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Zhang D, Cai H, Xie J, Chen L, Zhang Z, Shi J. Cumulative live birth rates following intrauterine insemination using donor and husband sperm in different age groups: A cohort study of 10 415 insemination cycles. Int J Gynaecol Obstet 2024. [PMID: 38623946 DOI: 10.1002/ijgo.15539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To assess the age-specific cumulative live birth rates (CLBRs) in intrauterine insemination (IUI) cycles using either donor or husband sperm, and to investigate the impact of sperm sources on IUI success among women within the same age group. METHODS This retrospective cohort study comprised women who underwent IUI with donor sperm (IUI-D) or husband sperm (IUI-H) from 2017 to 2021. The women were stratified based on their age at the initiation of insemination into four categories: <35, 35-37, 38-39 and ≥40 years. RESULTS A total of 5253 women undergoing 10 415 insemination cycles (3354 with IUI-D and 7061 with IUI-H) were included. The CLBRs decreased significantly with increasing maternal age within donor and husband insemination groups (P < 0.001). In the IUI-D group, the crude CLBRs were 61.50% in women aged <35, 48.91% in 35-37, 24.14% in 38-39 and 11.76% in the ≥40-year age category, respectively. The corresponding rates in the IUI-H group were 27.62%, 22.96%, 13.73% and 6.90%, respectively. Within the <35 and 35-37-year age categories, the CLBRs were significantly higher following IUI-D cycles compared to IUI-H cycles, with hazard ratios (HR) of 1.85 (1.68-2.04) and 1.69 (1.16-2.47), respectively. However, within the 38-39 and ≥40-year age categories, both IUI-D and IUI-H resulted in comparable low CLBRs, with HRs of 1.91 (0.77-4.76) and 1.80 (0.33-9.86), respectively. CONCLUSION Advanced maternal age affects the whole process of fertility. Therefore, it could be reasonable to limit the number of IUI performed in women aged 40 years and older, even in couple using donor sperm for reproduction.
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Affiliation(s)
- Dian Zhang
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
- Graduate Department, Xi'an Medical University, Xi'an, China
| | - He Cai
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Jinlin Xie
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Lijuan Chen
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Zhou Zhang
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Juanzi Shi
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
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Fluks M, Collier R, Walewska A, Bruce AW, Ajduk A. How great thou ART: biomechanical properties of oocytes and embryos as indicators of quality in assisted reproductive technologies. Front Cell Dev Biol 2024; 12:1342905. [PMID: 38425501 PMCID: PMC10902081 DOI: 10.3389/fcell.2024.1342905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
Assisted Reproductive Technologies (ART) have revolutionized infertility treatment and animal breeding, but their success largely depends on selecting high-quality oocytes for fertilization and embryos for transfer. During preimplantation development, embryos undergo complex morphogenetic processes, such as compaction and cavitation, driven by cellular forces dependent on cytoskeletal dynamics and cell-cell interactions. These processes are pivotal in dictating an embryo's capacity to implant and progress to full-term development. Hence, a comprehensive grasp of the biomechanical attributes characterizing healthy oocytes and embryos is essential for selecting those with higher developmental potential. Various noninvasive techniques have emerged as valuable tools for assessing biomechanical properties without disturbing the oocyte or embryo physiological state, including morphokinetics, analysis of cytoplasmic movement velocity, or quantification of cortical tension and elasticity using microaspiration. By shedding light on the cytoskeletal processes involved in chromosome segregation, cytokinesis, cellular trafficking, and cell adhesion, underlying oogenesis, and embryonic development, this review explores the significance of embryo biomechanics in ART and its potential implications for improving clinical IVF outcomes, offering valuable insights and research directions to enhance oocyte and embryo selection procedures.
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Affiliation(s)
- Monika Fluks
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
- Department of Molecular Biology and Genetics, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czechia
| | - Rebecca Collier
- Department of Molecular Biology and Genetics, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czechia
| | - Agnieszka Walewska
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Alexander W. Bruce
- Department of Molecular Biology and Genetics, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czechia
| | - Anna Ajduk
- Department of Embryology, Institute of Developmental Biology and Biomedical Sciences, Faculty of Biology, University of Warsaw, Warsaw, Poland
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Bahadur G, Homburg R, Jayaprakasan K, Raperport CJ, Huirne JAF, Acharya S, Racich P, Ahmed A, Gudi A, Govind A, Jauniaux E. Correlation of IVF outcomes and number of oocytes retrieved: a UK retrospective longitudinal observational study of 172 341 non-donor cycles. BMJ Open 2023; 13:e064711. [PMID: 36592998 PMCID: PMC9809223 DOI: 10.1136/bmjopen-2022-064711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE How do numbers of oocytes retrieved per In vitro fertilisation (IVF) cycle impact on the live birth rate (LBR) and multiple gestation pregnancy (MGP) rates? DESIGN Retrospective observational longitudinal study. SETTING UK IVF clinics. POPULATION Non-donor IVF patients. MAIN OUTCOME MEASURES LBR per IVF cycle and MGP levels against number of oocytes retrieved into subgroups: 0, 1-5, 6-15, 16-25, 26-49 oocytes and 50+ oocytes. Relative risk (RR) and 95% CIs were calculated for each group against the intermediate responder with '6-15 oocytes collected'. RESULTS From 172 341 attempted fresh oocyte retrieval cycles, the oocyte retrieved was: 0 in 10 148 (5.9%) cycles from 9439 patients; 1-5 oocytes in 42 574 cycles (24.7%); 6-15 oocytes in 91 797 cycles (53.3%); 16-25 oocytes in 23 794 cycles (13.8%); 26-49 oocytes in 3970 cycles (2.3%); ≥50 oocytes in 58 cycles (0.033%). The LBRs for the 1-5, 6-15, 16-25 and 26-49 subgroups of oocytes retrieved were 17.2%, 32.4%, 35.3% and 18.7%, respectively. The RR (95% CI) of live birth in comparison to the intermediate group (6-15) for 1-5, 16-25 and 26-49 groups was 0.53 (0.52 to 0.54), 1.09 (1.07 to 1.11) and 0.58 (0.54 to 0.62), respectively. The corresponding MGP rates and RR were 9.2%, 11.0%, 11.4% and 11.3%, respectively and 0.83 (0.77 to 0.90), 1.04 (0.97 to 1.11) and 1.03 (0.84 to 1.26), respectively. CONCLUSION There was only limited benefit in LBR beyond the 6-15 oocyte group going to the 16-25 oocytes group, after which there was significant decline in LBR. The MGP risk was lower in 1-5 group.
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Affiliation(s)
- Gulam Bahadur
- Reproductive Medicine Unit, North Middlesex University Hospital, London N18 1QX, London, UK
- Homerton Fertility Unit, Homerton University Hospital, London E9 6SR, London, UK
| | - Roy Homburg
- Homerton Fertility Unit, Homerton University Hospital, London E9 6SR, London, UK
| | - Kanna Jayaprakasan
- University Hospitals of Derby and Burton NHS Trust, Royal Derby Hospital, Derby, DE22 3NE, UK
| | | | - Judith A F Huirne
- Department of Obstetrics and Gynaecology, University medical centers Amsterdam- location VUmc and AMC-,Research institute Reproduction and development-, Amsterdam, The Netherlands
| | - Santanu Acharya
- University Hospital Crosshouse, Ayrshire Fertility Unit, Kilmarnock- KA2 0BE, Scotland, UK
| | - Paul Racich
- Linacre College, Oxford University, Oxford OX13JA, England, UK
| | - Ali Ahmed
- Reproductive Medicine Unit, North Middlesex University Hospital, London N18 1QX, London, UK
- The Brooklyn Hospital Center/The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, Brooklyn, NY 11201, USA
| | - Anil Gudi
- Homerton Fertility Unit, Homerton University Hospital, London E9 6SR, London, UK
| | - Abha Govind
- Reproductive Medicine Unit, North Middlesex University Hospital, London N18 1QX, London, UK
| | - Eric Jauniaux
- EGA Institute for Women's Health, Faculty of Population HealthScience, University College London, London, WC1E 6HX, London, UK
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Gao X, Sun S, Xie L, Lu S. Effects of donor sperm on perinatal and neonatal outcomes resulting from in vitro fertilization-intracytoplasmic sperm injection and embryo transfer cycles: a retrospective cohort study. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:819. [PMID: 36034991 PMCID: PMC9403916 DOI: 10.21037/atm-21-5492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 06/24/2022] [Indexed: 12/02/2022]
Abstract
Background The impact of donor sperm on pregnancy outcomes is controversial. The aim of this study was to investigate whether donor sperm in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment could reduce the rate of live births or increase the incidence of adverse pregnancy outcomes and birth defects in neonates. Methods This single-centre, retrospective cohort study included 1,559 patients with infertility who received donor sperm at our hospital from 2015 to 2019. All the patients received fresh embryos and underwent first-cycle transfer. After propensity score matching, 4,677 controls who received their partners’ sperm were matched at 1:3. Clinical pregnancy, perinatal, and neonatal outcomes were compared between the donor sperm and partner sperm groups. Results The embryo development was better in the donor sperm group than in the partner sperm group. The high-quality embryo and available embryo rates were significantly higher in the donor sperm group (P<0.05 for both groups). The rate of high-quality embryos transferred from the donor sperm group was higher than that from the partner sperm group (P<0.05). The clinical pregnancy (62.99% vs. 59.65%; P=0.02) and live birth (54.65% vs. 51.59%; P=0.036) rates were higher in the donor sperm group. After adjusting for confounding factors, no significant difference in live birth rates was observed between the two groups (adjusted P=0.057). The low birthweight (18.21% vs. 21.39%; P=0.023) and small for gestational age (SGA) (7.60% vs. 11.97%; P<0.001) rates were lower in the donor sperm group. To exclude the effect of multiple pregnancies, we evaluated neonatal outcomes of singleton pregnancies. No significant differences were noted in preterm and very preterm birth, SGA, mean birthweight, high birthweight, and low birth weight (LBW) and very low birth weight (VLBW) rates (P>0.05 for both groups). Further, no significant between group differences were observed in the ectopic pregnancy rate, early and late spontaneous abortion rates, gestational age, rate of large for gestational age (LGA), and neonatal defects. Conclusions Compared with partner sperm, donor sperm did not reduce live birth rate and did not increase neonatal LBW or low birth defects.
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Affiliation(s)
- Xinyan Gao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
| | - Shihu Sun
- Tengzhou Maternal and Child Health Hospital, Zaozhuang, China
| | - Lei Xie
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
| | - Shaoming Lu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
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Does advanced paternal age affect outcomes following artificial reproductive technologies? A systematic review and meta-analysis. Reprod Biomed Online 2022; 45:283-331. [DOI: 10.1016/j.rbmo.2022.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 11/20/2022]
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