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Li M, Kang Y, Wang Q, Yan L. Efficacy of Autologous Intrauterine Infusion of Platelet-Rich Plasma in Patients with Unexplained Repeated Implantation Failures in Embryo Transfer: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11. [PMID: 36431229 DOI: 10.3390/jcm11226753] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Controversial conclusions have been made in previous studies regarding the influence of autologous platelet-rich plasma (PRP) in the reproductive outcomes of women with repeated implantation failures (RIF) who are undergoing embryo transfer (ET). (2) Methods: This study aimed to evaluate the effect of PRP intrauterine infusion in patients with unexplained RIF, who are undergoing in vitro fertilization (IVF) or intracytoplasmic injection (ICSI), by a systematic review and meta-analysis. (3) Results: A fixed-effects model was used, and 795 cases and 834 controls were included in these studies. The pooling of the results showed the beneficial effect of PRP which were compared with those of the control in terms of the clinical pregnancy rates (n = 10, risk ratio (RR) = 1.79, 95% confidence intervals (CI): 1.55, 2.06; p < 0.01, I2 = 40%), live birth rates (n = 4, RR = 2.92, 95% CI: 2.22, 3.85; p < 0.01, I2 = 83%), implantation rates (n = 3, RR = 1.74, 95% CI: 1.34, 2.26; p < 0.01, I2 = 0%), and positive serum β-HCG 14 days after the ET (n = 8, RR = 1.77, 95% CI: 1.54, 2.03; p < 0.01, I2 = 36%). However, we did not find that the miscarriage rates indicated a significant difference between the two groups (n = 6, RR = 1.04, 95% CI: 0.72, 1.51; p = 0.83, I2 = 0%). (4) Conclusions: The findings of this systemic review and meta-analysis suggest that PRP appears to improve the results of IVF/ICSI treatments in the cases of unexplained RIF.
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Andrabi SW, Arora PR, Mir J, Kaur S, Khan A, Albarki AS. Developmental Potential of embryos does not Impact Pregnancy Outcomes, but it Affects Live Birth Rates in Frozen Blastocyst Transfer Cycles. JBRA Assist Reprod 2022; 26:426-431. [PMID: 35938735 PMCID: PMC9355450 DOI: 10.5935/1518-0557.20210109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study aimed to determine whether or not developmental potential impacts clinical outcomes, when good grade blastocysts from Days 5 and 6 were transferred in frozen embryo transfer (FET) cycles. METHODS 654 women, including 460 (70.33%) on Day 5 and 194 (29.66%) on Day 6 were analyzed, in which 905 Day-5 and 274 Day-6 blastocysts were transferred. Only grade AA, AB, BA, BB quality and expansion grade between 3-6 (Gardner grading system) blastocysts survived and were included. RESULTS The implantation rate was higher, 41.9% (379/905) in normal Day-5 compared to delayed Day-6 blastocyst transfers - 36.5% (100/274), but not significant (p=0.1). The clinical pregnancy rate was similar and not significant (p=0.4) in normal Day-5 (32.4%), compared to delayed Day-6 (35%). Miscarriage rates were higher in normal Day-5 (13.3%) compared to delayed Day-6 (6.3%) blastocyst transfers but were not significant (p=0.06). On the other hand, the biochemical pregnancy rate was significantly higher (p=0.001) in the delayed Day-6 blastocysts (16.7%) transfer group compared to patients with normal Day-5 (2.4%) blastocyst transfers. Two patients had ectopic pregnancies from the delayed Day-6 blastocyst transfer group. Live-Birth rates were significantly higher in Day-5 blastocysts compared to Day-6 (p=0.03). CONCLUSIONS The developmental potential of embryos should not be considered a negative influence on pregnancy outcomes, especially good grade blastocysts vitrified on Days 5 and 6. Fully expanded blastocysts on Day-5 are considered similar in terms of outcomes to delayed Day-6 blastocysts; however, live-birth rates are significantly higher in Day-5 blastocysts.
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Affiliation(s)
- Syed Waseem Andrabi
- Milann-The Fertility Centre, New Delhi, India ,Corresponding author: Syed Waseem Andrabi Division of Embryology Milann-The Fertility Centre New Delhi, India E-mail:
| | - Puneet Rana Arora
- CIFAR- Centre for InFertility and Assisted Reproduction, Gurgaon, India
| | - Jaffar Mir
- Milann-The Fertility Centre, New Delhi, India
| | | | - Aarish Khan
- Milann-The Fertility Centre, New Delhi, India
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Gomez R, Schorsch M, Gerhold-Ay A, Hasenburg A, Seufert R, Skala C. Fertility After Ovarian Cystectomy: How Does Surgery Affect IVF/ICSI Outcomes? Geburtshilfe Frauenheilkd 2019; 79:72-78. [PMID: 30686836 PMCID: PMC6336490 DOI: 10.1055/a-0767-6722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 09/20/2018] [Accepted: 10/19/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction
For patients considering undergoing assisted reproductive techniques (ART), many concerns arise when persistent ovarian cysts are found. This large study aimed to determine how ovarian cyst removal affects success rates of IVF/ICSI therapies.
Methods
550 patients who underwent an IVF/ICSI treatment between 2002 and 2011 with a persistent ovarian cyst ≤ 5 cm before treatment were analyzed retrospectively. 328 patientsʼ preference was to undergo a laparoscopic cystectomy and 222 patients opted for a conservative management. Control subjects included 13 552 patients undergoing IVF/ICSI at the same period of time without an ovarian cyst.
Results
After adjusting for age, patients with ovarian cysts without surgery needed a significant higher stimulation dose than the control group (2576.4 vs. 2207.5 IU, p < 0.001). However, on average, they had 1.13 (− 0.25 – 2.01) higher oocyte number retrieved compared to the operated patients (9.0 ± 5.5 vs. 8.2 ± 5.0) (p = 0.012). Patients after surgical cyst removal had a significant lower number of oocytes retrieved (MNOR) in comparison to the control group (8.2 ± 5.0 vs. 9.5 ± 5.4) (p = 0.00). Compared to controls, operated patients had similar clinical pregnancy rate (CPR) (34.2 vs. 33.5%) OR 1.031 (95% CI 0.817 – 1.302) (p = 0.815). Compared to controls, patients without surgery showed significant lower pregnancy rate (34.2 vs. 25,7%) OR 1.428 (95% CI 1.054 – 1.936) (p = 0.002) and lower live birth rate (LBR) (21.9 vs. 13.5%) OR 1.685 (95% CI 1.143 – 2.485) (p = 0.008).
Conclusions
Ovarian cystectomy did not negatively impact the pregnancy rate or the live birth rate compared to controls.
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Affiliation(s)
- Ruth Gomez
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Germany
| | | | - Aslihan Gerhold-Ay
- IMBEI-Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Annette Hasenburg
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Germany
| | - Rudolf Seufert
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Germany
| | - Christine Skala
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Germany
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Adeviye Erşahin A, Acet M, Erşahin SS, Dokuzeylül Güngör N. Frozen embryo transfer prevents the detrimental effect of high estrogen on endometrium receptivity. J Turk Ger Gynecol Assoc 2017; 18:38-42. [PMID: 28506949 PMCID: PMC5450209 DOI: 10.4274/jtgga.2016.0186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To investigate whether serum levels of estradiol affect reproductive outcomes of normoresponder women undergoing fresh embryo transfer (ET) versus frozen-thawed ET (FET). MATERIAL AND METHODS Two hundred fifty-five normoresponder women underwent fresh ET in their first or second in vitro fertilization cycle. Ninety-two women with negative pregnacy test results underwent FET. Clinical and ongoing pregnancy rates, implantation, and live birth rates of women undergoing fresh ET versus FET were compared. RESULTS One hundred forty-seven (57.65%) out of the 255 normoresponder women receiving FET had positive beta-human chorionic gonadotrophin (hCG) results. The remaining 108 women had negative beta-hCG results. The clinical pregnancy rates of the fresh ET group were found as 55.69% (n=142). Ninety-two of the 108 women with failed pregnancies underwent FET; 72.83% had positive beta-hCG results (n=67), and 70.65% had clinical pregnancy (n=65). Both biochemical and clinical pregnancy rates of women undergoing FET increased significantly (p<0.012 and p<0.013, respectively). Ongoing pregnancy (60.87% vs. 52.94%) and live birth rates (59.87% vs. 48.63%) were similar in both fresh and FET groups. Serum E2 levels of women who failed to conceive were significantly higher than those women did conceive. Serum progesterone levels of women who conceived versus those that did not were similar. CONCLUSION The detrimental effect of high serum estradiol levels on endometrial receptivity could be prevented by FET.
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Affiliation(s)
- Aynur Adeviye Erşahin
- Department of Obstetrics and Gynecology, Bahçesehir University Faculty of Medicine, İstanbul, Turkey
| | - Mustafa Acet
- Department of Obstetrics and Gynecology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Suat Süphan Erşahin
- Department of Obstetrics and Gynecology, Kemerburgaz University Faculty of Medicine, İstanbul, Turkey
| | - Nur Dokuzeylül Güngör
- Department of Obstetrics and Gynecology, Medicalpark Göztepe Hospital, İstanbul, Turkey
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Huang PC, Chen MJ, Guu HF, Yi YC, Ho JYP, Chen YF, Chen LY, Chou MM. Effect of premature serum progesterone rise on embryo transfer outcomes and the role of blastocyst culture and transfer in assisted reproductive technology cycles with premature progesterone rise. Taiwan J Obstet Gynecol 2016; 54:641-6. [PMID: 26700978 DOI: 10.1016/j.tjog.2014.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2014] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE In 1991, researchers reported that a modest preovulatory increase in serum progesterone levels is associated with lower pregnancy rates and higher incidence of pregnancy loss in in vitro fertilization (IVF). We wonder whether embryo transfer (ET) in assisted reproductive technology (ART) cycles in patients with premature progesterone rise (PPR) have a negative impact on the clinical pregnancy rates (CPRs) and/or live birth rates (LBRs) in our series. Consequently, will blastocyst transfer reverse the negative impact? MATERIALS AND METHODS This noninterventional, retrospective, observational tertiary center study was conducted between January 2010 and December 2012. All fresh ET cycles with serum progesterone levels measured (n = 599) on the day of hCG administration were analyzed. RESULTS Sera lutenizing hormone (LH), E2, and progesterone (P) were measured and analyzed. The CPRs of cycles in patients with p ≤ 1.5 ng/mL (low) versus those with p > 1.5 ng/mL (high) were 37.04% versus 41.03% [odds ratio (OR) = 1.18, 95% confidence interval (CI): 0.728-1.920; p = 0.50). The LBRs of cycles in patients with low progesterone level versus those with PPR were 30.52% versus 34.62% (OR = 1.21, 95% CI: 0.729-1.992; p = 0.47). No statistically significant association was detected. We further analyzed the outcomes according to different stages of ET and found that blastocyst (D5) ET significantly increase the LBRs as compared with cleavage stage (D2/D3) ET in the PPR group (44.44% versus 21.43%; p = 0.043). CONCLUSION PPR did not significantly compromise the clinical outcomes in this series. However, shifting to blastocyst transfer probably could increase the live birth in cycles with PPR.
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Affiliation(s)
- Pei-Chen Huang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Jer Chen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Hwa-Fen Guu
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Chiao Yi
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jason Yen-Ping Ho
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ya-Fang Chen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Yu Chen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Min-Min Chou
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan
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Kaur P, Swarankar ML, Maheshwari M, Acharya V. A comparative study between cleavage stage embryo transfer at day 3 and blastocyst stage transfer at day 5 in in-vitro fertilization/intra-cytoplasmic sperm injection on clinical pregnancy rates. J Hum Reprod Sci 2014; 7:194-7. [PMID: 25395745 PMCID: PMC4229795 DOI: 10.4103/0974-1208.142481] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 07/14/2012] [Accepted: 09/10/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of blastocyst transfer in comparison with cleavage stage transfer. STUDY DESIGN A randomized, prospective study was conducted in Infertility clinic, Department of Obstetrics and Gynecology, Mahatma Gandhi Hospital, Jaipur on 300 patients aged 25-40 years undergoing in-vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) cycle from May 2010-April 2011. When three or more Grade-I embryos were observed on day 2 of culture, patients were divided randomly into two study groups, cleavage stage transfer and blastocyst transfer group having 150 patients each. Primary outcomes evaluated were, Clinical pregnancy rate and Implantation rate. The results were analyzed using proportions, standard deviation and Chi-square test. RESULTS Both the groups were similar for age, indication and number of embryos transferred. Clinical pregnancies after blastocyst transfer were significantly higher 66 (44.0%) compared to cleavage stage embryo transfer 44 (29.33%) (P < 0.01). Implantation rate for blastocyst transfer group was also significantly higher (P < 0.001). CONCLUSION Blastocyst transfer having higher implantation rate and clinical pregnancy rate lead to reduction in multiple pregnancies.
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Affiliation(s)
- Prabhleen Kaur
- Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
| | - M L Swarankar
- Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
| | - Manju Maheshwari
- Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
| | - Veena Acharya
- Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
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