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Boogaerts M, Mengels A, Lie Fong S, Peeraer K, Tomasseti C, Vanhie A. Impact of Indication for Oocyte and Embryo Reception on Reproductive and Obstetric Outcomes. Gynecol Obstet Invest 2023; 88:267-277. [PMID: 37231826 DOI: 10.1159/000530885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVES This study aimed to assess if the indication for oocyte reception (OR) or embryo reception (ER) impacts the reproductive and obstetric outcomes by evaluating our experience at a tertiary fertility centre and by performing a literature review on this subject. Several previous studies have reported that, in contrast to other types of fertility treatment, the indication for OR/ER seems to have little impact on the outcomes. However, the compared indication groups vary considerably between these studies, and some data indicates worse outcomes in patients who developed premature ovarian insufficiency (POI) due to Turner syndrome or treatment with chemotherapy/radiotherapy. DESIGN A retrospective analysis of all cases of OR/ER at a tertiary fertility centre from 2001 until 2020 was conducted. We analysed 584 cycles from 194 individual patients. A literature review on the impact of indication on reproductive or obstetric outcomes of OR/ER was performed using the following databases: PubMed/MEDLINE, Embase, and the Cochrane Library. A total of 27 studies were included and analysed. PARTICIPANTS, SETTING, METHODS For the retrospective analysis, patients were divided into three major indication groups: failure of autologous assisted reproductive technology, POI, and genetic disease carrier. To assess reproductive outcomes, we determined pregnancy rate, implantation rate, miscarriage rate, and live birth rate. For comparing obstetric outcomes, we reviewed the term of birth, mode of delivery, and birthweight. Outcomes were compared using Fisher's exact test, χ2 test, and one-way ANOVA utilizing the GraphPad tool. RESULTS There were no significant differences in reproductive and obstetric outcomes between the three major indication groups in our population, in line with the findings reported by existing literature. Data on impaired reproductive outcomes in patients with POI after chemotherapy/radiotherapy are conflicting. Obstetrically, these patients are at higher risk of preterm birth and possibly also low birthweight, especially after abdomino-pelvic or total body irradiation. For patients with POI due to Turner syndrome, most data suggest similar pregnancy rates but a higher rate of pregnancy loss, and obstetrically an increased risk of hypertensive disorders and caesarean section. LIMITATIONS The small number of patients in the retrospective analysis resulted in low statistical power when evaluating differences between smaller subgroups. There were some missing data on the occurrence of complications during pregnancy. Our analysis covers a period of 20 years, during which several technological innovations have also been made. CONCLUSIONS Our study shows that the important heterogeneity in couples treated with OR/ER does not significantly impact their reproductive or obstetric outcomes, except for POI due to Turner syndrome or treatment with chemotherapy/radiotherapy, where there seems to be an important uterine/endometrial component that cannot be entirely overcome by providing a healthy oocyte.
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Affiliation(s)
- Matthias Boogaerts
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Annemie Mengels
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Sharon Lie Fong
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Karen Peeraer
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Carla Tomasseti
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Arne Vanhie
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
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Guo Y, Chen P, Li T, Jia L, Zhou Y, Huang J, Liang X, Zhou C, Fang C. Single-cell transcriptome and cell-specific network analysis reveal the reparative effect of neurotrophin-4 in preantral follicles grown in vitro. Reprod Biol Endocrinol 2021; 19:133. [PMID: 34481496 PMCID: PMC8417972 DOI: 10.1186/s12958-021-00818-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/24/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND In-vitro-grow (IVG) of preantral follicles is essential for female fertility preservation, while practical approach for improvement is far from being explored. Studies have indicated that neurotrophin-4 (NT-4) is preferentially expressed in human preantral follicles and may be crucial to preantral follicle growth. METHODS We observed the location and expression of Tropomyosin-related kinase B (TRKB) in human and mouse ovaries with immunofluorescence and Western blot, and the relation between oocyte maturation and NT-4 level in follicular fluid (FF). Mice model was applied to investigate the effect of NT-4 on preantral follicle IVG. Single-cell RNA sequencing of oocyte combined with cell-specific network analysis was conducted to uncover the underlying mechanism of effect. RESULTS We reported the dynamic location of TRKB in human and mouse ovaries, and a positive relationship between human oocyte maturation and NT-4 level in FF. Improving effect of NT-4 was observed on mice preantral follicle IVG, including follicle development and oocyte maturation. Transcriptome analysis showed that the reparative effect of NT-4 on oocyte maturation might be mediated by regulation of PI3K-Akt signaling and subsequent organization of F-actin. Suppression of advanced stimulated complement system in granulosa cells might contribute to the improvement. Cell-specific network analysis revealed NT-4 may recover the inflammation damage induced by abnormal lipid metabolism in IVG. CONCLUSIONS Our data suggest that NT-4 is involved in ovarian physiology and may improve the efficiency of preantral follicle IVG for fertility preservation.
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Affiliation(s)
- Yingchun Guo
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Peigen Chen
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Tingting Li
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Lei Jia
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Yi Zhou
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Jiana Huang
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Xiaoyan Liang
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Chuanchuan Zhou
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
| | - Cong Fang
- grid.488525.6Reproductive Medicine Research Center, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510275 Guangdong China
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Sekhon L, Feuerstein J, Pan S, Overbey J, Lee JA, Briton-Jones C, Flisser E, Stein DE, Mukherjee T, Grunfeld L, Sandler B, Copperman AB. Endometrial preparation before the transfer of single, vitrified-warmed, euploid blastocysts: does the duration of estradiol treatment influence clinical outcome? Fertil Steril 2019; 111:1177-1185.e3. [PMID: 31029432 DOI: 10.1016/j.fertnstert.2019.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate whether the duration of estrogen administration before euploid embryo transfer affects clinical outcome. DESIGN Retrospective cohort study. SETTING Private, academic fertility center. PATIENT(S) Patients (n = 1,439) undergoing autologous freeze-only in vitro fertilization with preimplantation genetic testing (PGT) followed by endometrial preparation with estrogen and progesterone in a frozen, euploid blastocyst transfer cycle. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Primary outcome was live birth, and secondary outcomes included implantation, clinical pregnancy, early pregnancy loss, live birth, infant birthweight, low birth weight, infant gestational age at delivery, and preterm birth. RESULT(S) The duration of estrogen administration (mean: 17.5 ± 2.9 days; range: 10-36 days) before frozen embryo transfer did not impact implantation (odds ratio [OR] 0.99; 95% confidence interval [CI], 0.95-1.03), clinical pregnancy (OR 0.98; 95% CI, 0.94-1.01), early pregnancy loss (OR 1.03; 95% CI, 0.95-1.12), or live birth (OR 0.99; 95% CI, 0.95-1.03). The duration of estrogen exposure did not affect infant birthweight (in grams) (β= -10.65 ± 8.91) or the odds of low birth weight (OR 0.87; 95% CI, 0.68-1.13). For every additional day of estrogen administration, we observed a reduction in gestational age at delivery (in weeks) (β= -0.07 ± 0.03), but the odds of preterm delivery were not affected (OR 1.05; 95% CI, 0.95-1.17). CONCLUSION(S) Variation in the duration of estradiol supplementation before progesterone initiation does not impact frozen, euploid blastocyst transfer outcome. The duration of estrogen administration was inversely correlated with gestational age at delivery, but this did not translate into an increase in preterm delivery. Further studies are required on the downstream effects of endometrial preparation on the placental-endometrium interface.
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Affiliation(s)
- Lucky Sekhon
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York.
| | | | - Stephanie Pan
- Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Jessica Overbey
- Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Joseph A Lee
- Reproductive Medicine Associates of New York, New York, New York
| | | | - Eric Flisser
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Daniel E Stein
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Tanmoy Mukherjee
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Lawrence Grunfeld
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Benjamin Sandler
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Alan B Copperman
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
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Tesarik J. Customised Oocyte Donation Enhancement and New Findings Regarding the Role of Growth Hormone. EUROPEAN MEDICAL JOURNAL 2018. [DOI: 10.33590/emj/10313812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
In vitro fertilisation (IVF) with donated oocytes is the most effective assisted reproduction treatment currently available; however, repeated implantation failure (RIF) can occur with this treatment. The protocol of patient preparation for IVF with donated oocytes is relatively simple and works well in most cases; however, it can fail in a minority of women, which is what occurs in RIF patients. While the probability of RIF occuring is 20–35%, it is reasonable to take adequate measures in all patients in order to avoid procedural failure. The risk of oocyte donation failure can be minimised by applying a customised oocyte donation enhancement (CODE) protocol, in which pitfalls of the standard protocol are detected and corrected in the pretreatment phase, during the patient’s uterus preparation for embryo transfer, and after the transfer. Growth hormone, recently reported to improve pregnancy outcomes in women with RIF after oocyte donation, is a possible component of the CODE protocol, but it cannot be considered a unique solution to RIF. This article reviews possible causes of RIF and places growth hormone treatment in the context of other important measures to be followed in the CODE protocol.
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Palomba S, Homburg R, Santagni S, La Sala GB, Orvieto R. Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review. Reprod Biol Endocrinol 2016; 14:76. [PMID: 27814762 PMCID: PMC5097409 DOI: 10.1186/s12958-016-0211-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 10/26/2016] [Indexed: 11/10/2022] Open
Abstract
In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.
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Affiliation(s)
- Stefano Palomba
- Center of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova (ASMN)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Roy Homburg
- Homerton Fertility Unit, Homerton University Hospital, Homerton Row, London, UK
| | - Susanna Santagni
- Center of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova (ASMN)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Giovanni Battista La Sala
- Center of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova (ASMN)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Viale Risorgimento 80, 42123 Reggio Emilia, Italy
- University of Modena, Reggio Emilia, Italy
| | - Raoul Orvieto
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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7
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Saito S, Nakabayashi Y, Nakashima A, Shima T, Yoshino O. A new era in reproductive medicine: consequences of third-party oocyte donation for maternal and fetal health. Semin Immunopathol 2016; 38:687-697. [DOI: 10.1007/s00281-016-0577-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/07/2016] [Indexed: 11/24/2022]
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Savasi VM, Mandia L, Laoreti A, Cetin I. Maternal and fetal outcomes in oocyte donation pregnancies. Hum Reprod Update 2016; 22:620-33. [DOI: 10.1093/humupd/dmw012] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 03/07/2016] [Indexed: 12/11/2022] Open
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Vincent-Rohfritsch A, Marszalek A, Santulli P, Gayet V, Chapron C, Goffinet F, Le Ray C. [Risk of perinatal complication and egg donation: Role of resorting to cross-border care?]. ACTA ACUST UNITED AC 2016; 45:866-875. [PMID: 27083429 DOI: 10.1016/j.jgyn.2016.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 03/03/2016] [Accepted: 03/10/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES In France, egg donation is covered by Social insurance among women<43 years old. Because of shortage of egg donor, women aged 43 years or more cannot resort to egg donation in French infertility centers, leading them to turn to the foreign centers having practices different and less regulated than in France. We are thus brought to take care of the pregnancy and of the delivery of these women. Our objective was to estimate if the perinatal risks are more important after egg donation abroad than in case of egg donation in a French center. MATERIAL AND METHODS Retrospective study between January, 2010 and April, 2013, comparing women having had an egg donation to Cochin then having delivered in the maternity hospital of their choice (n=88) and the women having had an egg donation abroad then having delivered in the Port-Royal maternity (n=121). First, the modalities of egg donation were compared between the Cochin hospital and the foreign centers. Second, the obstetric and perinatal outcomes were compared between both groups, then by stratifying according to the type of pregnancy (singleton or multiple). RESULTS Among women having had an egg donation abroad, the age of the donor was lower (25.7 vs. 31.7, P=0.001), the average number of embryos transferred higher (2.1±0.6 vs. 1.7±0.5, P=0.001) and the rate of multiple pregnancies higher (47.9% vs. 9.1%, P=0.001) than among women having had an egg donation at Cochin. We observed after egg donation abroad compared to egg donation at Cochin, a birth weight significantly lower (2678±745g vs. 3045±682g, P=0.001) and a prevalence of intrauterine growth retardation higher (11.1% vs. 4.2%, P=0.04). Among singletons, abnormal placentation was more frequent in case of egg donation abroad (17.5% vs. 5.1%, P=0.02). In case of twin pregnancy, we highlighted very high rates of complications, without significant difference according to the place where egg donation was practiced. CONCLUSION We observed an increased risk of intrauterine growth retardation after egg donation abroad, which could essentially be explained by the association between advanced maternal age and multiple gestation. For other obstetric and perinatal complications, the differences between both groups were less important than expected, but very high in both groups, whether the egg donation was realized in France or abroad. The complications seem mainly due to the multiple gestations, justifying the transfer of a single embryo whenever possible.
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Affiliation(s)
- A Vincent-Rohfritsch
- Maternité Port-Royal, hôpital Hôtel-Dieu, groupe hospitalier Cochin, Broca, Assistance publique-Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris Cité, 123, boulevard de Port-Royal, 75014 Paris, France.
| | - A Marszalek
- Service de gynécologie-obstétrique 2 et médecine de la reproduction, hôpital Hôtel-Dieu, groupe hospitalier Cochin, Broca, Assistance publique-Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris Cité, 123, boulevard de Port-Royal, 75014 Paris, France
| | - P Santulli
- Service de gynécologie-obstétrique 2 et médecine de la reproduction, hôpital Hôtel-Dieu, groupe hospitalier Cochin, Broca, Assistance publique-Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris Cité, 123, boulevard de Port-Royal, 75014 Paris, France
| | - V Gayet
- Service de gynécologie-obstétrique 2 et médecine de la reproduction, hôpital Hôtel-Dieu, groupe hospitalier Cochin, Broca, Assistance publique-Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris Cité, 123, boulevard de Port-Royal, 75014 Paris, France
| | - C Chapron
- Service de gynécologie-obstétrique 2 et médecine de la reproduction, hôpital Hôtel-Dieu, groupe hospitalier Cochin, Broca, Assistance publique-Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris Cité, 123, boulevard de Port-Royal, 75014 Paris, France
| | - F Goffinet
- Maternité Port-Royal, hôpital Hôtel-Dieu, groupe hospitalier Cochin, Broca, Assistance publique-Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris Cité, 123, boulevard de Port-Royal, 75014 Paris, France
| | - C Le Ray
- Maternité Port-Royal, hôpital Hôtel-Dieu, groupe hospitalier Cochin, Broca, Assistance publique-Hôpitaux de Paris, université Paris Descartes, Sorbonne Paris Cité, 123, boulevard de Port-Royal, 75014 Paris, France
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Lashley LEELO, Haasnoot GW, Spruyt-Gerritse M, Claas FHJ. Selective advantage of HLA matching in successful uncomplicated oocyte donation pregnancies. J Reprod Immunol 2015; 112:29-33. [PMID: 26232147 DOI: 10.1016/j.jri.2015.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 04/20/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022]
Abstract
Oocyte donation (OD) enables women with various causes of reproductive failure to conceive, but is accompanied by a high risk of certain pregnancy disorders. Possibly, the allogeneic nature of the fetus in OD pregnancies plays a role in the development of these disorders. In this study, we investigated whether there is a selection for some degree of HLA matching in successful and uncomplicated OD pregnancies. Mothers and children from OD pregnancies that used unrelated donors (n=75) were typed for HLA-A, -B, -C, -DR, and -DQ and the observed number of HLA matches of the child was compared with the expected number of HLA matches. Moreover, we studied the possibility of a preferential selection for maternal KIR and fetal C combinations. We observed a significantly higher level of HLA matching between mother and child than expected by chance. In particular, the incidence of children with 5 or more HLA matches, which is the situation in autologous pregnancy, was higher than expected. A higher level of matching was shown, especially for HLA class I, while no significant differences were observed for the individual HLA loci. With respect to maternal KIR and fetal HLA-C no selection for a favorable combination was found. Larger observational studies including uncomplicated, preeclamptic, and aborted pregnancies are essential to determine to what extent HLA matching affects the outcome of OD pregnancies.
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Affiliation(s)
- Lisa E E L O Lashley
- Department of Gynecology and Obstetrics, Leiden University Medical Centre, the Netherlands.
| | - Geert W Haasnoot
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, the Netherlands
| | - Marijke Spruyt-Gerritse
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, the Netherlands
| | - Frans H J Claas
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, the Netherlands
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Lashley LEELO, Buurma A, Swings GMJS, Eikmans M, Anholts JDH, Bakker JA, Claas FHJ. Preeclampsia in autologous and oocyte donation pregnancy: is there a different pathophysiology? J Reprod Immunol 2015; 109:17-23. [PMID: 25863695 DOI: 10.1016/j.jri.2015.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/20/2015] [Accepted: 03/03/2015] [Indexed: 12/25/2022]
Abstract
Oocyte donation (OD) is a specific method of artificial reproductive technology that is accompanied by a higher risk of preeclampsia during pregnancy. The pathophysiological mechanism underlying preeclampsia in OD pregnancies is thought to differ from preeclampsia in autologous pregnancies. As preeclampsia in autologous pregnancies is suggested to be associated with complement activation, we studied C4d deposition, circulating complement components and placental complement regulatory proteins in preeclamptic OD pregnancies. Women with uncomplicated and preeclamptic pregnancies after OD or spontaneous conception were selected. We stained the placentas for C4d, marker for complement activation, measured complement factors C1q, C3 and C4 in maternal sera and quantified the placental mRNA expression of complement regulatory proteins CD46, CD55 and CD59. A significantly (p < 0.03) higher incidence of C4d deposition was observed in placentas from women with preeclampsia compared with uncomplicated pregnancies, both OD and autologous. The level of complement factors in serum did not differ between the groups. Children born in the autologous preeclampsia group were significantly lower in birth weight (p < 10th percentile) compared with the preeclamptic OD group. In addition, the placental mRNA expression level of complement regulatory proteins was significantly lower in uncomplicated and preeclamptic OD compared with the autologous pregnancies. In line with autologous preeclampsia pregnancies, there is excessive activation of complement in preeclamptic OD pregnancies. However, in contrast to autologous pregnancies this is not associated with counterbalancing upregulation of complement regulatory proteins. Furthermore, C4d deposition in OD pregnancies is not related to the severity of preeclampsia, suggesting another trigger or regulatory mechanism of placental C4d deposition in preeclamptic OD pregnancies.
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Affiliation(s)
- Lisa E E L O Lashley
- Department of Gynecology and Obstetrics, Leiden University Medical Centre, The Netherlands.
| | - Aletta Buurma
- Department of Pathology, Leiden University Medical Centre, The Netherlands
| | - Godelieve M J S Swings
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, The Netherlands
| | - Michael Eikmans
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, The Netherlands
| | - Jacqueline D H Anholts
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, The Netherlands
| | - Jaap A Bakker
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Centre, The Netherlands
| | - Frans H J Claas
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, The Netherlands
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van Dorp W, Rietveld AM, Laven JSE, van den Heuvel-Eibrink MM, Hukkelhoven CWPM, Schipper I. Pregnancy outcome of non-anonymous oocyte donation: a case-control study. Eur J Obstet Gynecol Reprod Biol 2014; 182:107-12. [PMID: 25268777 DOI: 10.1016/j.ejogrb.2014.09.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 08/27/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the maternal and neonatal outcome of non-anonymous oocyte donation compared to in vitro fertilization. Study design We compared 84 oocyte donation pregnancies with a 251 matched in vitro fertilization cohort. Maternal and neonatal outcomes were retrieved from a nationwide perinatal registry. Oocyte donation and in vitro fertilization pregnancies were matched for maternal age, study center, ZIP code and embryo transfer date. Both maternal and neonatal complications and outcome were compared between oocyte donation and in vitro fertilization with univariate and multivariate logistic regression analyses, adjusting for maternal age, donor age, socio-economic status, ethnicity, and parity. RESULTS In total, 277 women underwent 541 oocyte donation cycles. The median recipient age was 34.9 years (IQR: 31.5-38.5), while the median donor age was 34.4 years (IQR: 31.7-37.0). Clinical pregnancy rate was 26.6%, which is comparable to standard in vitro fertilization treatment. Donor age in years (OR 0.93, 95% CI 0.88-0.99) and a previous pregnancy of the recipient (OR 1.69, 95% CI 1.02-2.78) were significantly associated with clinical pregnancy rate. Both singleton and multiple oocyte donation pregnancies were associated with pregnancy-induced hypertension compared with in vitro fertilization singleton and multiple pregnancies (OR 1.99, 95%CI 1.02-3.89, OR 6.43, 95% CI 1.67-24.72, respectively). No significant differences in neonatal outcome were observed. CONCLUSION Oocyte donation pregnancies are associated with an increased incidence of pregnancy-induced hypertension compared with age-matched in vitro fertilization controls. However, no significant differences in neonatal outcome were observed between oocyte donation and in vitro fertilization.
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Affiliation(s)
- Wendy van Dorp
- Department of Gynaecology and Obstetrics, Division Reproductive Medicine, Erasmus MC-University Medical Centre Rotterdam, s'Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands; Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
| | - Annemarie M Rietveld
- Department of Gynaecology and Obstetrics, Division Reproductive Medicine, Erasmus MC-University Medical Centre Rotterdam, s'Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Joop S E Laven
- Department of Gynaecology and Obstetrics, Division Reproductive Medicine, Erasmus MC-University Medical Centre Rotterdam, s'Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Department of Gynaecology and Obstetrics, Division Reproductive Medicine, Erasmus MC-University Medical Centre Rotterdam, s'Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands; Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
| | - Chantal W P M Hukkelhoven
- Department of Gynaecology and Obstetrics, Division Reproductive Medicine, Erasmus MC-University Medical Centre Rotterdam, s'Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands; The Netherlands Perinatal Registry, PO Box 8588, 3503 RN Utrecht, The Netherlands
| | - Izaäk Schipper
- Department of Gynaecology and Obstetrics, Division Reproductive Medicine, Erasmus MC-University Medical Centre Rotterdam, s'Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
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Lombart M, Cabry R, Boulard V, Lourdel E, Lanta S, Verhoest P, Copin H, Gondry J, Merviel P. [How far can we go to oocyte donation? Debates on the risks of late pregnancies]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2013; 41:672-7. [PMID: 24183579 DOI: 10.1016/j.gyobfe.2013.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 06/25/2013] [Indexed: 11/19/2022]
Abstract
In France, there is a decline in first-time motherhood influenced by many sociocultural factors thus leading to a reproductive age where fertility decreases and which increase the risks associated with late pregnancy. The oocyte donation in France is subject to The Bioethic law granting no support in infertility beyond past 43 years. Thus, to satisfy their need for maternity, the French use a gift abroad. Then we will report the case of a pregnancy obtained by an oocyte donation, after 42 years, which was complicated. We will discuss the importance of taking into account the risk factors before a support to ART, and the ethical issues raised by this case. After a brief review of French legislative framework governing the practice of oocyte donation, we will evoke ways to improve the coverage needs of it in France.
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Affiliation(s)
- M Lombart
- Service de gynécologie-obstetrique et médecine de la reproduction, CHU d'Amiens, 124, rue Camille-Desmoulins, 80054 Amiens cedex 1, France
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Srebnik N, Miron-Shatz T, Rolison JJ, Hanoch Y, Tsafrir A. Physician recommendation for invasive prenatal testing: the case of the 'precious baby'. Hum Reprod 2013; 28:3007-11. [PMID: 24045783 DOI: 10.1093/humrep/det354] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Do clinicians manage pregnancies conceived by assisted reproductive technologies (ART) differently from spontaneous pregnancies? SUMMARY ANSWER Clinicians' decisions about prenatal testing during pregnancy depend, at least partially, on the method of conception. WHAT IS KNOWN ALREADY Research thus far has shown that patients' decisions regarding prenatal screening are different in ART pregnancies compared with spontaneous ones, such that ART pregnancies may be considered more valuable or 'precious' than pregnancies conceived without treatment. STUDY DESIGN, SIZE AND DURATION In this cross-sectional study, preformed during the year 2011, 163 obstetricians and gynecologists in Israel completed an anonymous online questionnaire. PARTICIPANTS, SETTING, METHODS Clinicians were randomly assigned to read one of two versions of a vignette describing the case of a pregnant woman. The two versions differed only with regard to the method of conception (ART; n = 78 versus spontaneous; n = 85). Clinicians were asked to provide their recommendations regarding amniocentesis. MAIN RESULTS AND THE ROLE OF CHANCE The response rate among all clinicians invited to complete the questionnaire was 16.7%. Of the 85 clinicians presented with the spontaneous pregnancy scenario, 37 (43.5%) recommended amniocentesis. In contrast, of the 78 clinicians presented with the ART pregnancy scenario, only 15 (19.2%) recommended the test. Clinicians were 3.2 (95% confidence interval [CI]: 1.6-6.6) times more likely to recommend amniocentesis for a spontaneous pregnancy than for an ART pregnancy. LIMITATIONS AND REASONS FOR CAUTION The study is limited by a low response rate, the relatively small sample and the hypothetical nature of the decision, as clinician recommendations may have differed in an actual clinical setting. WIDER IMPLICATIONS OF THE FINDINGS Our findings show that fertility history and use of ART may affect clinicians' recommendations regarding amniocentesis following receipt of screening test results. This raises the question of how subjective factors influence clinicians' decisions regarding other aspects of pregnancy management. STUDY FUNDING AND COMPETING INTEREST There was no funding source to this study. The authors declare no conflicts of interest.
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Affiliation(s)
- Naama Srebnik
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, the Hebrew University, Jerusalem 91031, Israel
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Perinatal outcomes in 375 children born after oocyte donation: a Danish national cohort study. Fertil Steril 2013; 99:1637-43. [DOI: 10.1016/j.fertnstert.2013.01.128] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 11/22/2022]
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Gupta P, Banker M, Patel P, Joshi B. A study of recipient related predictors of success in oocyte donation program. J Hum Reprod Sci 2013; 5:252-7. [PMID: 23531511 PMCID: PMC3604831 DOI: 10.4103/0974-1208.106336] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Revised: 04/28/2012] [Accepted: 06/03/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND: Oocyte donation is an invaluable therapy for couples with impending or complete ovarian failure. In addition, oocyte donation affords a scientific opportunity to study the unique biologic participation of the uterus in the process of human embryo implantation. AIM: To identify the recipient variables that may have a significant impact on pregnancy outcome in order to optimize results of an oocyte donation program. DESIGN AND SETTINGS: A prospective study conducted from March 1, 2010 to March 31, 2011 at a private tertiary care IVF Clinic. Materials and methods A total of 270 recipients resulting in embryo transfer as a result of oocyte donation were enrolled. Clinical and Ongoing pregnancy rates, Implantation rates were calculated according to different age groups, Endometrial thickness, Indication, Day and number of embryos transferred. Data was evaluated as chi square analyses with comparative significance determined at P <.05. RESULTS: In recipients less than 40 years of age, higher ongoing pregnancy and implantation rates (41.9% and 24.6%) were seen as compared to recipients above 40 years (21.8% and 13.18%) respectively. Pregnancy and implantation rates increased with increasing endometrial thickness but the difference was not statistically significant. A higher ongoing pregnancy rate (40.9% vs.28.8%) and implantation rate (23% vs.19.6%) was demonstrated with Day 3 embryo transfer compared to Day 2 transfer. CONCLUSION: A declining endometrial receptivity may result in lower implantation and pregnancy rates in recipients above the age of 40 years, more pronounced after the age of 45 years. An endometrial thickness of >8 mm is considered ideal before transfer. Transfer of two selected embryos on day 3 yields a favorable pregnancy outcome with reduced multiple pregnancy rates. Recipient's age above 45 years has negative impact on pregnancy outcome whereas embryo transfers on Day 3 yields better pregnancy
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Affiliation(s)
- Pooja Gupta
- Department of Reproductive, Medicine and Endoscopy, The Pulse Women Hospital Pvt. Ltd. Ahmedabad, Gujarat, India
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Hagman A, Loft A, Wennerholm UB, Pinborg A, Bergh C, Aittomaki K, Nygren KG, Bente Romundstad L, Hazekamp J, Soderstrom-Anttila V. Obstetric and neonatal outcome after oocyte donation in 106 women with Turner syndrome: a Nordic cohort study. Hum Reprod 2013; 28:1598-609. [DOI: 10.1093/humrep/det082] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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van der Hoorn MLP, Scherjon SA, Claas FH. Egg donation pregnancy as an immunological model for solid organ transplantation. Transpl Immunol 2011; 25:89-95. [DOI: 10.1016/j.trim.2011.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 06/10/2011] [Indexed: 10/18/2022]
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Alvaro Mercadal B, Imbert R, Demeestere I, Englert Y, Delbaere A. Pregnancy outcome after oocyte donation in patients with Turner's syndrome and partial X monosomy. Hum Reprod 2011; 26:2061-8. [PMID: 21646279 DOI: 10.1093/humrep/der166] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Fertility expectations for patients with Turner's syndrome (TS) have clearly changed in the last three decades. However, medical risks during pregnancy are supposed to be highly increased. The aim of the study was to assess clinical outcome and obstetrical complications in a series of patients with TS in an oocyte donor programme. METHODS A retrospective study was carried out on 24 women with TS seeking a pregnancy in the Fertility Clinic of the Erasme Hospital from 1992 up until March 2011. RESULTS Twenty-three patients with TS were included in an oocyte donation cycle. Forty-nine oocyte donation cycles were performed, which led to 45 fresh and 10 frozen-thawed embryo transfers. Altogether, 18 pregnancies were obtained, 10 deliveries (9 singletons and 1 pair of twins), 3 miscarriages and 5 biochemical pregnancies. The clinical pregnancy rate per transfer was 24.4% in fresh cycles and 20% in frozen replacement cycles. Complications of pregnancy occurred in 5 of 10 pregnancies (50%), which led to three premature deliveries because of pregnancy-induced hypertensive disorders. The mean birthweight (g) (±SD) for singletons and twins was 2728 ± 577 and 2335 ± 318, respectively. Four babies were below the 10th percentile. No cardiac complications were observed in any of the pregnant women. CONCLUSIONS Pregnancy rates after oocyte donation in patients with TS are comparable with those previously published but a high risk of pregnancy hypertensive disorders and a high risk of low birthweight can be highlighted from our study. Strict inclusion criteria and single embryo transfer are necessary to minimize complications during pregnancy in this high-risk group.
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Affiliation(s)
- B Alvaro Mercadal
- Research Laboratory on Human Reproduction, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium.
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Pecks U, Maass N, Neulen J. Oocyte donation: a risk factor for pregnancy-induced hypertension: a meta-analysis and case series. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:23-31. [PMID: 21285999 DOI: 10.3238/arztebl.2011.0023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 09/23/2010] [Indexed: 01/02/2023]
Abstract
BACKGROUND In 2008 and 2009, the authors saw in their institution three women who had undergone oocyte donation and went on to develop severe de novo hypertension before the 26(th) week of gestation, with values above 180/110 mm Hg. Pregnancy was prematurely terminated in these cases because of the acute threat to the mother's life, and none of the three neonates survived. Five further cases with better outcomes were found to have occurred from 2006 to 2010. On the basis of this experience, the authors performed a meta-analysis to determine whether oocyte donation elevates the risk of pregnancy-induced hypertension (PIH). The cases are discussed in detail. METHODS Systematic review of the literature on PIH after oocyte donation, with meta-analysis and calculation of an odds ratio. We also provide a retrospective chart review of our own case series. RESULTS 28 publications were evaluated. The overall rate of PIH in a total of 2308 deliveries after oocyte donation was 22.6%. With the aid of data from 11 studies, the course of pregnancy in a total of 644 oocyte recipients was compared to that in a control group of 2320 women who were not oocyte recipients. The calculated odds ratio for PIH after oocyte donation, compared to conventional reproductive therapy, was 2.57 (95% CI, 1.91-3.47), while the calculated odds ratio for PIH after oocyte donation, compared to other women in the control group, was 6.60 (95% CI, 4.55-9.57). CONCLUSION The data reveal that oocyte donation confers a considerable risk that the recipient will develop PIH. The very early and severe cases of preeclampsia that we report here are rather atypical; similar cases may have occurred elsewhere without finding their way into the relevant literature. The authors recommend close surveillance of pregnancies following allogenic oocyte transplantation by physicians with special expertise in prenatal medicine.
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Affiliation(s)
- Ulrich Pecks
- Frauenklinik für Gynäkologie und Geburtsmedizin, Universitätsklinikum der RWTH Aachen, Pauwelsst. 30, 52057 Aachen, Germany
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van der Hoorn MLP, Lashley EELO, Bianchi DW, Claas FHJ, Schonkeren CMC, Scherjon SA. Clinical and immunologic aspects of egg donation pregnancies: a systematic review. Hum Reprod Update 2010; 16:704-12. [DOI: 10.1093/humupd/dmq017] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dessolle L, Darai E, Cornet D, Rouzier R, Coutant C, Mandelbaum J, Antoine JM. Determinants of pregnancy rate in the donor oocyte model: a multivariate analysis of 450 frozen-thawed embryo transfers. Hum Reprod 2009; 24:3082-9. [DOI: 10.1093/humrep/dep303] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Simchen MJ, Shulman A, Wiser A, Zilberberg E, Schiff E. The aged uterus: multifetal pregnancy outcome after ovum donation in older women. Hum Reprod 2009; 24:2500-3. [DOI: 10.1093/humrep/dep238] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kortman M, Macklon N. Oocyte donation in postmenopausal women: medical and ethical considerations. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.ogrm.2008.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Soares SR, Garcia Velasco JA, Fernandez M, Bosch E, Remohí J, Pellicer A, Simón C. Clinical factors affecting endometrial receptiveness in oocyte donation cycles. Fertil Steril 2008; 89:491-501. [DOI: 10.1016/j.fertnstert.2008.01.080] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 01/23/2008] [Indexed: 11/29/2022]
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Bodri D, Colodron M, Vidal R, Galindo A, Durban M, Coll O. Prognostic factors in oocyte donation: an analysis through egg-sharing recipient pairs showing a discordant outcome. Fertil Steril 2007; 88:1548-53. [PMID: 17412330 DOI: 10.1016/j.fertnstert.2007.01.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Revised: 01/14/2007] [Accepted: 01/15/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To analyze prognostic factors that are associated with a discordant outcome in egg recipients sharing oocytes from the same donor. DESIGN Matched case-control single-center study. SETTING Private infertility clinic. PATIENT(S) Four hundred forty-four recipients (222 pairs) sharing oocytes from the same donor and showing a discordant outcome. INTERVENTION(S) Controlled ovarian hyperstimulation of egg donors, oocyte donation, intracytoplasmic sperm injection, and ET in egg recipients. MAIN OUTCOME MEASURE(S) Recipient age, obstetric (gravidity, parity) and gynecologic variables (previous uterine surgery, uterine fibroids, uterine malformations, endometriosis, history of tubal infertility), previous oocyte donation cycles, duration of E(2) replacement, received cumulus-oocyte complexes, mature (MII) oocytes, fertilized oocytes, transferred embryos, mean embryo score, transfer difficulty, and semen parameters. RESULT(S) No significant differences were found in the above-mentioned prognostic factors between the study and control groups. CONCLUSION(S) Recipient- and cycle-related prognostic factors investigated in our study were not associated with a discordant outcome in recipient pairs sharing oocytes from the same donor. Other possible prognostic factors involving oocyte donor heterogeneity, embryo aneuploidy rates, male factor infertility, and endometrial receptivity should be further investigated.
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Vernaeve V, Reis Soares S, Budak E, Bellver J, Remohi J, Pellicer A. Facteurs cliniques et résultats du don d'ovocytes. ACTA ACUST UNITED AC 2007; 35:1015-23. [PMID: 17905636 DOI: 10.1016/j.gyobfe.2007.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Accepted: 06/06/2007] [Indexed: 11/28/2022]
Abstract
This article aims at reviewing the literature in order to provide a summary of the actual knowledge about the clinical factors of the oocyte recipient (other than those affecting the morphology of the uterine cavity) influencing the outcome of oocyte donation cycles. Recipient age, from 45 years onwards, is clearly associated with a poorer outcome in oocyte donation cycles as well as the presence of a hydrosalpinx. The negative impact of smoking has recently been confirmed. The exact influence of a high body mass index is under examination but it is likely that it is associated with a lower ongoing pregnancy rate. Endometriosis does not have a negative impact when standard endometrial priming protocols are used in oocyte donation. During endometrial priming, serum estradiol levels and endometrial thickness, if >5 mm, does not influence negatively the outcome; however duration of estrogen treatment of more than 7 weeks is associated with a diminished pregnancy and implantation rate.
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Affiliation(s)
- V Vernaeve
- Instituto Valenciano de Infertilidad -Barcelona, 14, Ronda General-Mitre, 08017 Barcelone, Espagne.
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Budak E, Garrido N, Soares SR, Melo MAB, Meseguer M, Pellicer A, Remohí J. Improvements achieved in an oocyte donation program over a 10-year period: sequential increase in implantation and pregnancy rates and decrease in high-order multiple pregnancies. Fertil Steril 2007; 88:342-9. [PMID: 17335819 DOI: 10.1016/j.fertnstert.2006.11.118] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2006] [Revised: 11/17/2006] [Accepted: 11/27/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare outcome parameters and cumulative pregnancy rates (PRs) in oocyte donation cycles over a period of 10 years. DESIGN Retrospective study. SETTING University-affiliated assisted reproductive technology program. PATIENT(S) Women undergoing oocyte donation (10,537 cycles) between 1995 and 2005. INTERVENTION(S) Ovarian stimulation and oocyte retrieval in donors. Embryo transfer performed in recipients after endometrial preparation. MAIN OUTCOME MEASURE(S) Outcome parameters and cumulative PRs were calculated and compared in relation to indication, age, and origin of sperm used. RESULT(S) Overall PR, implantation rate, clinical PR, and miscarriage rate per embryo transfer performed were 54.9%, 27%, 50.3%, and 19%, respectively. Ongoing PR per transfer was 40.2%, and twin and high-order multiple PRs were 39% and 6%, respectively. Mean number of embryos transferred was reduced from 3.6 +/- 0.8 to 1.9 +/- 0.3, implantation rate improved from 16.7% to 38.3%, and ongoing PR improved from 31% to 44.3%. Cumulative PRs did not differ significantly among different indications for oocyte donation, age groups, or origin of sperm used for oocyte insemination. Overall cumulative PRs after three and five cycles were calculated as 87% and 96.8%, respectively. CONCLUSION(S) Significant improvements in outcome parameters were achieved within 10 years. Similar cumulative PRs were observed regardless of recipient age, indication for oocyte donation, or sperm origin.
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Affiliation(s)
- Erdal Budak
- Instituto Valenciano de Infertilidad, University of Valencia, Valencia, Spain
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Söderström-Anttila V, Vilska S. Five years of single embryo transfer with anonymous and non-anonymous oocyte donation. Reprod Biomed Online 2007; 15:428-33. [PMID: 17908406 DOI: 10.1016/s1472-6483(10)60369-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Single embryo transfer (SET) has been the main embryo transfer strategy in the oocyte donation programme at the authors' clinic since 2000. The primary aim of this study was to evaluate the effect of SET on the clinical outcome in an unselected group of oocyte recipients. A retrospective analysis of the outcome in 142 recipient cycles (116 from anonymous donors; 26 from known donors) was performed. The oocytes from each anonymous donor were shared between two recipients if at least 10 oocytes were obtained. The proportion of SET of all fresh transfers was 77.3%. The clinical pregnancy rate (CPR) was 43.2% and the delivery rate 31.1% per embryo transfer. The outcome was similar in recipients undergoing anonymous and non-anonymous donation. The delivery rates were similar after SET (30.4%) or double embryo transfer (DET) (33.3%), whereas the twin rate was 0% after SET and 40% after DET. The implantation rate was significantly better (P < 0.01) with good-quality embryos (54.7%) compared with non-optimal embryos (27.1%). Of 152 frozen-thawed embryo transfer cycles, 78.9% were SET. The CPR was 28.3% and the twin rate was 7.1%. In fresh oocyte donation cycles, elective SET can be recommended if the embryo quality is considered good, and always if there is a contraindication for twin pregnancy.
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Noyes N, Hampton BS, Berkeley A, Licciardi F, Grifo J, Krey L. Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis. Fertil Steril 2001; 76:92-7. [PMID: 11438325 DOI: 10.1016/s0015-0282(01)01823-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To establish prognostic relevance of parameters assessed in oocyte donation cycles. DESIGN Retrospective analysis. SETTING Large university-based donor oocyte program. PATIENT(S) All oocyte recipient cycles achieving embryo transfer from September 1995 to October 1998. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Pregnancy. RESULT(S) Recipient age and reproductive status, day 9 and 12 serum estradiol (E(2)) levels and a progesterone (P) level obtained 2 days after initiation of hormonal therapy did not correlate with pregnancy. Endometrial thickness, but not endometrial pattern, was useful in predicting pregnancy outcome. The clinical pregnancy and live-birth rate in cycles where the endometrial thickness was less than 8 mm was significantly lower when compared to cycles with an endometrial thickness > or =9 mm. Cycles where optimal quality embryos were transferred had the highest implantation (36%), clinical pregnancy (63%) and live birth (54%) rates and these rates were significantly higher than those of cycles where only poor quality embryos were available for transfer (10% implantation, 17% clinical pregnancy, and 8% live birth rates, respectively; P<.05). CONCLUSION(S) The most reliable predictive factors for pregnancy in oocyte donation cycles are the quality of the embryos transferred and the recipient's mid-cycle endometrial thickness. Recipient monitoring should minimally include ultrasound assessment of endometrial thickness.
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Affiliation(s)
- N Noyes
- Program for IVF, Reproductive Surgery and Infertility, Department of Obstetrics and Gynecology, New York University Medical Center, New York, New York, USA.
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Shapiro BS, Harris DC, Richter KS. Predictive value of 72-hour blastomere cell number on blastocyst development and success of subsequent transfer based on the degree of blastocyst development. Fertil Steril 2000; 73:582-6. [PMID: 10689016 DOI: 10.1016/s0015-0282(99)00586-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To determine the predictive value of 72-hour blastomere cell number on blastocyst development and to compare success rates of subsequent transfer based on the degree of blastocyst development. DESIGN Retrospective clinical study. SETTING Private assisted reproductive technology center. PATIENT(S) Ninety-three women aged 32.0 +/- 5.1 years undergoing oocyte retrieval for IVF. INTERVENTION(S) Bipronucleate oocytes obtained from IVF were grown for up to 168 hours after fertilization and subsequently transferred at the blastocyst stage. MAIN OUTCOME MEASURE(S) Percentages of embryos developing to blastocyst from 72-hour embryos by blastomere cell number and subsequent implantation and pregnancy rates of transferred blastocysts. RESULT(S) Rates of blastocyst formation and expansion increased as cell numbers at 72 hours increased. Implantation rates were 43% for embryos transferred to women receiving only expanded blastocysts and 17% for embryos transferred to women receiving one or more less developed blastocysts. Pregnancy rates were higher for women receiving only expanded blastocysts than for women receiving one or more less developed blastocysts, although the difference was not significant. CONCLUSION(S) More developed 72-hour embryos are more likely to become blastocysts and expand. Implantation rates are greater for the transfer of expanded rather than unexpanded blastocysts.
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Affiliation(s)
- B S Shapiro
- Fertility Center of Las Vegas, Las Vegas, Nevada 89117, USA.
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Fasouliotis SJ, Schenker JG. A historical perspective of the clinical evolution of the assisted reproductive technologies. Gynecol Endocrinol 1999; 13:420-40. [PMID: 10685336 DOI: 10.3109/09513599909167589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The practice of assisted reproduction technology today is the result of the dedicated patient care, observation, research, and experimentation undertaken by previous generations of physicians. The building blocks of progress have been assembled over past decades, by scientists whose primary objective has been to push forward the frontiers of knowledge, in order to offer more effective methods of infertility treatment. And fortunately that process continues today. Amongst the many scientific developments that have led to the modern practice in assisted reproductive technology, a small number stand out as having had a unique importance. This historical review redraws the path through which in vitro fertilization went from an experimental to an accepted infertility treatment.
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Affiliation(s)
- S J Fasouliotis
- Department of Obstetrics and Gynecology, Hadassah Medical Center-Hebrew University, Jerusalem, Israel
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Abstract
Oocyte donation has become a common treatment modality for a large spectrum of infertility conditions. The purpose of this study was to assess the success rate of a shared egg donation programme, and to define the profile of a successful 'donor-recipient' couple in view of the limitations imposed by the shared programme. The results of all consecutive cycles of egg donation from 1st January 1995 to 31st December 1996 were analysed. A total of 383 donor cycles were matched with 946 recipient cycles; clinical pregnancy rates were 23. 5 and 16.7% respectively. With the exception of endometriosis, which significantly reduced the pregnancy rate in both groups, similar pregnancy rates were obtained in both groups for all the other infertility aetiologies of the donors. The donor's age had no impact on pregnancy rate of the recipient, but pregnancy rate was significantly decreased in donors >35 years. Recipients >50 years had significantly reduced pregnancy rates and those >45 years a significantly increased abortion rate. Recipients with severe male factor infertility, who had intracytoplasmic sperm injection treatment, showed pregnancy rates equivalent to those recipients who had regular in-vitro fertilization. We conclude that in a shared egg donation programme, the recipients' pregnancy rate and outcome are dependent only on the donors' infertility aetiologies and on recipients' ages.
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Affiliation(s)
- A Shulman
- The IVF Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
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Salha O, Sharma V, Dada T, Nugent D, Rutherford AJ, Tomlinson AJ, Philips S, Allgar V, Walker JJ. The influence of donated gametes on the incidence of hypertensive disorders of pregnancy. Hum Reprod 1999; 14:2268-73. [PMID: 10469693 DOI: 10.1093/humrep/14.9.2268] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pregnancies achieved from oocyte, sperm or embryo donation are unique, since they have resulted from donor gametes that are immunologically foreign to the mother. Thus, studying the obstetric outcome of such pregnancies may shed some light on the pathophysiology of preeclampsia, particularly in women conceiving with donated embryos, since the entire fetal genome is allogenic in these pregnancies. In this retrospective cohort study, a total of 144 women were studied. Of these, 72 were infertility patients who had conceived as a result of sperm, ovum or embryo donation and the other 72 women were age- and parity-matched control patients who became pregnant with their own gametes, either spontaneously, or following intrauterine insemination with their partner's spermatozoa. Study patients were divided into three groups depending on the origin of the donated gametes. Group 1 consisted of pregnancies achieved by intrauterine insemination with washed donor spermatozoa (n = 33). Group 2 included women who conceived using donated oocytes (n = 27) and group 3 consisted of women who conceived as a result of embryo donation (n = 12). The incidence of pregnancy-induced hypertension in the donated gametes study group was 12.5% (9/72) compared with 2.8% (2/72) in the control group. In addition, pre-eclampsia was diagnosed in 18.1% (13/72) of the donated gametes study group compared to 1.4% (1/72) in the age- and parity-matched controls. The increased incidence of gestational hypertension in pregnancies resulting from donated gametes gives evidence for a maternal genetic component, with an equally strong fetal influence, in the complicated aetiology of gestational hypertension, and pre-eclampsia in particular.
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Affiliation(s)
- O Salha
- Assisted Conception Unit, St James's University Hospital, Leeds, UK
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