Non-invasive prediction of implantation window in controlled hyperstimulation cycles: Can the time from the menstrual day at embryo transfer to expected menstrual cycle give a clue?

Effects of serum estrogen levels before frozen-thawed blastocyst transfer on pregnancy outcomes in hormone replacement cycles

We investigated the effects of serum estrogen levels before frozen-thawed blastocyst transfer on pregnancy outcomes in hormone replacement cycles. Clinical data of 708 hormone replacement cycles with frozen-thawed blastocyst were retrospectively analyzed. According to quartile (P25) of serum estrogen levels on the endometrium transformation day, the 708 cycles were divided into group A1 (E2 < 157.5 pg/ml), group A2 (157.5 pg/ml ≤ E2 < 206.4 pg/ml), group A3 (206.4 pg/ml ≤ E2 < 302.3 pg/ml) and group A4 (E2 ≥ 302.3 pg/ml). According to quartile (P25) of serum estrogen levels on the frozen-thawed blastocyst transfer day, the 708 cycles were divided into group B1 (E2 < 147 pg/ml), group B2 (147 pg/ml ≤ E2 < 200.4 pg/ml), group B3 (200.4 pg/ml ≤ E2 < 323 pg/ml) and group B4 (E2 ≥ 323 pg/ml). According to different clinical outcomes, the 708 cycles were divided into clinical pregnant group and non-clinical pregnant group. The group A4 (E2 ≥ 302.3 pg/ml on the endometrium transformation day) was significantly lower than other groups in blastocyst implantation rate and multiple-pregnancy rate (P < 0.05). The days of taking progynova was significantly different among groups on both endometrium transformation day and frozen-thawed blastocyst transfer day (P < 0.05), but there were no statistical differences in the mean age, endometrial thickness and number of high-quality blastocysts transferred among groups (P > 0.05). The mean age was significantly younger and the number of high-quality blastocysts transferred was significantly higher in the clinical pregnant group than in the non-clinical pregnant group (P < 0.05), but endometrial thickness, days of taking progynova, progesterone level on the blastocyst transfer day, and E2 level were not significantly different between both groups (P > 0.05). Multivariate regression analysis indicated that age was an independent factor affecting clinical pregnancy (P < 0.05). Correlation analysis displayed that the serum estrogen levels did not affect clinical pregnancy (P > 0.05). The days of taking progynova and serum estrogen levels before frozen-thawed blastocyst transfer do not affect pregnancy outcomes in hormone replacement cycles.

The Disordered Vaginal Microbiota Is a Potential Indicator for a Higher Failure of in vitro Fertilization

Infertility is one of the most common reproductive system diseases, and no effective method is available for its treatment. Although in vitro fertilization (IVF) has been widely used to enhance the clinical pregnancy outcome of infertility, the unsatisfied pregnancy rate with unknown reasons is obtained. To identify the possible cause of IVF failure, 555 patients were enrolled in the present study to determine their relevant clinical characteristics and vaginal microbiota. Our results indicated that the age and endometrium thickness significantly affected the pregnancy success rate of pregnant patients (P group) and non-pregnant patients (NP group) receiving IVF, and high values of luteinizing hormone, estrogen and progesterone were observed from P group. Furthermore, the Partial Least Squares Discriminant Analysis (PLS-DA) indicated a different microbial composition in P group and NP group, and a higher microbial abundance had been identified in non-pregnant patients compared with pregnant patients. At phylum level, a higher abundance of Firmicutes and Proteobacteria, and a lower abundance of Actinobacteria, Fusobacteria, and Bacteroidetes were obtained in pregnant patients compared with non-pregnant patients. At genus level, a lower abundance of the probiotic Lactobacillus, and higher abundance of pathogens Gardnerella and Prevotella were identified from non-pregnant patients. Therefore, the disordered microbiota, characterizing by the reduction of probiotics and overgrowth of pathogens in non-pregnant patients, may be used as a potential indicator for a higher IVF failure rate.