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Lan Y, Zheng H, Fu X, Peng T, Liao C, Liu J, Liu M, An G. Clinical Outcomes and Live Birth Rate Resulted From Microdissection Testicular Sperm Extraction With ICSI-IVF in Non-Obstructive Azoospermia: A Single-Center Cohort Study. Front Endocrinol (Lausanne) 2022; 13:893679. [PMID: 35813616 PMCID: PMC9259991 DOI: 10.3389/fendo.2022.893679] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most of data available in the literature reported the sperm retrieval rate and limited intracytoplasmic sperm injection (ICSI) results of microdissection testicular sperm extraction (micro-TESE) in non-obstructive azoospermia (NOA) patients with different etiologies. Unfortunately, there is currently a lack of comprehensive data to guide clinicians in conducting comprehensive consultations with NOA patients. OBJECTIVES To obtain more comprehensive evidence-based data and clinical outcomes for better consultation of NOA patients who opted to undergo micro-TESE combined with ICSI-IVF. METHODS It was a retrospective study involved 968 NOA patients underwent micro-TESE during January 2015 to December 2019. Embryological, clinical, and live birth outcomes were demonstrated comprehensively and three kinds of stratification analyses were performed based on ICSI-IVF cycles using frozen and fresh sperm, different etiologies of NOA and various amounts of sperm retrieved. RESULTS The sperm retrieval rate was 44.6%, and ICSI was performed in 299 couples leading to 150 clinical pregnancies and 140 live-birth deliveries. The clinical pregnancy rate (CPR) was 50.17%, and the cumulative live birth rate (LBR) was 46.82%, and the low birth defects rate was 1.43%. No significant difference was observed about cumulative LBR in frozen sperm group and fresh sperm group (47.5% vs 42.9%, P>0.05). NOA patients with AZFc microdeletions had the lowest rate of a high-score embryo on day 3 (4.4%, P<0.05) and the lowest cumulative LBR (19.4%, P<0.05). NOA patients with lower sperm count (having fewer than 20 sperms retrieved) had significantly lower cumulative LBR than those with higher sperm count (having more than 20 sperms retrieved) (28.1% vs 51.9%, P<0.05). CONCLUSIONS For those NOA patients who stepped in ICSI-IVF cycles, the cumulative LBR was 46.82%. No significant difference was indicated in the LBR between ICSI-IVF cycles using frozen or fresh testicular sperm. Compared to other etiologies, NOA caused by AZFc microdeletions have the poorest embryological and clinical outcomes. Patients with less testicular sperm retrieved have poorer embryological and clinical outcomes.
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Affiliation(s)
- Yu Lan
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haiyan Zheng
- Center for Reproductive Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Fu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tianwen Peng
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chen Liao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jianan Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Geng An
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Geng An,
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Abstract
OBJECTIVE To improve awareness of the natural age-related decline in female and male fertility with respect to natural fertility and assisted reproductive technologies (ART), provide recommendations for their management, and to review investigations in the assessment of ovarian aging. OPTIONS This guideline reviews options for the assessment of ovarian reserve and fertility treatments using ART with women of advanced reproductive age presenting with infertility. OUTCOMES The outcomes measured are the predictive value of ovarian reserve testing and pregnancy rates with natural and assisted fertility. EVIDENCE Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in June 2010, using appropriate key words ("ovarian aging," "ovarian reserve," "advanced maternal age," "advanced paternal age," and "assisted reproductive technology"). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated into the guideline to December 2010. VALUES The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described in that report. BENEFITS, HARMS, AND COSTS Primary and specialist health care providers and women will be better informed about ovarian aging and the age-related decline in natural fertility and about options for ART. RECOMMENDATIONS
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Liu KE, Case A. N o 346-Âge génésique avancé et fertilité. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 39:696-708. [PMID: 28549562 DOI: 10.1016/j.jogc.2017.03.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIFS Sensibiliser la population à la baisse naturelle de la fertilité avec l'âge, chez les femmes et les hommes, et à l'égard de la reproduction naturelle et des technologies de procréation assistée (TPA); formuler des recommandations de prise en charge; et analyser les méthodes d'évaluation du vieillissement ovarien. OPTIONS La présente directive clinique passe en revue les options offertes pour l'évaluation de la réserve ovarienne et pour le traitement de l'infertilité faisant appel aux TPA chez les femmes d'âge génésique avancé infertiles. ISSUES Les issues mesurées sont les valeurs prédictives de l'évaluation de la réserve ovarienne et les taux de grossesse découlant de la fertilité naturelle et de la fertilité assistée. DONNéES: Nous avons examiné des études publiées récupérées au moyen de recherches dans PubMed, Medline, CINAHL et la Bibliothèque Cochrane en juin 2010 à l'aide de mots-clés appropriés (ovarian aging, ovarian reserve, advanced maternal age, advanced paternal age, et assisted reproductive technology). Nous n'avons tenu compte que des résultats provenant de revues systématiques, d'essais cliniques, randomisés ou non, et d'études observationnelles. Aucune restriction de date ou de langue n'a été employée. Les recherches ont été refaites régulièrement, et les résultats ont été incorporés à la directive clinique jusqu'en décembre 2010. VALEURS La qualité des données a été évaluée au moyen des critères énoncés dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs. Les recommandations quant à la pratique ont été classées conformément à la méthode décrite dans ce rapport. AVANTAGES, DéSAVANTAGES ET COûTS: Les patientes et les fournisseurs de soins primaires et spécialisés seront mieux renseignés sur le vieillissement ovarien, la baisse de la fertilité naturelle liée à l'âge et les TPA. RECOMMENDATIONS
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Boulard V, Charbit B, Brasseur F, Lourdel E, Copin H, Merviel P. Facteurs pronostiques de grossesse en insémination intra-utérine avec sperme de donneur : analyse sur 535 cycles. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jgyn.2012.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mokdad C, Clavier B, Perdrix A, Roman H, Marpeau L, Rives N. Facteurs pronostiques en insémination avec sperme de donneur : suivi rétrospectif d’une cohorte de 188 patientes. ACTA ACUST UNITED AC 2013; 41:96-104. [DOI: 10.1016/j.gyobfe.2012.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 06/11/2012] [Indexed: 11/28/2022]
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Liu K, Case A, Cheung AP, Sierra S, AlAsiri S, Carranza-Mamane B, Case A, Dwyer C, Graham J, Havelock J, Hemmings R, Lee F, Liu K, Murdock W, Senikas V, Vause TD, Wong BCM. Advanced Reproductive Age and Fertility. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2011; 33:1165-1175. [DOI: 10.1016/s1701-2163(16)35087-3] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kase NG. Impact of hormone therapy for women aged 35 to 65 years, from contraception to hormone replacement. ACTA ACUST UNITED AC 2009; 6 Suppl 1:37-59. [DOI: 10.1016/j.genm.2009.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2008] [Indexed: 11/16/2022]
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Muhammad F, Yivgi-Ohana N, Shveiky D, Orly J, Alexander S, Laufer N. Levels of steroidogenic acute regulatory protein and mitochondrial membrane potential in granulosa cells of older poor-responder women. Fertil Steril 2008; 91:220-5. [PMID: 18191841 DOI: 10.1016/j.fertnstert.2007.10.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 10/03/2007] [Accepted: 10/03/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare mitochondrial function in granulosa cells obtained from older (>40 y) low-responder IVF patients with that of young (<35 y) good-responder patients. DESIGN Prospective laboratory research. SETTING In vitro fertilization unit in a university hospital. PATIENT(S) Twenty patients undergoing IVF treatment cycles. INTERVENTION(S) Ultrasound guided oocytes pick-up. MAIN OUTCOME MEASURE(S) Mitochondrial function examined by using JC-1 stain for the mitochondrial membrane potential in granulosa cells of both groups and Western blots for assaying and quantification of steroidogenic acute regulatory protein (StAR) and p450scc (side-chain cleavage). RESULT(S) The number of granulosa cells per follicle differed between the two groups, with fewer granulosa cells isolated in the older low-responder women, compared with in the young, normal responders who were the control women. Trypan blue-negative cells showed similar undisturbed mitochondrial membrane potential, and similar ratios of apoptotic granulosa cells were observed in the two groups. In addition, there was no difference in StAR and P450scc protein levels between the two groups. CONCLUSION(S) Our results demonstrate a significant decrease in the number of total aspirated granulosa cells per follicle in older, poor-responder women, which probably explains the reduced hormonal production by those follicles. However, those cells demonstrate normal mitochondrial membrane potential as well as similar levels of StAR, P450scc, and de novo steroid hormone synthesis in the two groups of patients. Our results do not support mitochondrial dysfunction as a main mechanism of reproductive aging.
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Affiliation(s)
- Fatum Muhammad
- IVF Unit, Department of Obstetrics and Gynecology, Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.
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Allamaneni SSR, Bandaranayake I, Agarwal A. Use of semen quality scores to predict pregnancy rates in couples undergoing intrauterine insemination with donor sperm. Fertil Steril 2004; 82:606-11. [PMID: 15374703 DOI: 10.1016/j.fertnstert.2004.02.113] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2003] [Revised: 02/04/2004] [Accepted: 02/04/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To establish semen quality scores in a population of sperm donors and determine whether the scores can be used to predict pregnancy rates after donor insemination. DESIGN Retrospective study. SETTING Infertility clinic at a tertiary care teaching hospital between 1993-2001. PATIENT(S) One hundred eleven women who underwent IUI with sperm from 27 anonymous donors. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The semen analysis results before freezing and after thawing were analyzed, and overall donor insemination semen quality (DI-SQ) and donor insemination relative quality (DI-RQ) scores were calculated. After adjusting for female characteristics, the scores were compared with samples that did and did not result in pregnancy. RESULT(S) Of 111 patients, 70 had at least one pregnancy, and 60 had at least one live birth, with a mean of 6.52 +/- 4.67 IUI cycles per patient. Five significant risk factors for low pregnancy and live birth rates were identified: female infertility factor, positive laparoscopy, older maternal age, low number of previous births, and lack of ovulatory stimulation. After adjusting for these factors, both prefreeze and postthaw DI-SQ scores were statistically significantly associated with IUI live birth rates. Using only the samples with a DI-SQ score of >110 doubled the expected live birth rate, compared with using samples with a DI-SQ score less than 100, from 8.5% to 16.1%. CONCLUSION(S) The DI-SQ score was an effective predictor of pregnancy and live birth outcomes in IUI patients who underwent artificial insemination with anonymous donor semen. The DI-SQ score could also be used by sperm banks to help select donors.
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Affiliation(s)
- Shyam S R Allamaneni
- Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Guerif F, Fourquet F, Marret H, Saussereau MH, Barthelemy C, Lecomte C, Lecomte P, Lansac J, Royere D. Cohort follow-up of couples with primary infertility in an ART programme using frozen donor semen. Hum Reprod 2002; 17:1525-31. [PMID: 12042272 DOI: 10.1093/humrep/17.6.1525] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study was designed to determine the crude cumulative live-birth rates in a cohort initiating frozen donor semen treatment until completion. METHODS This cohort study included 588 couples with primary infertility in one University Hospital centre. The treatment sequence involved first artificial insemination (AID) followed by IVF if necessary (IVF-D). Live birth, drop-out for personal or medical reasons and recourse to IVF-D were recorded for all patients. Live births and drop-out were expressed both as rates per cycle and crude cumulative rates. RESULTS At the completion of AID and IVF-D cycles, 406 couples in the cohort (69%) achieved a live-birth and 182 couples (31%) discontinued treatment. In most cases, couples stopped treatment for personal reasons (74%) whereas fewer couples were denied further treatment for medical reasons (26%). CONCLUSIONS This is the first report on the crude cumulative live-birth rate in a cohort after AID and IVF-D cycles. Although calculation based on crude cumulative live-birth rate shows lower results in comparison with life table analysis, this method allows patients to obtain an insight into their actual chances of achieving a successful pregnancy.
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Affiliation(s)
- Fabrice Guerif
- CECOS, Biologie de la Reproduction, Département de Gynécologie-Obstétrique et Reproduction Humaine, Centre Hospitalier Universitaire Bretonneau, 37044 Tours, France
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Lashen H, Afnan M, Kennefik A. Early resort to ovarian stimulation improves the cost-effectiveness of a donor insemination programme. Hum Reprod 1999; 14:1983-8. [PMID: 10438414 DOI: 10.1093/humrep/14.8.1983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Women undergoing donor insemination (DI) are usually regularly ovulating, therefore the role of ovulation induction in this modality of treatment has been controversial. Some recent studies reported higher pregnancy rates in stimulated cycles in comparison with natural cycles. We employed a sequential step-up protocol in which treatment was started in a natural cycle, continued with a clomiphene citrate-stimulated cycle, and finished with an ovulation induction cycle. The patients were allowed three attempts at each step before moving to the next if conception did not occur. The aim of this protocol was to enhance the cost-effectiveness of the DI programme by increasing the cycle fecundability. A total of 101 patients underwent 216 cycles of DI, including 44 patients in 80 natural cycles, 38 patients in 89 CC-stimulated cycles, and 19 patients in 47 ovulation induction cycles. The clinical pregnancy rate per started cycle (CPR/C) and per patient during this period was 14% and 30% respectively. The pregnancy rates per started cycle and per patient in the natural, CC-stimulated and ovulation induction cycles were: 13 and 32%, 10 and 18%, and 21 and 53% respectively. There was no significant difference in the CPR/C in the three groups; however, the CPR per patient in the induced ovulation cycles was significantly higher than in the CC-stimulated cycles (P = 0.005). Only one patient during this period had a multiple pregnancy in the ovulation induction group, giving an overall multiple pregnancy of 3%. By using this treatment strategy, we achieved a high clinical pregnancy rate, a low multiple pregnancy rate and a low cost of treatment per pregnancy.
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Affiliation(s)
- H Lashen
- Assisted Conception Unit, Birmingham Women's Hospital, Edgbaston, Birmingham B15 2TG, UK
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Ecochard R, Cottinet D, Mathieu C, Rabilloud M, Czyba JC. The mean of sperm parameters in semen donations from the same donor. An important prognostic factor in insemination. INTERNATIONAL JOURNAL OF ANDROLOGY 1999; 22:163-72. [PMID: 10367236 DOI: 10.1046/j.1365-2605.1999.00164.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We analysed 12,100 consecutive cycles of artificial insemination by donor spermatozoa in 1901 infertile couples. In our analysis, particular attention was given to finding an appropriate way of taking into account the respective effects of female and male factors on the pregnancy success rate and the level at which these factors act (cycle vs. woman and donation vs. donor). A total of 1213 pregnancies occurred. The pregnancy rate per cycle was lower as the age of the woman increased (p < 0.0001) and varied with the type of infertility: fecundity was higher (p = 0.03) in the case of azoospermia than of severe oligozoospermia. After taking into account these factors, significant unexplained variation in likelihood to conceive remained. A part of this heterogeneity was shown to be due to variation in fecundability between semen donors. In order to explain this heterogeneity between donors, compositional covariates were used, particularly the mean of results of the semen analysis performed for donations from the same donor. For each semen characteristic, the overall mean of the different donations of a donor was an important predictive factor of successful insemination: after taking into account all of the other factors, the odds ratios for an increase of 50 x 10(6)/mL spermatozoa, of a 20% increase in sperm motility and of a 2 point increase in the post-thaw quality index, were, respectively, 1.13, 1.37 and 1.56. After adjustment for these factors, the specific characteristics of each semen donation were no longer significantly predictive of successful insemination. This observation has a biological interpretation: sperm with low parameters but produced by a normally fertile man can have a satisfactory success rate.
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Affiliation(s)
- R Ecochard
- Département d'Information Médicale, Hospices Civils de Lyon, France
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Dew JE, Don RA, Hughes GJ, Johnson TC, Steigrad SJ. The influence of advanced age on the outcome of assisted reproduction. J Assist Reprod Genet 1998; 15:210-4. [PMID: 9565851 PMCID: PMC3454935 DOI: 10.1023/a:1023004503697] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Our purpose was to determine the influence of age on the outcome of assisted reproduction, with particular interest in women aged 40 years or older. METHODS A retrospective review of the 779 patients enrolled in the Royal Hospital for Women Fertility Group fertility program between 1987 and 1994 was performed. The results for women aged 40 years or older were compared with those for women between 36 and 39 years and those younger than 36 years. The main outcome measures were pregnancy rate, pregnancy outcome, fertilization rate, and ovarian response. RESULTS Compared with those in younger women, pregnancy rate, pregnancy outcome, fertilization rate, and ovarian response to controlled ovarian stimulation were significantly worse in women aged 40 years or older. CONCLUSIONS The outcome of assisted reproduction in women of 40 years of age or older was extremely poor. Compared with those in younger women, pregnancy outcome and ovarian response to controlled ovarian stimulation were significantly worse in women of 40 years or more.
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Affiliation(s)
- J E Dew
- Department of Reproductive Medicine, Royal Hospital for Women, Randwick, NSW, Australia
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Darder MC, Epstein YM, Treiser SL, Comito CE, Rosenberg HS, Dzingala L. The effects of prior gravidity on the outcomes of ovum donor and own oocyte cycles. Fertil Steril 1996; 65:578-82. [PMID: 8774290 DOI: 10.1016/s0015-0282(16)58157-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effects of prior gravidity on hormonal parameters, medication regimen, oocyte parameters, fertilization, and clinical pregnancy rates (PRs) in donor and own oocyte cycles. DESIGN A retrospective study of 64 first-attempt ovum donor cycles and 102 first-attempt IVF and ZIFT cycles using own oocytes conducted during a 2.5-year time period. Analyses of covariance and t-tests using gravidity of oocyte source (gravida versus nulligravida) and controlling for sperm parameters were used to assess differences in hormonal, endometrial, medication, and demographic parameters and were performed separately for donor cycles and for own oocyte cycles. SETTING Private fertility center. PATIENTS In ovum donation cycles, oocyte parameters, medication administered, and hormonal parameters of 64 oocyte donors between the ages of 21 and 35, 34 of whom were never pregnant, i.e., nulligravida and 30 who had ever been pregnant, regardless of the outcome of that pregnancy, i.e., gravida, were studied. In own oocyte cycles, oocyte parameters, medication administered, and hormonal parameters of 102 women, 54 nulligravida and 48 gravida, between the ages of 23 and 44 were studied. MAIN OUTCOME MEASURE Medication requirements, hormonal response, seminal parameters, oocyte quality, fertilization, and clinical PRs. RESULTS For patients using their own oocytes, there were no significant differences in any of the parameters studied. In contrast, compared with their nulligravida counterparts, gravida oocyte donors had fewer poor quality oocytes, had more high quality oocytes that fertilized, had a higher proportion of their oocytes fertilize, and had a higher PR per transfer. CONCLUSION A prior history of gravidity is an important predictor of clinical pregnancy in donor oocyte cycles but not in cycles in which patients use their own oocytes. Oocyte recipients may wish to consider donor gravidity in selecting their donor.
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Tan SL, Doyle P, Maconochie N, Edwards RG, Balen A, Bekir J, Brinsden P, Campbell S. Pregnancy and birth rates of live infants after in vitro fertilization in women with and without previous in vitro fertilization pregnancies: A study of eight thousand cycles at one center. Am J Obstet Gynecol 1994. [DOI: 10.1016/s0002-9378(13)70276-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tan SL, Doyle P, Maconochie N, Edwards RG, Balen A, Bekir J, Brinsden P, Campbell S. Pregnancy and birth rates of live infants after in vitro fertilization in women with an without previous in vitro fertilization pregnancies: a study of eight thousand cycles at one center. Am J Obstet Gynecol 1994; 170:34-40. [PMID: 8296841 DOI: 10.1016/s0002-9378(94)70380-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Our aim was to compare the cumulative conception and live-birth rates after in vitro fertilization in women undergoing their first course of in vitro fertilization treatment with those in women undergoing their second course of treatment, having previously achieved an in vitro fertilization pregnancy. This study occurred in a tertiary referral-assisted conception unit. STUDY DESIGN The cumulative conception rates obtained by life-table analysis in 4115 women having their first course of in vitro fertilization therapy (7327 treatment cycles leading to 1123 pregnancies) were compared by means of the log-rank test with those of 331 women in their second course of treatment, having previously achieved an in vitro fertilization pregnancy (561 treatment cycles leading to 138 second in vitro fertilization pregnancies). Similarly, the cumulative live birth rates of 3824 women in their first course of treatment (7136 treatment cycles leading to 732 live births) were compared with those of 105 women in their second course of treatment, having previously achieved an in vitro fertilization live birth (205 treatment cycles leading to 33 second in vitro fertilization live births). RESULTS The cumulative conception rates and cumulative live birth rates were significantly higher in women having their second course of in vitro fertilization treatment than in those having their first course (cumulative conception rate: p = 0.0001; cumulative live birth rate, p = 0.007). After five cycles of in vitro fertilization, the cumulative conception rates and cumulative live birth rates were 49.8% (95% confidence interval, 46.3% to 53.5%) and 39.0% (95% confidence interval, 35.4% to 42.9%), respectively, in those having their first course of treatment compared with 69.9% (95% confidence interval, 57.6% to 81.3%) and 68.6% (95% confidence interval, 46.1% to 88.5%), respectively, in those having their second course. The estimated median numbers of cycles taken to achieve a pregnancy and live birth (assuming all women could potentially undergo the same number of cycles) were six and eight, respectively, in the first course of treatment compared with only three and five in the second course. CONCLUSION Women who have achieved a previous in vitro fertilization pregnancy have significantly higher cumulative conception rate and cumulative live birth rates compared with those of women having their first course of treatment.
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Affiliation(s)
- S L Tan
- Hallam Medical Centre, London Women's Clinic, King's College School of Medicine and Dentistry, London School of Hygiene and Tropical Medicine, United Kingdom
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