However, it has been reported inconsistently in the literature and solely focusing on live birth can lead to misinterpretation of research findings. In this review, we provide an overview on the definitions of live birth, including various denominators and numerators use. We present a series of real clinical examples in ART research to demonstrate the impact of variations in live birth on research findings and the importance of other outcomes, including multiple pregnancy, pregnancy loss, time to pregnancy leading to live birth, other short and long term maternal and offspring health outcomes and cost effectiveness measures. We suggest that outcome choices in ART research should be tailored for the research questions. A holistic outcome assessment beyond live birth would provide a full picture to address research questions in ART in terms of effectiveness and safety, and thus facilitate evidence-based decision making.
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Affiliation(s)
- Zheng Wang
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Astrid E P Cantineau
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Annemieke Hoek
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rik van Eekelen
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam, the Netherlands
| | - Ben W Mol
- Department of Obstetrics and Gynecology, The Richie Centre, Monash University, Melbourne, Australia; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Rui Wang
- Department of Obstetrics and Gynecology, The Richie Centre, Monash University, Melbourne, Australia.
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Wei C, Xiang S, Liu D, Wang C, Liang X, Wu H, Lian F. Laser-assisted hatching improves pregnancy outcomes in frozen-thawed embryo transfer cycles of cleavage-stage embryos: a large retrospective cohort study with propensity score matching. J Assist Reprod Genet 2023; 40:417-27. [PMID: 36609944 DOI: 10.1007/s10815-022-02711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Laser-assisted hatching (LAH) is a commonly used adjunct technique; however, its effectiveness has not been fully established. OBJECTIVE We evaluated the effects of LAH on pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles of cleavage-stage embryos. MATERIALS AND METHODS This retrospective study involved 5779 FET cycles performed at the Reproductive and Genetic Center in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between January 2016 and December 2020. After propensity score matching, 3535 FET cycles were included, out of which 1238 were subjected to LAH while the remaining 2297 cycles were non-LAH (NLAH). The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR) while secondary outcomes included implantation rate (IR), biochemical pregnancy rate (BPR), ectopic pregnancy rate (EPR), pregnancy loss rate (PLR), multiple pregnancy rate (MPL), and monozygotic twinning rate (MTR). Logistic regression analysis was conducted to adjust for possible confounders. Subgroup analysis was also performed based on the endometrial preparation regimen. RESULTS The LAH group exhibited a higher LBR, compared to the NLAH group (34.9% vs. 31.4%, OR = 1.185, 95% CI = 1.023, 1.374, P = 0.024). Additionally, the LAH group showed a decreasing trend in PLR and EPR; however, differences were insignificant (P = 0.078, P = 0.063 respectively). Differences in IR (24.6% vs. 24.3%), BPR (41.8% vs. 40.4%), CPR (40.7% vs. 38.3%), MPR (14.1% vs. 17.3%), and MTR (1.4% vs. 1.1%) were insignificant. Subgroup analysis revealed that LAH may be more conducive for pregnancy outcomes in hormone replacement cycles. CONCLUSIONS In summary, LAH has an increased chance of achieving live births. However, further prospective studies should be performed to confirm our findings.
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Luo X, Deng B, Li L, Ma R, Mai X, Wu Z. LH level on ovulation trigger day has a different impact on the outcomes of agonist and antagonist regimens during in vitro fertilization. J Ovarian Res 2023; 16:26. [PMID: 36707867 PMCID: PMC9883898 DOI: 10.1186/s13048-023-01110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/20/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To assess the impact of the luteinizing hormone level on ovulation trigger day (LHOTD) on in vitro fertilization (IVF) outcomes in gonadotropin-releasing hormone (GnRH) agonist and antagonist regimens during fresh embryo transfer cycles. METHODS A stepwise, progressive multivariate regression model was introduced to assess the effect of the LHOTD on clinical pregnancy and live birth rates. Mantel‒Haenszel stratification analysis was used to examine the association between the LHOTD and clinical outcomes with the antagonist regimen. RESULTS The LHOTD had different distributions in the agonist and antagonist regimens. The cycles were assigned into three LHOTD tertile groups. In the agonist regimen, compared with the 1st tertile (T1), in the 2nd (T2) and 3rd (T3) tertiles, the adjusted odds ratios (ORs) (95% confidence intervals [CIs], P value) were 1.187 (1.047-1.345, 0.007) and 1.420 (1.252-1.610, < 0.001) for clinical pregnancy, respectively, and 1.149 (1.009-1.309, 0.036) and 1.476 (1.296-1.681, < 0.001) for live birth. In the antagonist regimen, there was no significant difference in clinical pregnancy and live birth rates among the tertiles. However, in the stratified group of patients aged less than 35 years, the ORs (95% CIs, P value) of T2 and T3 were 1.316 (1.051-1.648, 0.017) and 1.354 (1.077-1.703, 0.009) for clinical pregnancy, respectively, and 1.275 (1.008-1.611, 0.043) and1.269 (0.999-1.611, 0.051) for live birth. Moreover, there was a discrepancy in the results among the subdivided LHOTD T1 groups adopting the antagonist regimen. Compared with that of the < 1.06 mIU/mL subgroup, the ORs (95% CIs, P value) of the > 1.5 mIU/mL subgroup were 1.693 (1.194-2.400, 0.003) for clinical pregnancy and 1.532 (1.057-2.220, 0.024) for live birth after eliminating potential confounders. CONCLUSIONS The LHOTD was profoundly suppressed in the agonist regimen, and its level was positively correlated with clinical pregnancy and live birth rates. In contrast, in the flexible antagonist regimen, the LHOTD was significantly higher than that in the agonist regimen and did not correlate with the outcome, except for women in the nonadvanced age group and those with an excessively suppressed LHOTD. Further investigation is required to determine the rationale for these findings.
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Affiliation(s)
- Xi Luo
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China ,grid.218292.20000 0000 8571 108XFaculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China ,grid.218292.20000 0000 8571 108XMedical School, Kunming University of Science and Technology, Kunming, China
| | - Bo Deng
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Lei Li
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Rui Ma
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Xuancheng Mai
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Ze Wu
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
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Xia Q, Xie L, Wu Q, Cong J, Ma H, Li J, Cai W, Wu X. Elevated baseline LH/FSH ratio is associated with poor ovulatory response but better clinical pregnancy and live birth in Chinese women with PCOS after ovulation induction. Heliyon 2023; 9:e13024. [PMID: 36711322 PMCID: PMC9876966 DOI: 10.1016/j.heliyon.2023.e13024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Background What is the association between elevated baseline LH/FSH ratio and reproductive outcomes, especially ovulatory response, among Chinese women with polycystic ovary syndrome (PCOS) after ovulation induction. Methods This was a secondary analysis of a multicenter randomized trial in 1000 women with PCOS from 21 sites (27 hospitals) in Mainland China. LH and FSH levels before ovulation induction and the main outcomes including ovulation, biochemical pregnancy, clinical pregnancy, miscarriage, and live birth were measured. A linear regression model, logistic regression models and Cox proportional hazard regression model were used to estimate the association between LH/FSH ratios and reproductive outcomes in PCOS. Results LH/FSH ratio was significantly associated with age, body mass index (BMI), total testosterone (TT), estradiol (E2), free testosterone (FT), and antimullerian hormone (AMH). Anovulatory women had significantly higher LH/FSH ratio than ovulatory women (P = 0.003), especially in women with young age (P = 0.023), high BMI (P = 0.002), low E2 (P = 0.002), FT (P = 0.010), TT (P < 0.001) and AMH(P = 0.032). Women with elevated LH/FSH ratio were associated with lower ovulation (LH/FSH≥1 OR = 0.42, 95% CI, 0.26-0.68; LH/FSH≥2 OR = 0.32, 95% CI, 0.20-0.54; LH/FSH≥3 OR = 0.40, 95% CI 0.21-0.74) when compared with LH/FSH<1. The association was held after adjustment for treatment with or without the confounding factors. Although no association between LH/FSH ratio and biochemical pregnancy, women with 1 ≤ LH/FSH<2 were associated with higher clinical pregnancy (OR = 1.71; 95% CI, 1.09-2.67) and live birth (OR = 1.73; 95% CI, 1.09-2.75) compared to women with LH/FSH<1. Women with 2 ≤ LH/FSH<3 were associated with lower miscarriage rate (OR = 0.38; 95% CI, 0.16-0.93). Conclusions Elevated baseline LH/FSH ratio in women with PCOS was associated with poor ovulatory response, but women were more likely to achieve clinical pregnancy and live birth than women with normal LH/FSH. It suggests LH and FSH in women with PCOS may play a role in successful pregnancy despite of negative impact in ovulation.
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Affiliation(s)
- Qing Xia
- Department of Obstetrics and Gynaecology, Heilongjiang University of Chinese Medicine, Harbin 150001, China,Department of Obstetrics and Gynaecology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100010, China
| | - Liangzhen Xie
- Department of Obstetrics and Gynaecology, Heilongjiang University of Chinese Medicine, Harbin 150001, China
| | - Qi Wu
- Department of Obstetrics and Gynaecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200000, China,Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong City 999077, Hong Kong
| | - Jing Cong
- Department of Obstetrics and Gynaecology, Heilongjiang University of Chinese Medicine, Harbin 150001, China
| | - Hongli Ma
- Department of Obstetrics and Gynaecology, Heilongjiang University of Chinese Medicine, Harbin 150001, China
| | - Jian Li
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong City 999077, Hong Kong,Department of Obstetrics and Gynecology, The Affiliated Hospital, Gui Zhou Medical University, Gui Zhou 550000, China
| | - Wangyu Cai
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, China
| | - Xiaoke Wu
- Department of Obstetrics and Gynaecology, Heilongjiang University of Chinese Medicine, Harbin 150001, China,Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin 150001, China,Corresponding author. First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
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Li F, Cai H, Tian L, Bai H, Shi J. Effect modification by developmental stage of embryos on the association between late follicular phase progesterone elevation and live birth in fresh transfers. BMC Pregnancy Childbirth 2023; 23:24. [PMID: 36639777 PMCID: PMC9840276 DOI: 10.1186/s12884-023-05342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Late follicular phase progesterone elevation (LFPE) during ovarian stimulation is associated with reduced live birth rates (LBRs) after cleavage-stage embryo transfer. However, due to better synchronization with a stimulated endometrium, prior studies shown that LFPE had no effect on transferring embryos at blastocyst stage. The study aim to exam whether the developmental stage of embryos and serum progesterone levels on the day of human chorionic gonadotropin (hCG) administration jointly affect the odds of live birth in fresh fresh IVF/intracytoplasmic sperm injection (ICSI) cycles. METHODS: The single-center retrospective cohort study included a total of 4,471 fresh embryo transfer cycles with 2,342 at cleavage stage versus 2,129 at blastocyst stage. Patients underwent IVF/ICSI with ovarian stimulation in gonadotropin-releasing hormone antagonist protocol. The serum progesterone level was examined both as a continuous variable and as a categorical variable by quartiles. Analysis was performed using the generalized estimating equations framework and multivariate regression models. RESULTS LBRs were inversely associated with progesterone as a continuous variable on the day of hCG in both the cleavage-stage (crude OR 0.87, 95%CI 0.73-1.03; adjusted OR 0.80, 95% CI 0.65-0.98) and the blastocyst-stage (crude OR 0.66, 95%CI 0.56-0,78; adjusted OR 0.61, 95%CI 0.50-0.73) groups. The interaction testing was highly significant (P = 0.018) indicating an effect modifying role of stage of embryos transferred on the association of pregesterone values with the LBRs in fresh cycles. A similar pattern for a greater reduction in ORs for live birth in cycles with blastocysts transfer was also observed when progesterone was analyzed by interquartile ranges. The findings remained unchanged in subgroup analysis stratified by types of ovarian response. CONCLUSIONS In fresh cycles, detrimental effect of late follicular phase progesterone elevation on live birth was more prominent in blastocyst-stage group compared with that in clevaged-stage group.
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Affiliation(s)
- Fei Li
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, 73#, Houzaimen North Street, Xi’an City, Shaanxi Province China ,grid.452672.00000 0004 1757 5804The Second Affiliated Hospital of Xi’an Medical University, Xi’an City, Shaanxi Province China
| | - He Cai
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, 73#, Houzaimen North Street, Xi’an City, Shaanxi Province China
| | - Li Tian
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, 73#, Houzaimen North Street, Xi’an City, Shaanxi Province China
| | - Haiyan Bai
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, 73#, Houzaimen North Street, Xi’an City, Shaanxi Province China
| | - Juanzi Shi
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, 73#, Houzaimen North Street, Xi’an City, Shaanxi Province China
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Huang J, Liu Y, Zeng H, Tian L, Hu Y, He J, Nie L, Li Y, Fang Z, Deng W, Chen M, Zhao X, Ouyang D, Fu Y, Lin J, Xia L, Wu Q. Effect of inactivated COVID-19 vaccination on pregnancy outcomes following frozen-thawed embryo transfer: A retrospective cohort study. Int Immunopharmacol 2023; 114:109552. [PMID: 36527882 PMCID: PMC9731924 DOI: 10.1016/j.intimp.2022.109552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/16/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the effect of inactivated coronavirus disease 2019 (COVID-19) vaccination on frozen-thawed embryo transfer (FET) outcomes. METHODS This retrospective cohort study enrolled 1,210 patients undergoing FET cycles in a single university-affiliated hospital between July 1, 2021, and May 1, 2022. Of them, 387 women with two full doses of inactivated SARS-CoV-2 vaccines (CoronaVac or BBIBP-CorV) after oocyte retrieval were assigned to the vaccinated group, while 823 were unvaccinated as controls. Propensity score matching and multiple regression analysis were applied to control for baseline and cycle characteristics (19 covariates in total). RESULTS There were 265 patients in each group after matching. The rates of clinical pregnancy (58.5% vs. 60.8%; P = 0.595) and live birth (44.4% vs. 48.8%; P = 0.693) were similar between vaccinated and unvaccinated patients, with adjusted odds ratios of 0.89 (95% confidence interval [CI] 0.61-1.29) and 1.31 (95% CI 0.37-4.56), respectively. Consistently, no significant differences were found in serum human chorionic gonadotropin levels as well as biochemical pregnancy, biochemical pregnancy loss, and embryo implantation rates. Based on the time interval from vaccination to FET, vaccinated patients were further subdivided into two categories of ≤2 months and >2 months, and the outcomes remained comparable. CONCLUSION Our study showed that inactivated COVID-19 vaccination in women did not have measurable detrimental impact on implantation performance and live birth outcome during FET treatment cycles. This finding denies the impairment of endometrial receptivity and trophoblast function by vaccine-induced antibodies at the clinical level.
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Affiliation(s)
- Jialyu Huang
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Yiqi Liu
- Department of Clinical Medicine, School of Queen Mary, Nanchang University, Nanchang, China
| | - Han Zeng
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Lifeng Tian
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Yina Hu
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Jinxia He
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Ling Nie
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - You Li
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Zheng Fang
- Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Weiping Deng
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Mengyi Chen
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Xia Zhao
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Dongxiang Ouyang
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Yuqing Fu
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
| | - Jiaying Lin
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Corresponding authors at: Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China (J. Lin). Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Nanchang University School of Medicine, 318 Bayi Avenue, Nanchang 330006, China (L. Xia, Q. Wu)
| | - Leizhen Xia
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China,Corresponding authors at: Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China (J. Lin). Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Nanchang University School of Medicine, 318 Bayi Avenue, Nanchang 330006, China (L. Xia, Q. Wu)
| | - Qiongfang Wu
- Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Maternal and Child Health Hospital of Nanchang Medical College, Nanchang University, Nanchang, China,Corresponding authors at: Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China (J. Lin). Center for Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Nanchang University School of Medicine, 318 Bayi Avenue, Nanchang 330006, China (L. Xia, Q. Wu)
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Vaiarelli A, Cimadomo D, Scarafia C, Innocenti F, Amendola MG, Fabozzi G, Casarini L, Conforti A, Alviggi C, Gennarelli G, Benedetto C, Guido M, Borini A, Rienzi L, Ubaldi FM. Metaphase-II oocyte competence is unlinked to the gonadotrophins used for ovarian stimulation: a matched case-control study in women of advanced maternal age. J Assist Reprod Genet 2023; 40:169-177. [PMID: 36586005 PMCID: PMC9840736 DOI: 10.1007/s10815-022-02684-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/04/2022] [Indexed: 01/01/2023] Open
Abstract
PURPOSE An impact of different gonadotrophins selection for ovarian stimulation (OS) on oocyte competence has yet to be defined. In this study, we asked whether an association exists between OS protocol and euploid blastocyst rate (EBR) per metaphase-II (MII) oocytes. METHODS Cycles of first preimplantation genetic testing for aneuploidies conducted by women ≥ 35 years old with their own metaphase-II oocytes inseminated in the absence of severe male factor (years 2014-2018) were clustered based on whether recombinant FSH (rec-FSH) or human menopausal gonadotrophin (HMG) was used for OS, then matched for the number of fresh inseminated eggs. Four groups were outlined: rec-FSH (N = 57), rec-FSH plus rec-LH (N = 55), rec-FSH plus HMG (N = 112), and HMG-only (N = 127). Intracytoplasmic sperm injection, continuous blastocyst culture, comprehensive chromosome testing to assess full-chromosome non-mosaic aneuploidies and vitrified-warmed euploid single embryo transfers (SETs) were performed. The primary outcome was the EBR per cohort of MII oocytes. The secondary outcome was the live birth rate (LBR) per first SETs. RESULTS Rec-FSH protocol was shorter and characterized by lower total gonadotrophin (Gn) dose. The linear regression model adjusted for maternal age showed no association between the Gn adopted for OS and EBR per cohort of MII oocytes. Similarly, no association was reported with the LBR per first SETs, even when adjusting for blastocyst quality and day of full blastulation. CONCLUSION In view of enhanced personalization in OS, clinicians shall focus on different endpoints or quantitative effects related to Gn action towards follicle recruitment, development, and atresia. Here, LH and/or hCG was administered exclusively to women with expected sub/poor response; therefore, we cannot exclude that specific Gn formulations may impact patient prognosis in other populations.
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Affiliation(s)
- Alberto Vaiarelli
- Clinica Valle Giulia, GeneraLife IVF, Via G. de Notaris 2B, 00197, Rome, Italy.
| | - Danilo Cimadomo
- Clinica Valle Giulia, GeneraLife IVF, Via G. de Notaris 2B, 00197, Rome, Italy
| | - Carlotta Scarafia
- Clinica Valle Giulia, GeneraLife IVF, Via G. de Notaris 2B, 00197, Rome, Italy
| | - Federica Innocenti
- Clinica Valle Giulia, GeneraLife IVF, Via G. de Notaris 2B, 00197, Rome, Italy
| | | | - Gemma Fabozzi
- Clinica Valle Giulia, GeneraLife IVF, Via G. de Notaris 2B, 00197, Rome, Italy
| | - Livio Casarini
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Conforti
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Carlo Alviggi
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Gianluca Gennarelli
- Obstetrics and Gynecology 1U, Physiology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant'Anna Hospital, University of Turin, Turin, Italy
- Livet, GeneraLife IVF, Turin, Italy
| | - Chiara Benedetto
- Obstetrics and Gynecology 1U, Physiology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - Maurizio Guido
- Department of Clinical Medicine, Public Health, Life Sciences and Environment (MeSVA), University of L'Aquila, L'Aquila, Italy
| | | | - Laura Rienzi
- Clinica Valle Giulia, GeneraLife IVF, Via G. de Notaris 2B, 00197, Rome, Italy
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
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Wang J, Diao Z, Fang J, Zhu L, Xu Z, Lin F, Zhang N, Chen L. The influence of day 3 embryo cell number on the clinical pregnancy and live birth rates of day 5 single blastocyst transfer from frozen embryo transfer cycles. BMC Pregnancy Childbirth 2022; 22:980. [PMID: 36581843 PMCID: PMC9798545 DOI: 10.1186/s12884-022-05337-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To evaluate the influence of day 3 embryo cell number on the clinical pregnancy and live birth rates of day 5 single blastocyst transfer in frozen embryo transfer (FET) cycles. METHODS Our retrospective study included 3761 day 5 single blastocyst FET cycles between January 2015 and December 2019. These FET cycles were divided into three groups according to the day 3 embryo cell number: 939 cycles in the < 8-cell group, 1224 cycles in the 8-cell group and 1598 cycles in the > 8-cell group. The clinical pregnancy and live birth rates were compared among the three groups. RESULTS The clinical pregnancy rate of day 5 single blastocyst transfer in FET cycles increased significantly as the day 3 embryo cell number increased (52.2%, 61.4% and 66.8%, P < 0.001). Similarly, the live birth rate increased significantly as the day 3 embryo cell number increased (42.7%, 49.8% and 54.9%, P < 0.001). The results of the subgroup analysis showed that the clinical pregnancy and live birth rates were not significantly different among the three groups when good-quality blastocysts were transferred. The clinical pregnancy and live birth rates increased significantly as the day 3 embryo cell number increased when fair- and poor-quality blastocysts were transferred. CONCLUSION The day 3 embryo cell number needs to be considered when day 5 single blastocyst transfer is performed in FET cycles, especially when fair- and poor-quality blastocysts are used for transfer. The transfer of a day 5 single blastocyst derived from an embryo with faster development on day 3 may shorten the time to achieving a live birth.
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Affiliation(s)
- Jie Wang
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
| | - Zhenyu Diao
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
| | - Junshun Fang
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
| | - Lihua Zhu
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
| | - Zhipeng Xu
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
| | - Fei Lin
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
| | - Ningyuan Zhang
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
| | - Linjun Chen
- grid.428392.60000 0004 1800 1685Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, 210008 Nanjing, China ,grid.41156.370000 0001 2314 964XCenter for Molecular Reproductive Medicine, Nanjing University, 210008 Nanjing, China
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Liu Y, Mei Q, Yang J, Shen Q, Zou M, Li J, Li H, Zhang L, Xiang W. hsa-miR-320a-3p and hsa-miR-483-5p levels in human granulosa cells: promising bio-markers of live birth after IVF/ICSI. Reprod Biol Endocrinol 2022; 20:160. [PMID: 36411450 PMCID: PMC9677699 DOI: 10.1186/s12958-022-01037-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND MicroRNAs (miRNAs) are considered potential biomarkers for various diseases. This study investigated whether hsa-miR-320a-3p and hsa-miR-483-5p levels in human ovarian granulosa cells derived from follicular fluids are associated with embryo developmental competence. METHODS We collected 195 granulosa cells samples and analyzed the treatment outcomes in patients undergoing in vitro fertilization (n = 147) or intracytoplasmic sperm injection (n = 48) cycles. The hsa-miR-320a-3p and hsa-miR-483-5p levels in granulosa cells were measured using quantitative reverse transcription-polymerase chain reaction. RESULTS Patients were subdivided into four groups according to the granulosa cells hsa-miR-320a-3p and hsa-miR-483-5p levels quartiles (Q1-Q4). Embryo developmental competence was compared using the chi-square test. Patients in Q3 were less likely to achieve a normal fertilization rate for in vitro fertilization and blastocyst formation than those in Q1 as they expressed high levels of hsa-miR-320a-3p and hsa-miR-483-5p (P < 0.05). Patients in Q3 and Q4 were less likely to achieve a good-quality embryo as they expressed high levels of hsa-miR-483-5p and hsa-miR-320a-3p (P < 0.05). The hsa-miR-320a-3p and hsa-miR-483-5p levels were not associated with clinical pregnancy. However, multiple regression analysis indicated that in Q3 and Q4 intervals had experienced a decreased chance of live birth due to high expression levels of hsa-miR-320a-3p and hsa-miR-483-5p levels. The relative hsa-miR-320a-3p expression levels in granulosa cells were weakly and positively correlated with the patient age (P = 0.0033). Moreover, both the basal follicle stimulating hormone (P = 0.0003) and ovarian stimulation protocols (P = 0.006 and P = 0.004) significantly and positively affected hsa-miR-320a-3p levels. The days of stimulation was negatively correlated with the relative hsa-miR-320a-3p expression level (P = 0.047). CONCLUSIONS The hsa-miR-320a-3p and hsa-miR-483-5p levels in human granulosa cells negatively correlated with the good-quality embryo rate and live birth, indicating that hsa-miR-320a-3p and hsa-miR-483-5p can be used as potential negative indicators to predict good-quality embryos and live births.
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Affiliation(s)
- Yu Liu
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Wuhan, 430070, P. R. China
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Qiaojuan Mei
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Jiahao Yang
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Qiuzi Shen
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Min Zou
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Jiao Li
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Huaibiao Li
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
| | - Ling Zhang
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China.
| | - Wenpei Xiang
- Institute of Reproductive Health and Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China.
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Kakinuma T, Kakinuma K, Matsuda Y, Ohwada M, Yanagida K. Successful live birth following hysteroscopic adhesiolysis under laparoscopic observation for Asherman’s syndrome: A case report. World J Clin Cases 2022; 10:11949-11954. [PMID: 36405260 PMCID: PMC9669856 DOI: 10.12998/wjcc.v10.i32.11949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/27/2022] [Accepted: 10/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Asherman’s syndrome is characterized by reduced menstrual volume and adhesions within the uterine cavity and cervix, resulting in inability to carry a pregnancy to term, placental malformation, or infertility. We present the case of a 40-year-old woman diagnosed with Asherman’s syndrome who successfully gave birth to a live full-term neonate after hysteroscopic adhesiolysis under laparoscopic observation, intrauterine device insertion, and Kaufmann therapy.
CASE SUMMARY A 40-year-old woman (Gravida 3, Para 0) arrived at our hospital for specialist care to carry her pregnancy to term. She had previously undergone six sessions of dilation and curettage owing to a hydatidiform mole and persistent trophoblastic disease, followed by chemotherapy. She subsequently became pregnant twice, but both pregnancies resulted in spontaneous miscarriages during the first trimester. Her menstrual periods were very light and of short duration. Hysteroscopic adhesiolysis with concurrent laparoscopy was performed, and Asherman’s syndrome was diagnosed. The uterine adhesions covered the area from the internal cervical os to the uterine fundus. Postoperative Kaufmann therapy was administered, and endometrial regeneration was confirmed using hysteroscopy. She became pregnant 9 mo postoperatively and delivered through elective cesarean section at 37 wk of gestation. The postpartum course was uneventful, and she was discharged on postoperative day 7.
CONCLUSION Hysteroscopic adhesiolysis with concurrent laparoscopy enables identification and resection of the affected area and safe and accurate surgery, without complications.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City 329-2763, Tochigi, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City 329-2763, Tochigi, Japan
| | - Yoshio Matsuda
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City 329-2763, Tochigi, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City 329-2763, Tochigi, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City 329-2763, Tochigi, Japan
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Bayram A, Elkhatib I, Abdala A, Nogueira D, Melado L, Fatemi HM, Lawrenz B. ART outcome after euploid frozen embryo transfer is not affected by previous Cesarean section delivery in the absence of intracavitary fluid. J Assist Reprod Genet 2022; 39:2529-2537. [PMID: 36190594 PMCID: PMC9723015 DOI: 10.1007/s10815-022-02627-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/21/2022] [Indexed: 10/10/2022] Open
Abstract
PURPOSE To evaluate the impact of a cesarean section (CS) on the chance of clinical pregnancy and live birth (LB) in frozen embryo transfer (FET) cycles in the setting of euploid embryos and the absence of intracavitary fluid (ICF) as causes of implantation failure were excluded. METHODS Retrospective study, including patients with at least one previous CS or at least one previous vaginal delivery, who underwent a euploid FET cycle. RESULTS A total of 412 euploid embryo transfer cycles had been included. Patients' mean age was 34.5 years and 42.48% of patients have had at least one previous CS. A clinical pregnancy was seen in 69.42% and 60.19% of the patients had a LB. Positive pregnancy test, clinical pregnancy, and LB rate were not significantly different between the groups without/with a history of a previous CS (p = 0.6/0.45/0.94, respectively). LB rate was significantly reduced by the presence of mucus on the ET catheter (OR: 0.413; p = 0.010), the BMI (OR: 0.946; p = 0.006), the combined embryo quality (embryo quality fair: OR: 0.444; p = 0.001; embryo quality low: OR: 0.062; p < 0.001), and by the HRT endometrial preparation approach (OR: 0.609; p = 0.023). CONCLUSION The possible negative impact of a CS can be overcome when a euploid FET after exclusion of ICF is performed.
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Affiliation(s)
- Asina Bayram
- ART Fertility Clinic, Royal Marina Village, B22-23, Abu Dhabi, 60202, UAE
| | - Ibrahim Elkhatib
- ART Fertility Clinic, Royal Marina Village, B22-23, Abu Dhabi, 60202, UAE
| | - Andrea Abdala
- ART Fertility Clinic, Royal Marina Village, B22-23, Abu Dhabi, 60202, UAE
| | - Daniela Nogueira
- ART Fertility Clinic, Royal Marina Village, B22-23, Abu Dhabi, 60202, UAE
| | - Laura Melado
- ART Fertility Clinic, Royal Marina Village, B22-23, Abu Dhabi, 60202, UAE
| | - Human M Fatemi
- ART Fertility Clinic, Royal Marina Village, B22-23, Abu Dhabi, 60202, UAE
| | - Barbara Lawrenz
- ART Fertility Clinic, Royal Marina Village, B22-23, Abu Dhabi, 60202, UAE.
- Women's University Hospital Tübingen, Calwer Str. 7, Tübingen, Germany.
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Zhang Y, de Ziegler D, Hu X, Tai X, Han Y, Ma J, Zhang Y, Luo H. Previous caesarean delivery and the presence of caesarean scar defects could affect pregnancy outcomes after in vitro fertilization frozen-thawed embryo transfer: a retrospective cohort study. BMC Pregnancy Childbirth 2022; 22:769. [PMID: 36229782 PMCID: PMC9559067 DOI: 10.1186/s12884-022-05085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Due to various iatrogenic and social factors, the global caesarean delivery (CD) rate has risen sharply in the past 30 years. It is more complicated and dangerous for women with a scarred uterus to experience pregnancy again than for women with a previous vaginal delivery (VD). In this study we investigated the impact of previous caesarean delivery (CD) and caesarean scar defects (CSDs) on pregnancy outcomes after in vitro fertilization frozen-thawed embryo transfer (IVF-FET). METHODS We conducted a retrospective cohort study that included 1122 women aged < 40 years who had a history of only one parturition (after 28 weeks of pregnancy) and who underwent their first FET cycle between January 2014 and January 2020. Patients were divided into the CD group, VD group, and CSD group. Thereafter, according to the number of transferred embryos, the CD, VD, and CSD groups were divided into the single embryo transfer (SET) group and the double embryo transfer (DET) group. Outcome measures in this study were live birth, clinical pregnancy, multiple pregnancy, ectopic pregnancy, pregnancy loss, pregnancy complications, preterm birth, and neonatal birth weight. Multivariate logistic regression was performed to evaluate the relationship between pregnancy outcomes and CD. RESULTS In SET patients, the clinical pregnancy and live birth rates were decreased in the CSD group compared with the VD and CD groups. In DET patients, the clinical pregnancy and live birth rates were significantly lower in theCSD group than in the CD and VD groups. After adjustment for confounders, previous CD and CSD were associated with a significantly lower clinical pregnancy rate and live birth rate than previous VD in the total sample. This effect was observed in DET patients, but not in SET patients. Additionally, DET patients with previous CD had a significantly higher multiple pregnancy rate (AOR = 0.47, 95% CI = 0.29, 0.75, P = 0.002) than those with previous VD, but no significant associations were observed in CSD and multiple pregnancies (AOR = 0.55, 95% CI = 0.23, 1.34, P = 0.192) between DET patients with CD and those with VD after adjusting for potential confounders. CONCLUSIONS Our study showed that during an FET cycle, previous CD and the presence of a CSD could negatively affect pregnancy outcomes especially in DET patients.
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Affiliation(s)
- Yinfeng Zhang
- grid.216938.70000 0000 9878 7032Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity Hospital, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Dominique de Ziegler
- grid.508487.60000 0004 7885 7602Department of Obstetrics and Gynecology Hôpital Foch – Université de Paris Ouest (UVSQ), Suresnes France, France ,grid.240324.30000 0001 2109 4251Department Obstetrics and Gynecology- NYU Langone Health, New York, NY USA
| | - Xinyu Hu
- grid.265021.20000 0000 9792 1228Tianjin Medical University, Tianjin, 300070 China
| | - Xiaomei Tai
- grid.265021.20000 0000 9792 1228Tianjin Medical University, Tianjin, 300070 China
| | - Ying Han
- grid.216938.70000 0000 9878 7032Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity Hospital, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Junfang Ma
- grid.216938.70000 0000 9878 7032Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity Hospital, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Yunshan Zhang
- grid.216938.70000 0000 9878 7032Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity Hospital, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
| | - Haining Luo
- grid.216938.70000 0000 9878 7032Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity Hospital, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No 156 Sanma Road, Nankai District, Tianjin, 300100 China
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Hu KL, Yang R, Xu H, Mol BW, Li R, Wang R. Anti-Müllerian hormone in guiding the selection of a freeze-all versus a fresh embryo transfer strategy: a cohort study. J Assist Reprod Genet 2022; 39:2325-2333. [PMID: 35870096 PMCID: PMC9596674 DOI: 10.1007/s10815-022-02564-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/04/2022] [Indexed: 10/16/2022] Open
Abstract
PURPOSE To explore an interaction effect between serum anti-Müllerian hormone (AMH) levels and the relative treatment effect of a freeze-all versus a fresh embryo transfer strategy on live birth. METHODS This was a retrospective cohort study investigating couples with infertility and eligible for both freeze-all and fresh embryo transfer between 2017 and 2019. Women with an absolute indication for a freeze-all strategy were excluded. Multivariable fractional polynomial interaction analysis within a logistic regression model was used to evaluate whether the treatment effect of a freeze-all versus a fresh transfer strategy varied at different AMH levels. Non-linear interactions were also considered. The primary outcome was the live birth after the first transfer. RESULTS A total of 13,503 women underwent a fresh embryo transfer and 2247 women underwent a freeze-all strategy. Live birth rates were slightly higher in the freeze-all group compared to those in the fresh embryo transfer group (35% vs 33%). There was a non-linear interaction between baseline serum AMH levels and the relative treatment effect of a freeze-all strategy versus a fresh transfer strategy on live birth (P = 0.0161). The benefit on live birth from a freeze-all embryo transfer strategy was greatest in women with a high serum level (> 7 ng/ml). The interaction remained valid when different imputation methods were used. CONCLUSION As serum AMH level increased, there was a nonlinear increase in relative treatment effect of a freeze-only transfer versus a fresh transfer strategy on live birth, and such an effect reaches its maximum in women with high AMH levels.
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Affiliation(s)
- Kai-Lun Hu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, No. 49 HuaYuan North Road, Haidian District, Beijing, 100191, China
| | - Rui Yang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, No. 49 HuaYuan North Road, Haidian District, Beijing, 100191, China
| | - Huiyu Xu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, No. 49 HuaYuan North Road, Haidian District, Beijing, 100191, China
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, 3168, Australia
| | - Rong Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, No. 49 HuaYuan North Road, Haidian District, Beijing, 100191, China.
| | - Rui Wang
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, 3168, Australia
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Kahraman S, Duzguner INB, Sahin Y, Irez T. What to advise to patients with only one good quality blastocyst, PGT-A or not? Outcomes of 2064 cycles. J Assist Reprod Genet 2022; 39:2555-2562. [PMID: 36125650 PMCID: PMC9723074 DOI: 10.1007/s10815-022-02617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/07/2022] [Indexed: 10/14/2022] Open
Abstract
PURPOSE To evaluate whether preimplantation genetic testing for aneuploidy (PGT-A) is beneficial for patients who have only one blastocyst available for biopsy or transfer. METHODS This retrospective study was based on 1126 single blastocyst PGT-A and 938 non-PGT-A cycles, a total of 2064 ART cycles which resulted in a single good quality blastocyst in women between 20 and 45 years old. The PGT-A group had 225 single euploid embryo transfer cycles and the non-PGT-A group had 938 single blastocyst embryo transfer cycles. RESULTS In the generalized linear mixed model (GLMM), female age and PGT-A variables were found to be significant variables on pregnancy outcomes. In the PGT-A cases, regardless of the effect of other variables, the probabilities of clinical pregnancy and live birth were found to be 3.907 and 3.448 fold higher respectively than in the non-PGT-A cases (p < 0.001). In non PGT-A cases, the probability of a total pregnancy loss was found to be 1.943 fold higher (p = 0.013). CONCLUSION PGT-A in the presence of a single blastocyst significantly increases clinical pregnancy and live birth rates and decreases total pregnancy losses regardless of age. In addition, aneuploid embryo transfer cancelations prevent ineffective and potentially risky transfers.
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Affiliation(s)
- Semra Kahraman
- ART and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey.
| | - Ipek Nur Balin Duzguner
- ART and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Yucel Sahin
- ART and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Tulay Irez
- Faculty of Medicine, Department of Histology and Embryology, Biruni University, Istanbul, Turkey
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Grzegorczyk-Martin V, Roset J, Di Pizio P, Fréour T, Barrière P, Pouly JL, Grynberg M, Parneix I, Avril C, Pacheco J, Grzegorczyk TM. Adaptive data-driven models to best predict the likelihood of live birth as the IVF cycle moves on and for each embryo transfer. J Assist Reprod Genet 2022; 39:1937-49. [PMID: 35767167 DOI: 10.1007/s10815-022-02547-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/09/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To dynamically assess the evolution of live birth predictive factors' impact throughout the in vitro fertilization (IVF) process, for each fresh and subsequent frozen embryo transfers. METHODS In this multicentric study, data from 13,574 fresh IVF cycles and 6,770 subsequent frozen embryo transfers were retrospectively analyzed. Fifty-seven descriptive parameters were included and split into four categories: (1) demographic (couple's baseline characteristics), (2) ovarian stimulation, (3) laboratory data, and (4) embryo transfer (fresh and frozen). All these parameters were used to develop four successive predictive models with the outcome being a live birth event. RESULTS Eight parameters were predictive of live birth in the first step after the first consultation, 9 in the second step after the stimulation, 11 in the third step with laboratory data, and 13 in the 4th step at the transfer stage. The predictive performance of the models increased at each step. Certain parameters remained predictive in all 4 models while others were predictive only in the first models and no longer in the subsequent ones when including new parameters. Moreover, some parameters were predictive in fresh transfers but not in frozen transfers. CONCLUSION This work evaluates the chances of live birth for each embryo transfer individually and not the cumulative outcome after multiple IVF attempts. The different predictive models allow to determine which parameters should be taken into account or not at each step of an IVF cycle, and especially at the time of each embryo transfer, fresh or frozen.
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Li NJ, Yao QY, Yuan XQ, Huang Y, Li YF. Anti-müllerian hormone as a predictor for live birth among women undergoing IVF/ICSI in different age groups: an update of systematic review and meta-analysis. Arch Gynecol Obstet 2022. [PMID: 35907969 DOI: 10.1007/s00404-022-06683-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/19/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To update the evidence of anti-müllerian hormone (AMH) as predictive factors for live birth outcome in women undergoing assisted conception and discover the modulating effect of age. METHODS PubMed, Embase, Medline, and Web of Science were searched for studies published until June 2021. We included studies that measured serum AMH levels and reported the subsequent live birth outcomes. Random effects models and hierarchical summary receiver operating characteristics (HSROC) models were used. The QUADAS-2 checklist was employed to assess the quality of the included studies. RESULTS We included 27 studies (27,029 women) investigating the relationship between AMH and live birth outcome after assisted conception. The diagnostic odds ratios (DOR) from random effects models were ruled out due to high heterogeneity. Our findings suggested that AMH was associated with live birth. The DOR was 2.21 (95% CI 1.89-2.59), and 2.49 (95% CI 1.26-4.91) for studies on women with unspecified ovarian reserve and women with low ovarian reserve, respectively. The DOR of those with advanced ages was 2.50 (95% CI 1.87-2.60). For younger women, the DOR was 1.41 (95% CI 0.99-2.02). HSROCs showed that AMH had no predictive ability towards live birth in women with diminished ovarian reserve or younger age. Exclusion of Chinese cohorts lowered the heterogeneity. CONCLUSIONS This study revealed that AMH had better prediction for live birth in advanced-age women. AMH may have implicative predictive value for assisted conception counseling of couples of advanced ages.
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Ueno S, Berntsen J, Ito M, Okimura T, Kato K. Correlation between an annotation-free embryo scoring system based on deep learning and live birth/neonatal outcomes after single vitrified-warmed blastocyst transfer: a single-centre, large-cohort retrospective study. J Assist Reprod Genet 2022; 39:2089-2099. [PMID: 35881272 PMCID: PMC9475010 DOI: 10.1007/s10815-022-02562-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/04/2022] [Indexed: 11/30/2022] Open
Abstract
Propose Does an annotation-free embryo scoring system based on deep learning and time-lapse sequence images correlate with live birth (LB) and neonatal outcomes? Methods Patients who underwent SVBT cycles (3010 cycles, mean age: 39.3 ± 4.0). Scores were calculated using the iDAScore software module in the Vitrolife Technology Hub (Vitrolife, Gothenburg, Sweden). The correlation between iDAScore, LB rates, and total miscarriage (TM), including 1st- and 2nd-trimester miscarriage, was analysed using a trend test and multivariable logistic regression analysis. Furthermore, the correlation between the iDAScore and neonatal outcomes was analysed. Results LB rates decreased as iDAScore decreased (P < 0.05), and a similar inverse trend was observed for the TM rates. Additionally, multivariate logistic regression analysis showed that iDAScore significantly correlated with increased LB (adjusted odds ratio: 1.811, 95% CI: 1.666–1.976, P < 0.05) and decreased TM (adjusted odds ratio: 0.799, 95% CI: 0.706–0.905, P < 0.05). There was no significant correlation between iDAScore and neonatal outcomes, including congenital malformations, sex, gestational age, and birth weight. Multivariate logistic regression analysis, which included maternal and paternal age, maternal body mass index, parity, smoking, and presence or absence of caesarean section as confounding factors, revealed no significant difference in any neonatal characteristics. Conclusion Automatic embryo scoring using iDAScore correlates with decreased miscarriage and increased LB and has no correlation with neonatal outcomes. Supplementary information The online version contains supplementary material available at 10.1007/s10815-022-02562-5.
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Affiliation(s)
- Satoshi Ueno
- Kato Ladies Clinic, 7-20-3, Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan
| | | | - Motoki Ito
- Kato Ladies Clinic, 7-20-3, Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan
| | - Tadashi Okimura
- Kato Ladies Clinic, 7-20-3, Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan
| | - Keiichi Kato
- Kato Ladies Clinic, 7-20-3, Nishi-shinjuku, Shinjuku, Tokyo, 160-0023, Japan.
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Wang X, Xiao Y, Sun Z, Zhen J, Yu Q. Strategy for embryo transfer to improve pregnancy outcomes in advanced maternal age. ZYGOTE 2022;:1-9. [PMID: 35860989 DOI: 10.1017/S0967199422000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of this retrospective study was to optimize the transplantation strategy for women of advanced maternal age to achieve live births within the shortest time. Data were collected from patients older than 40 years who underwent assisted reproductive therapy at our centre from 1 January 2009 to 31 December 2019. In total, 1023 cases of fresh cleavage embryo transfer (CET) cycles, 280 cases of frozen-thawed blastocyst transfer (FBT) cycles, and 26 cases of frozen-thawed CET (FCET) cycles were included. The main outcome was the live birth rate (LBR). The secondary outcomes were the clinical pregnancy rate (CPR) and neonatal outcomes. Multivariable logistic regression was performed to adjust for confounding factors. The blastocyst formation rate of patients older than 40 years was 23.5%, the freezing cycle rate was 19.8%, and the fresh-embryo transfer rate was 83.0%. The implantation rate, CPR, and LBR were significantly different among the CET, FCET, and FBT groups. There were no significant differences in multiple pregnancies and abortion rates among the groups, and neonatal outcomes were similar. Multivariate logistic regression analysis showed that, compared with the CET group, LBR did not increase in the FCET group, whereas LBR increased in the FBT group. For patients older than 40 years when having approximately eight embryos after fertilization, blastocyst transfer can be considered after fully discussing the advantages and disadvantages of blastocyst culture. Alternatively, CET can be performed first, followed by FBT if the cleavage embryo transfer is unsuccessful.
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Tibebu NS, Emiru TD, Tiruneh CM, Getu BD, Abate MW, Nigat AB, Bantie B, Legas G, Walle BG, Feleke MG, Birrie E. Magnitude of birth asphyxia and its associated factors among live birth in north Central Ethiopia 2021: an institutional-based cross-sectional study. BMC Pediatr 2022; 22:425. [PMID: 35850676 DOI: 10.1186/s12887-022-03500-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background The leading cause of neonatal death worldwide is birth asphyxia. Yearly, in the first month of life, 2.5 million children died around the world. Birth asphyxia is a major problem, particularly in developing nations like Ethiopia. The goal of this study was to determine the magnitude of birth asphyxia and the factors that contributed to it among neonates delivered at the Aykel Primary Hospital in north-central Ethiopia. Methods From August 1 to August 31, 2021, a hospital-based cross-sectional study was conducted on 144 live births. An Apgar score less than 7 in the fifth minute of birth authorized the diagnosis of birth asphyxia. Variable contention (P < 0.250) for multivariable analysis was determined after data examination and cleaning. Then, to identify important factors of birth asphyxia, a multivariable logistic regression model with a p-value of 0.05 was developed. Finally, a significant relationship between a dependent variable and independent factors was defined as a p-value less than 0.05 with a 95% confidence interval. Results The majority of the mothers, 71.53%, received at least one Antenatal care visit, and more than half of the newborns were male (62.50%). The percentage of neonates that had asphyxia at delivery was 11.11% (95% CI: 6.3 -16.9%). Male newborns were 5.02 times more probable than female newborns to asphyxiate [AOR: 5.02, 95% CI (1.11–22.61)]. Mothers who have not had at least one Antenatal Care visit were 3.72 times more likely to have an asphyxiated newborn than those who have at least one Antenatal Care visit [AOR: 3.72, 95%CI (1.11–12.42)]. Similarly, mothers who had an adverse pregnancy outcome were 7.03 times more likely to have an asphyxiated newborn than mothers who had no such history [AOR: 7.03, 95% CI (2.17–22.70)]. Conclusion Birth asphyxia in newborn has come to a standstill as a major public health issue. The sexual identity of the newborn, Antenatal Care visits, and a history of poor pregnancy outcomes were all found to be significant risk factors for birth asphyxia. These findings have great importance for various stakeholders who are responsible for reducing birth asphyxia; in addition, policymakers should establish and revise guidelines associated to newborn activities and workshops.
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Ozyurt R, Karakus C. Follicular fluid 25-hydroxyvitamin D levels determine fertility outcome in patients with polycystic ovary syndrome. Taiwan J Obstet Gynecol 2022; 61:620-5. [PMID: 35779910 DOI: 10.1016/j.tjog.2022.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine the possible relationship between follicular fluid 25-hydroxyvitamin D [25(OH)D] levels and fertility outcome of women who underwent IVF/ICSI with the diagnosis of lean polycystic ovary syndrome. MATERIALS AND METHODS Thirty patients who were diagnosed with PCOS according to the Rotterdam criteria and decided on IVF/ICSI were included in the study. Thirty patients who were scheduled for IVF/ICSI for reasons other than PCOS and matched in terms of age and BMI were taken as the control group (non-PCOS). According to BMI values, patients in both PCOS and non-PCOS groups were lean. Women in both groups were aged 21-35 years with a normal BMI (18.5-24.9 kg/m2) and first IVF/ICSI attempt. Both groups of patients were followed up using the antagonist protocol. Vit D levels were measured in serum and follicular fluid (FF) samples taken on the day of oocyte collection. The correlation between FF vit D levels, the number of total oocytes, MII oocytes and 2 PN zygotes, HOMA-IR, hormonal and demographic parameters, clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate were evaluated. RESULTS At the time of oocyte retrieval women with PCOS had similar serum Vitamin D compared to non-PCOS women (21.8 (12.6-24.8) ng/ml vs 22.3 (11.5-25.1) ng/ml, p < 0.54). In FF, assessed on the day of oocyte retrieval, the concentration of Vitamin D was similar in women with PCOS when compared to non-PCOS women (11.2 (9.2-14.4) ng/ml vs 13.3 (11.1-17.4) ng/ml, p < 0.06). For both groups, Vitamin D levels were lower in FF compared to serum vit D. A positive correlation was found between serum and FF Vitamin D concentrations in the full cohort. A positive and significant correlation was found between FF-vit D levels and the number of total oocyte (r = 0.344, p < 0.04) and MII oocyte (r = 0.404, p < 0.02) in the PCOS group. The number of total oocyte, MII oocyte and 2 PN zygotes of the PCOS group were significantly higher than the non-PCOS group. Positive pregnancy test rate, clinical pregnancy and live birth rates were similar in both groups. The miscarriage rates in the non-PCOS group were significantly higher than in the PCOS group. A positive and significant correlation was also found between FF vit D levels and positive pregnancy test (r = 0.566, p < 0.03) and CPR (r = 0.605, p < 0.02) in PCOS group. There was no correlation between FF-vit D levels and live birth and miscarriage rates in neither the PCOS nor the non-PCOS group. CONCLUSIONS Both serum and FF 25-hydroxyvitamin D level of women with PCOS at the time of oocyte retrieval are similar to non-PCOS controls. While FF 25-hydroxyvitamin D levels correlate with total and MII oocyte counts, positive pregnancy test and CPR, it does not correlate with miscarriage and live birth rates.
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Mitter VR, Grädel F, Kohl Schwartz AS, von Wolff M. Gonadotropin Stimulation Reduces the Implantation and Live Birth Rate but Not the Miscarriage Rate of Embryos Transferred When Compared to Unstimulated In Vitro Fertilization. Reprod Sci 2022; 30:283-290. [PMID: 35768691 PMCID: PMC9810560 DOI: 10.1007/s43032-022-01016-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/14/2022] [Indexed: 01/07/2023]
Abstract
Research suggests that gonadotropin stimulation in in vitro fertilization (IVF) treatment affects embryo quality and the endometrium that might influence embryo implantation, placentation and establishment of a viable pregnancy. We assessed the impact of gonadotropin stimulation on implantation, live birth and miscarriage rates per transferred embryo by comparing stimulated and unstimulated IVF treatment. In a cohort of 728 couples, 1310 IVF cycles with successful embryo transfer were analysed; 857 cycles were stimulated with gonadotropins > 75 IU/day (333 poor responder < 4 oocytes; 524 normal responders), and 453 were unstimulated. In total, 1913 fresh cleavage-stage embryos were transferred. Zygote but no embryo selection was performed, and supernumerous zygotes were vitrified. The implantation rate was defined as number of sonographically detected amniotic sacs; live birth rate as number of children born per transferred embryo. Modified mixed effect Poisson regression was used to account for the dependency of cycles and embryos within the same women and the same transfer cycle. Adjustments were made for maternal age, parity, primary or secondary infertility and indication for IVF. Per transferred embryo, implantation rates (rate ratio (RR) 1.37; 95% CI 1.04-1.81; p = 0.028; aRR 1.42; 95% CI 1.10-1.84; p = 0.008) and live birth rates (RR 1.33; 95% CI 0.95-1.86; p = 0.093; aRR 1.38; 95% CI 1.01-1.88; p = 0.044) were higher in NC-IVF compared to cIVF normal responders. Miscarriage did not differ (RR 0.99; 95% CI 0.59-1.65; p = 0.965; aRR 0.90; 95% CI 0.52-1.53 p = 0.698). Similar results were obtained in poor responders. The study suggests an impact of gonadotropin stimulation on the implantation potential of embryos.
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Affiliation(s)
- Vera Ruth Mitter
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital, Inselspital Bern, University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland. .,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Flavia Grädel
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital, Inselspital Bern, University of Bern, Friedbühlstrasse 19, 3010 Bern, Switzerland ,Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Sabrina Kohl Schwartz
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital, Inselspital Bern, University of Bern, Friedbühlstrasse 19, 3010 Bern, Switzerland ,Division of Reproductive Medicine and Gynaecological Endocrinology, Cantonal Hospital Lucerne, Women’s Hospital, Lucerne, Switzerland
| | - Michael von Wolff
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital, Inselspital Bern, University of Bern, Friedbühlstrasse 19, 3010 Bern, Switzerland
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Han Y, Yao R, Zhang Y, Yang Z, Luo H, Wang X, Du A, Zhang Y, Zhu Y. Hysteroscopic resection of type 3 fibroids could improve the pregnancy outcomes in infertile women: a case-control study. BMC Pregnancy Childbirth 2022; 22:522. [PMID: 35764945 PMCID: PMC9241258 DOI: 10.1186/s12884-022-04828-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Type 3 fibroids are a special subtype of intramural fibroids that are likely to affect the pregnancy outcomes of assisted reproductive techniques. Hysteroscopic resection is a treatment for type 3 fibroids, but there has few study of its efficacy to date. In this study we evaluated the effect of hysteroscopic resection of type 3 fibroids on the pregnancy outcomes in infertile women. Methods This retrospective case–control study was conducted from January 1, 2014 to June 30, 2021. Patients who underwent IVF-ICSI in our unit were divided into a type 3 fibroid group and a hysteroscopic myomectomy group. The inclusion criteria for the type 3 fibroid group and the hysteroscopic myomectomy group were as follows: 1) age ≤ 40 years; 2) fibroid diameter or total fibroid diameter > 2.0 cm. The following exclusion criteria were used: 1) oocyte donor treatment cycles and 2) presence of chromosomal abnormalities; 3) history of other uterine surgery; 4) presence of intracavitary lesions, including submucosal fibroids; 5) single fibroid > 5.0 cm; 6) cervical fibroids; 7) unclear ultrasound description of fibroids; 8) preimplantation genetic testing was performed and 9) congenital or acquired uterine malformations. The control group in our study was selected from patients who were treated with IVF only because of fallopian tube factors. According to the age of the type 3 fibroid group and hysteroscopic myomectomy group, random sampling was carried out in the patients between 25 and 47 years of age to determine a control group. The outcomes measured included the average transfer times to live birth, cumulative clinical pregnancy rate, and cumulative live birth rate. Results A total of 302 cycles were enrolled in our study, including 125 cycles with type 3 fibroids, 122 cycles with hysteroscopic myomectomy, and 139 cycles of control patients. The average transfer times to live birth were significantly higher in the type 3 fibroid group than in the other two groups. The frequency of cumulative live births in the type 3 fibroid group was significantly lower than that in the control group. Compared with the control group, the hysteroscopic myomectomy patients had no statistically significant differences in the cumulative clinical pregnancy rate and cumulative live birth rate. Conclusions Type 3 fibroids significantly reduced the cumulative live birth rate of IVF patients. Ultrasound-guided hysteroscopic myomectomy can be used as a treatment for type 3 fibroids and could improve the pregnancy outcomes in infertile women.
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Affiliation(s)
- Ying Han
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China
| | - Ruqiang Yao
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China
| | - Yinfeng Zhang
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China
| | - Zexin Yang
- Tianjin Medical University, Tianjin, 300070, China
| | - Haining Luo
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China
| | - XinYan Wang
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China
| | - Aijun Du
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China
| | - Yunshan Zhang
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China.
| | - Yingjun Zhu
- Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Gynaecology Obstetrics, No 156 Sanma Road, Nankai District, Tianjin, 300100, China.
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Shi B, Cui L, Ye X, Ye Y. Long-term cryopreservation and frozen embryo transfer do not impact clinical and neonatal outcomes: a retrospective cohort study of slow-frozen early-cleavage human embryos. ZYGOTE 2022;:1-7. [PMID: 35730368 DOI: 10.1017/S0967199422000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study aimed to evaluate the effect of the cryopreservation duration (up to 160 months) on the clinical and neonatal outcomes of slow-frozen early-cleavage human embryos. Clinical data collected between February 2013 and August 2017 were included in this retrospective study. Cases were classified into five groups by the duration of cryopreservation: Group 1, 6-12 months; Group 2, 13-36 months; Group 3, 37-60 months; Group 4, 61-84 months; and Group 5, >84 months. The embryo survival rate, implantation rate, clinical pregnancy rate, live-birth rate, newborn sex ratio, singleton gestational age, singleton birth weight and malformation rate were compared between the groups. The cryopreservation duration did not significantly affect the rates of clinical pregnancy (P = 0.119) and live birth (P = 0.354), the newborn sex ratio (P = 0.614) or the singleton gestational age (P = 0.212) and birthweight (P = 0.212). Although decreases in the embryo survival and implantation rates were observed in groups 4 and 5 compared with those in groups 1-3, these differences were not statistically significant (P = 0.329, P = 0.279, respectively). Long-term cryopreservation does not appear to adversely affect the clinical and neonatal outcomes of slow-frozen early-cleavage human embryos.
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Björvang RD, Hallberg I, Pikki A, Berglund L, Pedrelli M, Kiviranta H, Rantakokko P, Ruokojärvi P, Lindh CH, Olovsson M, Persson S, Holte J, Sjunnesson Y, Damdimopoulou P. Follicular fluid and blood levels of persistent organic pollutants and reproductive outcomes among women undergoing assisted reproductive technologies. Environ Res 2022; 208:112626. [PMID: 34973191 DOI: 10.1016/j.envres.2021.112626] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/14/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Persistent organic pollutants (POPs) are industrial chemicals resistant to degradation and have been shown to have adverse effects on reproductive health in wildlife and humans. Although regulations have reduced their levels, they are still ubiquitously present and pose a global concern. Here, we studied a cohort of 185 women aged 21-43 years with a median of 2 years of infertility who were seeking assisted reproductive technology (ART) treatment at the Carl von Linné Clinic in Uppsala, Sweden. We analyzed the levels of 9 organochlorine pesticides (OCPs), 10 polychlorinated biphenyls (PCBs), 3 polybrominated diphenyl ethers (PBDEs), and 8 perfluoroalkyl substances (PFASs) in the blood and follicular fluid (FF) samples collected during ovum pick-up. Impact of age on chemical transfer from blood to FF was analyzed. Associations of chemicals, both individually and as a mixture, to 10 ART endpoints were investigated using linear, logistic, and weighted quantile sum regression, adjusted for age, body mass index, parity, fatty fish intake and cause of infertility. Out of the 30 chemicals, 20 were detected in more than half of the blood samples and 15 in FF. Chemical transfer from blood to FF increased with age. Chemical groups in blood crossed the blood-follicle barrier at different rates: OCPs > PCBs > PFASs. Hexachlorobenzene, an OCP, was associated with lower anti-Müllerian hormone, clinical pregnancy, and live birth. PCBs and PFASs were associated with higher antral follicle count and ovarian response as measured by ovarian sensitivity index, but also with lower embryo quality. As a mixture, similar findings were seen for the sum of PCBs and PFASs. Our results suggest that age plays a role in the chemical transfer from blood to FF and that exposure to POPs significantly associates with ART outcomes. We strongly encourage further studies to elucidate the underlying mechanisms of reproductive effects of POPs in humans.
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Affiliation(s)
- Richelle D Björvang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.
| | - Ida Hallberg
- Department of Clinical Sciences, Division of Reproduction, The Centre for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - Anne Pikki
- Carl von Linnékliniken, 751 83 Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Lars Berglund
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, 751 22 Uppsala, Sweden
| | - Matteo Pedrelli
- Cardio Metabolic Unit, Department of Laboratory Medicine and Department of Medicine, Karolinska Institutet, Huddinge, 141 52 Stockholm, Sweden; Medicine Unit Endocrinology, Theme Inflammation and Ageing, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Hannu Kiviranta
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Panu Rantakokko
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Päivi Ruokojärvi
- Department of Health Security, Finnish Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 223 61 Lund, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Sara Persson
- Department of Clinical Sciences, Division of Reproduction, The Centre for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - Jan Holte
- Carl von Linnékliniken, 751 83 Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Ylva Sjunnesson
- Department of Clinical Sciences, Division of Reproduction, The Centre for Reproductive Biology in Uppsala, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
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Paul R, Romero A, Moltó J, Ortuño N, Aizpurua J, Gómez-Torres MJ. Associations of paternal serum dioxin-like polychlorinated biphenyl concentrations with IVF success: A pilot study. Environ Res 2022; 206:112248. [PMID: 34688647 DOI: 10.1016/j.envres.2021.112248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
Dioxin-like polychlorinated biphenyls (DL-PCBs) are environmental pollutants that have been associated with impaired semen quality. However, research on the potential impact of paternal exposure to DL-PCBs and the risk of adverse pregnancy outcomes are limited. We examine the relationship between serum DL-PCB concentrations and IVF outcomes among 42 males seeking fertility treatment. Concentrations of 12 serum DL-PCBs were analyzed by high-resolution gas chromatography coupled to high-resolution mass spectrometry. Modified Poisson regressions, adjusted for confounders, were used to assess bivariate associations and to estimate risk ratios (RRs) between DL-PCBs and binary IVF outcomes. The median concentration (25th-75th percentiles) of the sum of the 12 DL-PCBs (∑DL-PCBs) obtained for the patients was 5.42 (3.78-7.78) ng/g lipid. No statistically significant association between DL-PCB levels and embryo quality was found. However, men with high serum PCB-77 concentrations present more probability of high-quality embryos (RR: 0.292; 95% CI: 0.090-0.942), whereas the opposite trend is observed for men with lower serum levels of PCB-156 (RR: 7.960; 95% CI: 1.020-62.100), who present increased odds of high-quality embryos. Serum concentrations of PCB-126 and PCB-114 were associated with decreased implantation rates (p < 0.05). Moreover, PCB-77 and ∑non-ortho PCBs were significantly associated with a lower likelihood of clinical pregnancy (p < 0.05). A lower likelihood of live birth was associated with higher levels of PCB-77, PCB-105, PCB-118, and recording significant differences for ∑non-ortho PCBs, ∑mono-ortho PCBs, and ∑DL-PCBs (p < 0.05). These findings suggest that paternal DL-PCB exposure before conception may be related to pregnancy endpoints. However, DL-PCB measurement were limited to male partners. Therefore, we propose that future studies with larger population sizes should include both maternal and paternal factors.
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Affiliation(s)
- Raiza Paul
- Biotechnology Department, University of Alicante, Alicante, Carretera de San Vicente s/n, P.O. Box 99, 03080, Alicante, Spain
| | - Alejandro Romero
- Biotechnology Department, University of Alicante, Alicante, Carretera de San Vicente s/n, P.O. Box 99, 03080, Alicante, Spain
| | - Julia Moltó
- Chemical Engineering Department, University of Alicante, Carretera de San Vicente s/n, P.O. Box 99, 03080, Alicante, Spain; University Institute of Engineering of Chemical Processes, University of Alicante, P.O. Box 99, E-03080, Alicante, Spain
| | - Nuria Ortuño
- Chemical Engineering Department, University of Alicante, Carretera de San Vicente s/n, P.O. Box 99, 03080, Alicante, Spain; University Institute of Engineering of Chemical Processes, University of Alicante, P.O. Box 99, E-03080, Alicante, Spain
| | - Jon Aizpurua
- Catedra Human Fertility, University of Alicante, Alicante, Carretera de San Vicente s/n, P.O. Box 99, 03080, Alicante, Spain; IVF Spain Treatment Clinic, Avenida de Ansaldo 13, 03540, Alicante, Spain
| | - María José Gómez-Torres
- Biotechnology Department, University of Alicante, Alicante, Carretera de San Vicente s/n, P.O. Box 99, 03080, Alicante, Spain; Catedra Human Fertility, University of Alicante, Alicante, Carretera de San Vicente s/n, P.O. Box 99, 03080, Alicante, Spain.
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87
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Li J, Sun Q, Zhang M, Fu X, Zhang Y, Gao S, Ma J. Natural cycles achieve better pregnancy outcomes than artificial cycles in non-PCOS women undergoing vitrified single-blastocyst transfer: a retrospective cohort study of 6840 cycles. J Assist Reprod Genet 2022; 39:639-646. [PMID: 35122175 PMCID: PMC8995231 DOI: 10.1007/s10815-022-02424-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/31/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To identify the optimal method for endometrial preparation in vitrified single-blastocyst transfer (VSBT) cycles. METHODS This was a retrospective cohort study for non-PCOS patients who underwent VSBT cycles from March 2015 to November 2019 in an academic reproductive medical center. A total of 6840 VSBT cycles were enrolled and classified into two groups according to different endometrial preparation methods. RESULTS The non-PCOS patients who underwent VSBT showed a significantly higher clinical pregnancy rate (61.96% vs 56.85%, p < 0.001) and live birth rate (49.09% vs 39.86%, p < 0.001), as well as a statistically lower early miscarriage rate (12.02% vs 18.08%, p < 0.001) in the natural cycle (NC) group compared with the artificial cycle (AC) group. Multivariable analysis further confirmed that NC was associated with an increased likelihood of clinical pregnancy (adjusted odds ratio (aOR) 0.852, 95% confidence interval (CI) 0.765-0.949, p = 0.004) and live birth (aOR 0.746, 95% CI 0.669-0.832, p < 0 .001), but decreased early miscarriage occurrence (aOR 1.447, 95% CI 1.215-1.724, p < 0.001) compared to AC. CONCLUSIONS Our study demonstrated that non-PCOS patients could benefit from NC in vitrified blastocyst transfer. Increased clinical pregnancy rate and decreased early miscarriage rate led to a significantly higher live birth rate in NC patients compared with AC with our present protocol.
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Affiliation(s)
- Jing Li
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Technology and Reproductive Genetics, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012 China
| | - Qian Sun
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Technology and Reproductive Genetics, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012 China
| | - Meng Zhang
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Technology and Reproductive Genetics, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012 China
| | - Xiao Fu
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Technology and Reproductive Genetics, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012 China
| | - Yiting Zhang
- grid.27255.370000 0004 1761 1174Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Technology and Reproductive Genetics, Jinan, Shandong 250012 China ,grid.27255.370000 0004 1761 1174National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012 China
| | - Shanshan Gao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Technology and Reproductive Genetics, Jinan, Shandong, 250012, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China. .,Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
| | - Jinlong Ma
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Technology and Reproductive Genetics, Jinan, Shandong, 250012, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China.
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Theodorou E, Jones BP, Cardenas Armas DF, Heath C, Serhal P, Ben-Nagi J. Live birth rate following a euploid blastocyst transfer is not affected by double vitrification and warming at cleavage or blastocyst stage. J Assist Reprod Genet 2022. [PMID: 35217947 DOI: 10.1007/s10815-022-02440-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/17/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To compare reproductive outcomes following a euploid embryo transfer, between those embryos vitrified-warmed twice to those vitrified-warmed once. METHODS We retrospectively analysed 694 single euploid frozen embryo transfer cycles following preimplantation genetic testing for aneuploidy (PGT-A). For cycles in group 1 (N = 451), embryos were biopsied for PGT-A at blastocyst stage and vitrified. For cycles in group 2 (N = 146), embryos were vitrified at blastocyst stage, before being warmed and biopsied for PGT-A and vitrified again. For cycles in group 3 (N = 97), embryos were vitrified on day-3, before being warmed, cultured to day-5 and biopsied for PGT-A and re-vitrified. RESULTS The pregnancy, clinical pregnancy and livebirth rate in group 2 were not statistically different to group 1 (pregnancy rate, adjusted OR 1.09, 95% CI 0.62-1.91; clinical pregnancy, aOR 0.89, 95% CI 0.58-1.37; live birth rate, aOR 0.85, 95% CI 0.56-1.28). There was also no significant difference between group 3 and group 1, with similar pregnancy rate (aOR 1.22, 95% CI 0.74-1.99), clinical pregnancy rate (aOR 1.21, 95% CI 0.75-1.96) and live birth rate (aOR 1.15, 95% CI, 0.73-1.80). There was no significant difference in miscarriage rates between all three groups. The age at the oocyte collection, embryo quality and day of biopsy were associated with pregnancy, clinical pregnancy and live birth rate. CONCLUSION This study suggests that vitrifying and warming embryos twice at blastocyst or at cleavage and then blastocyst stage, can lead to similar reproductive outcomes to embryos vitrified-warmed once, after a single euploid embryo transfer.
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89
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Zheng Y, Dong X, Chen B, Dai J, Yang W, Ai J, Jin L. Body mass index is associated with miscarriage rate and perinatal outcomes in cycles with frozen-thawed single blastocyst transfer: a retrospective cohort study. BMC Pregnancy Childbirth 2022; 22:118. [PMID: 35148705 PMCID: PMC8840631 DOI: 10.1186/s12884-022-04443-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/31/2022] [Indexed: 11/20/2022] Open
Abstract
Background The association between body mass index (BMI) and IVF cycle outcomes remain inconclusive. In addition, the impact of BMI on perinatal outcomes has been less well-studied. The aim of this study was to assess the effects of BMI on pregnancy outcomes, as well as maternal and neonatal outcomes. Methods This was a retrospective cohort study on 10,252 frozen-thawed cycles with single blastocyst transfer between January 2016 and December 2019. Patients were divided into four groups: underweight (< 18.5 kg/m2), normal-weight (18.5–24 kg/m2), overweight (24–28 kg/m2), and obesity (≥ 28 kg/m2), according to the Chinese classification. Multivariate logistic regression and multivariate general linear model were used for statistical analysis. Results The rates of live birth and clinical pregnancy were comparable among groups. Miscarriage rate was higher in the obese women than that in the normal controls (27.51 vs. 20.91%, aOR = 1.453 (1.066–1.982)). Using the normal-weight women as reference, the underweight women had lower incidences of preterm birth (6.97 vs. 11.19%, aOR = 0.611 (0.422–0.884)), macrosomia (4.90 vs. 8.65%, aOR = 0.544 (0.353–0.837)) and large-for-gestational age (LGA, 11.18 vs. 16.54%, aOR = 0.643 (0.477–0.866)); the overweight women had higher prevalence of gestational diabetes (6.56 vs. 3.82%, aOR = 1.744 (1.232–2.468)), hypertension (4.42 vs. 2.32%, aOR = 1.822 (1.186–2.800)), macrosomia (12.93 vs. 8.65%, aOR = 1.596 (1.240–2.054)) and LGA (23.22 vs. 16.54%, aOR = 1.549 (1.270–1.890)); the obese women had higher incidences of preterm birth (16.87 vs. 11.19%, aOR = 1.646 (1.068–2.536)), cesarean delivery (93.98 vs. 87.91%, aOR = 2.078 (1.083–3.987)), gestational hypertension (4.82 vs. 2.32%, aOR = 2.138 (1.005–4.547)), macrosomia (14.88 vs. 8.65%, aOR = 1.880 (1.192–2.964)) and LGA (25.60 vs. 16.54%, aOR = 1.764 (1.218–2.555)). Conclusions BMI has no significant effect on the chance of pregnancy or live birth, but obesity increases the risk of miscarriage. Underweight is associated with better maternal and neonatal outcomes, while overweight and obesity are associated with worse maternal and neonatal outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04443-2.
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Affiliation(s)
- Yu Zheng
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiyuan Dong
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Biao Chen
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Dai
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Yang
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jihui Ai
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
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Zhang W, Liu Z, Liu M, Li J, Guan Y. Is it necessary to monitor the serum luteinizing hormone (LH) concentration on the human chorionic gonadotropin (HCG) day among young women during the follicular-phase long protocol? A retrospective cohort study. Reprod Biol Endocrinol 2022; 20:24. [PMID: 35105359 PMCID: PMC8808976 DOI: 10.1186/s12958-022-00888-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The normal physiological function of LH requires a certain concentration range, but because of pituitary desensitization, even on the day of HCG, endogenous levels of LH are low in the follicular-phase long protocol. Therefore, our study aimed to determine whether it is necessary to monitor serum LH concentrations on the day of HCG (LHHCG) and to determine whether there is an optimal LHHCG range to achieve the desired clinical outcome. METHODS A retrospective cohort study included 4502 cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from January 1, 2016, to June 30, 2019, in a single department. The main outcome measures included retrieved eggs, available embryos, and live birth rate. RESULTS The LHHCG was divided into five groups: Group A (LH ≤ 0.5), Group B (0.5 IU/L < LH ≤ 1.2 IU/L), Group C (1.2 IU/L < LH ≤ 2.0 IU/L), Group D (2.0 IU/L < LH ≤ 5.0 IU/L), Group E (LH > 5 IU/L). In terms of the numbers of retrieved eggs (15.22 ± 5.66 vs. 13.54 ± 5.23 vs. 12.90 ± 5.05 vs. 12.30 ± 4.88 vs. 9.6 ± 4.09), diploid fertilized oocytes (9.85 ± 4.70 vs. 8.69 ± 4.41 vs. 8.39 ± 4.33 vs. 7.78 ± 3.96 vs. 5.92 ± 2.78), embryos (7.90 ± 4.48 vs. 6.83 ± 4.03 vs. 6.44 ± 3.88 vs. 6.22 ± 3.62 vs. 4.40 ± 2.55), and high-quality embryos (4.32 ± 3.71 vs. 3.97 ± 3.42 vs. 3.76 ± 3.19 vs. 3.71 ± 3.04 vs. 2.52 ± 2.27), an increase in the LHHCG level showed a trend of a gradual decrease. However, there was no significant difference in clinical outcomes among the groups (66.67% vs. 64.33% vs. 63.21% vs. 64.48% vs. 63.33%). By adjusting for confounding factors, with an increase in LHHCG, the number of retrieved eggs decreased (OR: -0.351 95%CI - 0.453-[- 0.249]). CONCLUSION In the follicular-phase long protocol among young women, monitoring LHHCG is recommended in the clinical guidelines to obtain the ideal number of eggs.
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Affiliation(s)
- Wenjuan Zhang
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, ZhengZhou, Henan, China
| | - Zhaozhao Liu
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, ZhengZhou, Henan, China
| | - Manman Liu
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, ZhengZhou, Henan, China
| | - Jiaheng Li
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, ZhengZhou, Henan, China
| | - Yichun Guan
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, ZhengZhou, Henan, China.
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Wang L, Xiong Y, Wang H, Zhong Q. High spontaneous pregnancy and live birth rates in patients with stage III-IV endometriosis following surgical management. Asian J Surg 2022; 45:912-913. [PMID: 34998637 DOI: 10.1016/j.asjsur.2021.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 12/03/2021] [Indexed: 11/02/2022] Open
Affiliation(s)
- Lifei Wang
- Department of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, PR China
| | - Ying Xiong
- Department of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, PR China
| | - Hongjing Wang
- Department of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, PR China
| | - Qian Zhong
- Department of Gynecology and Obstetrics, West China Second University Hospital of Sichuan University, Chengdu, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, PR China.
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Li J, Li C, Liu X, Yang J, Zhang Q, Han W, Huang G. GDF9 concentration in embryo culture medium is linked to human embryo quality and viability. J Assist Reprod Genet 2022; 39:117-125. [PMID: 34845575 PMCID: PMC8866627 DOI: 10.1007/s10815-021-02368-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/24/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE We aimed to evaluate the link between the GDF9 concentration in day 3 human embryo culture medium and embryo quality and viability. METHODS Two independent, prospective, observational studies were conducted. In study 1, a total of 280 embryos from 70 patients who obtained at least 4 embryos with 6-10 blastomeres (2 transferable and 2 non-transferable embryos) at day 3 were enrolled. In study 2, a total of 119 embryos from 61 patients (29 fully implanted and 32 non-implanted patients) were enrolled. The corresponding GDF9 concentrations in spent culture medium of embryos were quantified by ELISA assay. The expression pattern of GDF9 in human embryos was investigated using Q-PCR and immunofluorescence. RESULTS GDF9 mRNA and protein were detected from human oocytes to eight-cell embryos and displayed a slow decreasing trend. In study 1, GDF9 concentration in culture medium is lower for transferable embryos compared with non-transferable embryos (331 pg/mL (quartiles: 442, 664 pg/mL) vs. 518 pg/mL (quartiles: 328, 1086 pg/mL), P < 0.001), and increased commensurate with the diminution of the embryo quality (P < 0.001). In study 2, significantly lower GDF9 concentration was detected for implanted embryos than non-implanted embryos (331 pg/mL (quartiles: 156, 665 pg/mL) vs. 518 pg/mL (quartiles: 328, 1086 pg/mL), P < 0.001). The same trend was found between the embryos that led to live birth and those that failed. CONCLUSION The GDF9 concentration in culture medium is linked to embryo quality and viability, and exhibited the potential to be a non-invasive biomarker for embryo selection.
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Affiliation(s)
- Jingyu Li
- Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013 China ,Chongqing Key Laboratory of Human Embryo Engineering, Chongqing, China
| | - Chong Li
- Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013 China ,Chongqing Key Laboratory of Human Embryo Engineering, Chongqing, China
| | - Xuemei Liu
- Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013 China ,Chongqing Key Laboratory of Human Embryo Engineering, Chongqing, China
| | - Jingwei Yang
- Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013 China ,Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China
| | - Qi Zhang
- Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013 China ,Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China
| | - Wei Han
- Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013 China ,Chongqing Key Laboratory of Human Embryo Engineering, Chongqing, China
| | - Guoning Huang
- Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013 China ,Chongqing Key Laboratory of Human Embryo Engineering, Chongqing, China ,Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China
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93
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Zhou X, Li X, Ding H, Lu Y. Acupuncture effects on in-vitro fertilization pregnancy outcomes: A meta-analysis. Complement Ther Clin Pract 2021; 46:101525. [PMID: 34979465 DOI: 10.1016/j.ctcp.2021.101525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/22/2021] [Accepted: 12/26/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The effects of acupuncture on in-vitro fertilization outcomes remain controversial. This study aimed to perform a meta-analysis to assess the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. METHODS A systematic literature search up to January 2021 was performed and 29 studies included 6623 individuals undergoing in-vitro fertilization at the baseline of the study; 3091 of them were using acupuncture as an adjuvant therapy to embryo transfer, 1559 of them were using sham-controls, and 1441 of them were using no adjuvant therapy controls. They reported a comparison between the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls using the dichotomous method with a random or fixed-effect model. RESULTS Significantly higher outcomes with acupuncture were observed in biochemical pregnancy (OR, 1.98; 95% CI, 1.55-2.53, p < 0.001); clinical pregnancy (OR, 1.70; 95% CI, 1.46-1.98, p < 0.001); ongoing pregnancy (OR, 1.78; 95% CI, 1.41-2.26, p < 0.001); and live birth (OR, 1.58; 95% CI, 1.15-2.18, p = 0.005) compared to no adjuvant therapy controls. However, no significant difference were found between acupuncture and no adjuvant therapy controls in miscarriage (OR, 0.96; 95% CI, 0.48-1.92, p = 0.91). No significant difference was observed with acupuncture in biochemical pregnancy (OR, 1.16; 95% CI, 0.65-2.08, p = 0.62); clinical pregnancy (OR, 1.13; 95% CI, 0.83-1.54, p = 0.43); ongoing pregnancy (OR, 1.04; 95% CI, 0.66-1.62, p = 0.87); live birth (OR, 1.02; 95% CI, 0.73-1.42, p = 0.90), and miscarriage (OR, 1.16; 95% CI, 0.86-1.55, p = 0.34) compared to sham-controls. CONCLUSIONS Using acupuncture as an adjuvant therapy to embryo transfer may improve the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth outcomes compared to no adjuvant therapy controls. However, no significant difference was found between acupuncture as an adjuvant therapy to embryo transfer and sham-controls in any of the measured outcomes. This relationship forces us to recommend the use of acupuncture as adjuvant therapy in women undergoing in-vitro fertilization and inquire further studies comparing acupuncture and sham-controls to reach the best procedure.
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Affiliation(s)
- Xue Zhou
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Xiuling Li
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Hui Ding
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China
| | - Ying Lu
- Department of Reproductive Medicine Centre, Affiliated Maternity of Nanjing Medical University, Nanjing, Jiangsu, 210001, China.
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Li Y, Yu S, Huang C, Diao L, Chen C, Liu W, Lian R, Mo M, Du C, Liu F, Zeng Y. Predictive role of endometrial T-bet/GATA3 ratio during mid-luteal phase for live birth in patients undergoing in vitro fertilization: A retrospective observational study. J Reprod Immunol 2021; 149:103465. [PMID: 34953324 DOI: 10.1016/j.jri.2021.103465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/24/2021] [Accepted: 12/10/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To investigate whether endometrial T-bet (Th1 lineage-committed transcription factor)/GATA3 (Th2 lineage-committed transcription factor) ratio has predictive potential for embryo implantation in infertile women undergoing in vitro fertilization-embryo transfer (IVF-ET). STUDY DESIGN We performed a retrospective observational study. In total, this study included 319 infertile women (253 women as the development cohort and 66 women as the validation cohort). Samples were obtained by endometrial scratching in the mid-luteal phase before IVF-ET treatment. MAIN OUTCOME MEASURES Immunohistochemistry was utilized to analyze the expression levels of T-bet and GATA3 in the endometrium. Predictive value of endometrial T-bet/GATA3 for live birth were analyzed. RESULTS AND CONCLUSIONS In the development cohort, the T-bet/GATA3 ratio was significantly lower in women with live birth than those patients with non-live birth [0.148 (0.101, 0.212) vs. 0.246 (0.170, 0.399), P<0.0001]. In the validation cohort, changes in endometrial T-bet/GATA3 were similar among these groups. The endometrial T-bet/GATA3 ratio was an independent predictor of live birth after correction for patient age, anti-Mullerian hormone (AMH), quality of embryos transferred and other clinical characteristics (aOR = 0.280, 95 % CI: 0.169-0.462, P<0.001). We developed and validated that an endometrial T-bet/GATA3 ratio at the cut-off of 0.22 had significant predictive value for live birth (developmental cohort: AUC = 0.76, 95 % CI: 0.70-0.81, P < 0.0001. validation cohort: AUC = 0.85 95 % CI: 0.76-0.95, P < 0.0001). Our results suggest that elevated endometrial T-bet/GATA3 ratio is an independent marker of live birth in infertile patients.
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Affiliation(s)
- Yuye Li
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China
| | - Shuyi Yu
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China
| | - Chunyu Huang
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China
| | - Lianghui Diao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China
| | - Cong Chen
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China
| | - Wenjuan Liu
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou, 511400, Guangdong, China
| | - Ruochun Lian
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China
| | - Meilan Mo
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China
| | - Chenyang Du
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China
| | - Fenghua Liu
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou, 511400, Guangdong, China.
| | - Yong Zeng
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, 518045, Guangdong, China.
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Le HL, Ho VNA, Le TTN, Tran VTT, Ma MPQ, Le AH, Nguyen LK, Ho TM, Vuong LN. Live birth after in vitro maturation in women with gonadotropin resistance ovary syndrome: report of two cases. J Assist Reprod Genet 2021; 38:3243-9. [PMID: 34846627 DOI: 10.1007/s10815-021-02355-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Gonadotropin-resistant ovary syndrome (GROS) is a rare endocrine disorder that causes hypergonadotropic hypogonadism, amenorrhea, and infertility. This study reports live birth in two women with GROS who underwent fertility treatment with in vitro maturation (IVM). METHODS Both patients had primary infertility, amenorrhea (primary and secondary), typical secondary sexual characters, elevated gonadotropin levels, normal ovarian reserve, normal chromosomal characteristics, and previous nonresponsiveness gonadotropin stimulations. One patient had polymorphism of the follicle-stimulating hormone receptor, which is a predictor of poor ovarian response. Given unresponsiveness to exogenous gonadotropin stimulations, IVM with human chorionic gonadotropin priming (hCG-IVM) was performed in both patients. All transferrable embryos were vitrified. RESULTS Both patients achieved pregnancy after their first frozen embryos transfer, and each delivered a healthy baby boy. CONCLUSIONS These results suggest that IVM should be a first-line therapeutic option for patients with GROS.
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Ezoe K, Miki T, Okimura T, Uchiyama K, Yabuuchi A, Kobayashi T, Kato K. Characteristics of the cytoplasmic halo during fertilisation correlate with the live birth rate after fresh cleaved embryo transfer on day 2 in minimal ovarian stimulation cycles: a retrospective observational study. Reprod Biol Endocrinol 2021; 19:172. [PMID: 34836538 PMCID: PMC8620661 DOI: 10.1186/s12958-021-00859-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/04/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Information regarding the influence of cytoplasmic events during fertilisation on the clinical outcome remains limited. The cytoplasmic halo is one of these events. A previous study that used time-lapse technology found an association of the presence and morphokinetics of the cytoplasmic halo with cleavage patterns, development to the blastocyst stage, and the ongoing pregnancy rate after blastocyst transfer. Therefore, the cytoplasmic halo may be a useful predictor of the pregnancy outcome after cleaved embryo transfer. This study evaluated the ability of the cytoplasmic halo to predict a live birth after fresh cleaved embryo transfer on day 2, and sought to identify factors potentially influencing the presence and morphokinetics of the halo. METHODS A total of 902 embryos cultured in the EmbryoScope+® time-lapse system and subjected to single fresh cleaved embryo transfer were retrospectively analysed. The presence and duration of a cytoplasmic halo were annotated. The initial positions of the pronuclei were also observed. The correlation between the cytoplasmic halo and live birth was evaluated and the association of the cytoplasmic halo with patient, cycle, and embryonic characteristics was determined. RESULTS Absence of a cytoplasmic halo was associated with a significant decrease in the likelihood of a live birth after fresh cleaved embryo transfer. Prolongation of the halo, especially the duration of central repositioning of cytoplasmic granules, had an adverse impact on the live birth rate. The characteristics of the cytoplasmic halo were not affected by the ovarian stimulation method used, female age, the serum steroid hormone level on the day of trigger, or semen quality. However, the cytoplasmic halo was significantly affected by male age, oocyte diameter, and the initial position of the male pronucleus. CONCLUSIONS Absence or prolongation of the cytoplasmic halo was negatively correlated with the live birth rate after fresh cleaved embryo transfer. The characteristics of the cytoplasmic halo were strongly associated with oocyte diameter, male age, and the initial position of the male pronucleus. These findings indicate that the characteristics of the cytoplasmic halo can be used to select more competent embryos for transfer at the cleavage stage.
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Affiliation(s)
- Kenji Ezoe
- Kato Ladies Clinic, 7-20-3 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tetsuya Miki
- Kato Ladies Clinic, 7-20-3 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tadashi Okimura
- Kato Ladies Clinic, 7-20-3 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Kazuo Uchiyama
- Kato Ladies Clinic, 7-20-3 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Akiko Yabuuchi
- Kato Ladies Clinic, 7-20-3 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tamotsu Kobayashi
- Kato Ladies Clinic, 7-20-3 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Keiichi Kato
- Kato Ladies Clinic, 7-20-3 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
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Maignien C, Bourdon M, Marcellin L, Laguillier-Morizot C, Borderie D, Chargui A, Patrat C, Plu-Bureau G, Chapron C, Santulli P. Low serum progesterone affects live birth rate in cryopreserved blastocyst transfer cycles using hormone replacement therapy. Reprod Biomed Online 2021; 44:469-477. [PMID: 34980570 DOI: 10.1016/j.rbmo.2021.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/01/2021] [Accepted: 11/10/2021] [Indexed: 01/25/2023]
Abstract
RESEARCH QUESTION Does serum progesterone concentration on the day of vitrified-warmed embryo transfer affect live birth rate (LBR) with hormonal replacement therapy (HRT) cycles? DESIGN Observational cohort study of patients (n = 915) undergoing single autologous vitrified-warmed blastocyst transfer under HRT using vaginal micronized progesterone. Women were included once, between January 2019 and March 2020. Serum progesterone concentration was measured by a single laboratory on the morning of embryo transfer. The primary end point was LBR. Univariate and multivariate logistic regression models were used for statistical analyses. RESULTS Median (25th-75th percentile) serum progesterone concentration on the day of embryo transfer was 12.5 ng/ml (9.8-15.3). The LBR was 31.5% (288/915) in the overall population. No significant differences were found in implantation rates (40.7% versus 44.9%); LBR was significantly lower in women with a progesterone concentration ≤25th percentile (≤9.8 ng/ml) (26.1% versus 33.2%, P = 0.045) versus women with a progesterone concentration >25th percentile. This correlated with a significantly higher early miscarriage rate (35.9% versus 21.6%, P = 0.005). After adjusting for potential confounding factors in multivariate analysis, low serum progesterone levels (≤9.8 ng/ml) remained significantly associated with lower LBR (OR 0.68 95% CI 0.48 to 0.97). CONCLUSION A minimum serum progesterone concentration is needed to optimize reproductive outcomes in HRT cycles with single autologous vitrified-warmed blastocyst transfer. Whether modifications of progesterone administration routes, dosage, or both, can improve pregnancy rates needs further study so that treatment of patients undergoing HRT cycles can be further individualized.
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Affiliation(s)
- Chloé Maignien
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France
| | - Mathilde Bourdon
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Louis Marcellin
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Christelle Laguillier-Morizot
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Biological Endocrinology (Professor Guibourdenche), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Didier Borderie
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Automated Biological Diagnosis (Professor Borderie), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Ahmed Chargui
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Histology and Reproductive Biology (Professor Patrat), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France
| | - Catherine Patrat
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Histology and Reproductive Biology (Professor Patrat), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France
| | - Geneviève Plu-Bureau
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Equipe EPOPE, INSERM U1153
| | - Charles Chapron
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France
| | - Pietro Santulli
- Université de Paris, Faculté de Santé, 12 Rue de l'Ecole de Médecine 75006 Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal 75014 Paris, France; Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques 75014 Paris, France.
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Kolanska K, Uddin J, Dabi Y, Mathieu d'Argent E, Dupont C, Selleret L, Touboul C, Antoine JM, Chabbert-Buffet N, Daraï E. Secondary infertility with a history of vaginal childbirth: Ready to have another one? J Gynecol Obstet Hum Reprod 2021; 51:102271. [PMID: 34785399 DOI: 10.1016/j.jogoh.2021.102271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/25/2021] [Accepted: 11/10/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Up to 30% of couples may face secondary infertility. The impact of ectopic pregnancy, spontaneous abortion, pregnancy termination or live birth with caesarean section may impair further fertility in different ways. However, secondary infertility after physiological vaginal life childbirth has been little studied. The aim of this study was to describe the population and the fertility issues and analyze the predictive factors of success in in vitro fertilization in women presenting secondary infertility after a physiological vaginal childbirth. MATERIAL AND METHODS This single-centre retrospective study included women aged 18-43 years consulting between 2013 and 2020 for secondary infertility in a couple having already had previous vaginal life childbirth. Couples' characteristics, management decision after the first consultation and IVF outcomes were analyzed. RESULTS Secondary infertility was found in 286 couples, out of whom 138 had a history of vaginal life childbirth. Population was characterized by an advanced female age and overweight. After the first consultation, IVF was performed in only 40% of couples. No predictive factor of live birth was found. CONCLUSION Our study shows that in couples with secondary infertility after prior physiological delivery cigarette smoking is frequent in male partners, and ovarian reserve markers are altered. However, no statistically significant predictive factor of live birth after IVF treatment has been identified. Further large prospective studies are necessary.
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Affiliation(s)
- Kamila Kolanska
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, 75571 PARIS cedex 12, France.
| | - Jennifer Uddin
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Yohann Dabi
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Emmanuelle Mathieu d'Argent
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Charlotte Dupont
- INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, 75571 PARIS cedex 12, France; Service de biologie de la reproduction-CECOS, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Lise Selleret
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Cyril Touboul
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, 75571 PARIS cedex 12, France
| | - Jean-Marie Antoine
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France
| | - Nathalie Chabbert-Buffet
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, 75571 PARIS cedex 12, France
| | - Emile Daraï
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, 75571 PARIS cedex 12, France
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Auger N, Ghadirian M, Low N, Healy-Profitós J, Wei SQ. Premature mortality after pregnancy loss: Trends at 1, 5, 10 years, and beyond. Eur J Obstet Gynecol Reprod Biol 2021; 267:155-160. [PMID: 34773878 DOI: 10.1016/j.ejogrb.2021.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/08/2021] [Accepted: 10/26/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Little is known on the long-term risk of mortality following pregnancy loss. We assessed risks of premature mortality up to three decades after miscarriage, induced abortion, ectopic or molar pregnancy, and stillbirth relative to live birth. STUDY DESIGN We carried out a longitudinal cohort study of 1,293,640 pregnant women with 18,896,737 person-years of follow-up in Quebec, Canada, from 1989 to 2018. We followed the women up to 29 years after their last pregnancy event to determine the time and cause of future in-hospital deaths before age 75 years. We used adjusted Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of miscarriage, induced abortion, ectopic pregnancy, molar pregnancy, and stillbirth with premature mortality, compared with live birth. RESULTS Premature mortality rates were higher for most types of pregnancy loss than live birth. Compared with live birth, pregnancy loss was associated with an elevated risk of premature mortality (HRmiscarriage 1.48, 95% CI 1.33, 1.65; HRinduced abortion 1.50, 95% CI 1.39, 1.62; HRectopic 1.55, 95% CI 1.35, 1.79; and HRstillbirth 1.68, 95%. CI 1.17, 2.41). Molar pregnancy was not associated with premature mortality (HR 0.87, 95% CI 0.33, 2.32). Miscarriage and induced abortion were associated with most causes of death, whereas ectopic pregnancy was associated with cardiovascular (HR 2.18, 95 % CI 1.39, 3.42), cancer (HR 1.38, 95 % CI 1.11, 1.73), and suicide-related mortality (HR 4.94, 95 % CI 2.29, 10.68). Stillbirth was associated with cardiovascular mortality (HR 4.91, 95 % CI 2.33, 10.36). CONCLUSION Pregnancy loss is associated with an elevated risk of premature mortality up to three decades later, particularly cardiovascular, cancer, and suicide-related deaths.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
| | - Mona Ghadirian
- Institut national de santé publique du Québec, Montreal, Quebec, Canada; School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Jessica Healy-Profitós
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Shu Qin Wei
- Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, Sainte-Justine Research Center, University of Montreal, Montreal, Quebec, Canada
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Moazzeni SS, Hizomi Arani R, Asgari S, Azizi F, Hadaegh F. The association of parity/ live birth number with incident type 2 diabetes among women: over 15 years of follow-up in The Tehran Lipid and Glucose Study. BMC Womens Health 2021; 21:378. [PMID: 34715851 PMCID: PMC8556972 DOI: 10.1186/s12905-021-01519-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022]
Abstract
Background Childbearing may increase the future risk of developing type 2 diabetes mellitus (T2DM) in mothers. However, the issue is not clear completely and not investigated in the Middle East, a region with a high burden of T2DM. In the current study, we examined the association of parity/live birth number with incident T2DM among Iranian women. Methods The study population included 2552 women aged 30–65 years recruited in 1999–2001 and were followed for incident T2DM by 3-year intervals. Multivariable Cox proportional hazard models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the parity/live birth number for incident T2DM. Parity number was defined as the number of live childbirth (number of live birth) plus the number of stillbirth (defined as birth of an infant that died after the 20th week of pregnancy in the uterus). Results During a median follow-up of 15.4 years, 557 incident T2DM cases have occurred. After adjustment for potential T2DM risk factors and reproductive factors, each additional parity caused a 9% higher risk for incident T2DM. Moreover, compared to women with one parity, those with 3 and ≥ 4 parity had HRs of 1.73 [95% CI: 1.06–2.83] and 2.23 [1.36–3.65], respectively. After further adjustment for body mass index (BMI) and waist circumference, although the HRs were attenuated prominently, parity ≥ 4 was associated with significantly higher risk (HR: 1.72 [1.05–2.83]); even after further adjustment for triglycerides (TG)/ high-density lipoprotein cholesterol (HDL-C), the risk remained marginally significant (HR: 1.64 [1.00–2.70; P value: 0.051]). For the number of live birth, the results were also similar. Moreover, in a sensitivity analysis, when we considered BMI change during follow-up as another covariate, generally, the effect sizes did not change; the trend of HRs across categories of parity number remained marginally significant (P value: 0.064). Conclusions During a long-term follow-up, after adjustment for potential T2DM risk factors, reproductive factors, obesity indices, and TG/HDL-C (insulin resistance surrogate), we demonstrated that higher parity/live birth numbers could be associated with increased risk of T2DM development among Iranian women. Moreover, even after further adjustment for BMI change, the suggestive higher risk was still found. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01519-7.
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Affiliation(s)
- Seyyed Saeed Moazzeni
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reyhane Hizomi Arani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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