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Yuan RY, Li S, Feng X, Li XL, Lin XT, Gao FM, Zhu HJ, Li YS, Li YC, Ou XH. Comparison of embryo quality and pregnancy outcomes for patients with low ovarian reserve in natural cycles and mildly stimulated cycles: a cohort study. J OBSTET GYNAECOL 2024; 44:2303693. [PMID: 38263614 DOI: 10.1080/01443615.2024.2303693] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND As women with low ovarian reserve embark on the challenging journey of in-vitro fertilisation (IVF) treatment, the choice between natural and mildly stimulated cycles becomes a pivotal consideration. It is unclear which of these two regimens is superior for women with low ovarian reserve. Our study aims to assess the impact of natural cycles on embryo quality and pregnancy outcomes in women with low ovarian reserve undergoing IVF treatment compared to mildly stimulated cycles. METHODS This retrospective study enrolled consecutive patients with low ovarian reserve who underwent IVF/intracytoplasmic sperm injection (ICSI) at Guangdong Second Provincial General Hospital between January 2017 and April 2021. The primary outcome for pregnancy rate of 478 natural cycles and 448 mild stimulated cycles was compared. Secondary outcomes included embryo quality and oocyte retrieval time of natural cycles. RESULTS The pregnancy rate in the natural cycle group was significantly higher than that in the mildly stimulated cycle group (51.8% vs. 40.1%, p = 0.046). Moreover, natural cycles exhibited higher rates of available embryos (84.1% vs. 78.6%, p = 0.040), high-quality embryos (61.8% vs. 53.2%, p = 0.008), and utilisation of oocytes (73% vs. 65%, p = 0.001) compared to mildly stimulated cycles. Oocyte retrievals in natural cycles were predominantly performed between 7:00 and 19:00, with 94.9% occurring during this time frame. In natural cycles with high-quality embryos, 96.4% of oocyte retrievals were also conducted between 7:00 and 19:00. CONCLUSION Natural cycles with appropriately timed oocyte retrieval may present a valuable option for patients with low ovarian reserve.
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Affiliation(s)
- Rui-Ying Yuan
- The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Sen Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xie Feng
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiao-Long Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiao-Ting Lin
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Fu-Min Gao
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Hai-Jing Zhu
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yong-Shi Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yan-Chu Li
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiang-Hong Ou
- The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
- Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, China
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Ozgur K, Tore H, Berkkanoglu M, Bulut H, Donmez L, Coetzee K. Comparable ongoing pregnancy and pregnancy loss rates in natural cycle and artificial cycle frozen embryo transfers with intensive method-specific luteal phase support; a retrospective cohort study. J Gynecol Obstet Hum Reprod 2024; 53:102797. [PMID: 38735575 DOI: 10.1016/j.jogoh.2024.102797] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024]
Abstract
STUDY OBJECTIVE The absence of corpus lutea in artificial cycle (AC) frozen embryo transfers (FET) may increase the chances of pregnancy loss. In this retrospective cohort study, the efficacy of AC endometrial preparation was compared natural cycle (NC) endometrial preparation in terms of ongoing pregnancy. METHODS One thousand six hundred and eighteen consecutive vitrified-warmed blastocyst FET performed between December 2021 and November 2022 were included, with 1023 compared after exclusions according to the endometrial preparation method; 293 NC-FET, 143 modified NC-FET, 204 unprogrammed AC-FET, and 383 oral contraceptive pill (OCP) programmed AC-FET. Intensive method-specific luteal phase support (LPS) was administered in NC- (human chorionic gonadotropin and micronized vaginal progesterone), mNC- (micronized vaginal progesterone), and in AC-FET (micronized vaginal progesterone, intramuscular progesterone, and oral dydrogesterone). RESULTS Clinician choice of endometrial preparation method resulted in the NC- or AC-FET groups having distinct differences, with female age, antral follicle count and body mass index as well as the percentage of DOR or PCOS diagnosed patients significantly different. The unadjusted ongoing pregnancy and total pregnancy loss rates for NC-, mNC-, AC-, and ocp-AC-FET were 61.8 %, 55.2 %, 57.4 %, and 58.5 %, and 19.2 %, 24.0 %, 23.5 % and 23.8 %, respectively. In multivariate logistic regressions to predict the dependent outcomes of ongoing pregnancy and total pregnancy loss, none of the FET methods were selected as independent predictors. CONCLUSION Patients undergoing NC- and AC-FET with method-specific progesterone LPS had comparable ongoing pregnancy rates as well as total pregnancy loss rates, with NC-FET ranked first in the regression analysis.
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Affiliation(s)
| | - Hande Tore
- Antalya IVF Centre, Antalya, 07080, Turkey
| | - Murat Berkkanoglu
- Antalya IVF Centre, Antalya, 07080, Turkey; Istanbul Atlas University, School of Medicine, Department of Gynecology and Obstetrics, Istanbul 34408, Turkiye
| | - Hasan Bulut
- Antalya IVF Centre, Antalya, 07080, Turkey; Antalya Bilim University, School of Medicine, Department of Health Science, Antalya 07190, Turkiye
| | - Levent Donmez
- Akdeniz University, School of Medicine, Department of Public Health, Antalya, 07058, Turkiye
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Zhang W, Liu Z, Wang B, Liu M, Li J, Guan Y. Comparison of the perinatal outcomes of expected high ovarian response patients and normal ovarian response patients undergoing frozen-thawed embryo transfer in natural/small amount of HMG induced ovulation cycles. BMC Public Health 2024; 24:259. [PMID: 38254007 PMCID: PMC10804831 DOI: 10.1186/s12889-024-17725-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Due to the high risk of complications in fresh transfer cycles among expected high ovarian response patients, most choose frozen-thawed embryo transfer (FET). There are currently few researches on whether the FET outcomes of expected high ovarian response patients with regular menstrual cycles are similar to those of normal ovarian response. Therefore, our objective was to explore and compare pregnancy outcomes and maternal and neonatal outcomes of natural FET cycles between patients with expected high ovarian response and normal ovarian response with regular menstrual cycles based on the antral follicle count (AFC). METHODS This retrospective cohort study included 5082 women undergoing natural or small amount of HMG induced ovulation FET cycles at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2017, to March 31, 2021. The population was divided into expected high ovarian response group and normal ovarian response group based on the AFC, and the differences in patient characteristics, clinical outcomes and perinatal outcomes between the two groups were compared. RESULTS Regarding clinical outcomes, compared with the normal ovarian response group, patients in the expected high ovarian response group had a higher clinical pregnancy rate (57.34% vs. 48.50%) and live birth rate (48.12% vs. 38.97%). There was no difference in the early miscarriage rate or twin pregnancy rate between the groups. Multivariate logistic regression analysis suggested that the clinical pregnancy rate (adjusted OR 1.190) and live birth rate (adjusted OR 1.171) of the expected high ovarian response group were higher than those of the normal ovarian response group. In terms of maternal and infant outcomes, the incidence of very preterm delivery in the normal ovarian response group was higher than that in the expected high ovarian response group (0.86% vs. 0.16%, adjusted OR 0.131), Other maternal and infant outcomes were not significantly different. After grouping by age (< 30 y, 30-34 y, 35-39 y), there was no difference in the incidence of very preterm delivery among the age subgroups. CONCLUSION For patients with expected high ovarian response and regular menstrual cycles undergoing natural or small amount of HMG induced ovulation FET cycles, the clinical and perinatal outcomes are reassuring. For patients undergoing natural or small amount of HMG induced ovulation FET cycles, as age increases, perinatal care should be strengthened during pregnancy to reduce the incidence of very preterm delivery.
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Affiliation(s)
- Wenjuan Zhang
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, China
| | - Zhaozhao Liu
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, China
| | - Bijun Wang
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, China
| | - Manman Liu
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, China
| | - Jiaheng Li
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, China
| | - Yichun Guan
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, China.
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Zhang M, Li J, Fu X, Zhang Y, Zhang T, Wu B, Han X, Gao S. Endometrial thickness is an independent risk factor of hypertensive disorders of pregnancy: a retrospective study of 13,458 patients in frozen-thawed embryo transfers. Reprod Biol Endocrinol 2022; 20:93. [PMID: 35765069 PMCID: PMC9238038 DOI: 10.1186/s12958-022-00965-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/16/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are an important cause of maternal and fetal mortality, and its potential risk factors are still being explored. Endometrial thickness (EMT), as one of the important monitoring indicators of endometrial receptivity, has been confirmed to be related to the incidence of HDP in fresh embryo transfer. Our study was designed to investigate whether endometrial thickness is associated with the risk of hypertensive disorders of pregnancy in frozen-thawed embryo transfer (FET). METHODS This respective cohort study enrolled 13,458 women who received vitrified embryo transfer and had a singleton delivery in the Reproductive Hospital affiliated to Shandong University from January 2015 to December 2019. We set strict screening criteria and obtained the information from the hospital electronic medical system. Statistical methods including logistic regression analysis, receiver operating characteristic curve and restricted cubic spline were used to evaluate the relationship between endometrial thickness and the incidence of pregnancy-induced hypertension. RESULTS The incidences of HDP in a thin endometrial thickness group (< 0.8 cm) and a thick endometrial thickness group (> 1.2 cm) were significantly greater than in a reference group (0.8 cm-1.2 cm) (7.98 and 5.24% vs 4.59%, P < 0.001). A nonlinear relationship between endometrial thickness and risk of hypertensive disorders of pregnancy was examined by restricted cubic spline (P < 0.001). The thin endometrial thickness and thick endometrial thickness groups were significantly associated with the risk of HDP after adjusting for confounding variables by stepwise logistic regression analysis. Subsequently, subgroup logistic regression analysis based on endometrial preparation regimens showed that thin endometria were still significantly associated with a higher morbidity rate in the artificial cycle group, while in the natural cycle group, thick endometria were closely associated with increased morbidity. CONCLUSION Our study manifested that both the thin and thick endometria were associated with an increased risk of hypertensive disorders of pregnancy in frozen embryo transfer cycles. Reproductive clinicians should focus on adjusting endometrial thickness in different preparation regimens; and obstetricians should be mindful of the risk of hypertension during pregnancy, when women with thin (< 0.8 cm) or excessively thicker (> 1.2 cm) endometrial thickness achieve pregnancy through frozen-thawed embryo transfer.
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Affiliation(s)
- Meng Zhang
- Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Jing Li
- Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Xiao Fu
- Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Yiting Zhang
- Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bingjie Wu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xinyue Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shanshan Gao
- Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.
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Liu X, Wang H, Pan R, Li Q, Shi J, Zhang S. Comparison of the Method of Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer: a Retrospective Cohort Study from 9733 Cycles. Reprod Sci 2021. [PMID: 33970443 DOI: 10.1007/s43032-021-00603-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
Our objective was to compare the effectiveness of natural cycles (NC), modified natural cycle (mNC), and artificial cycles (AC) in women undergoing frozen-thawed embryo transfer (FET) after in vitro fertilization (IVF). This is a retrospective cohort study analyzing 9733 women undergoing the first cycle of FET over a 3-year period (June 2014-December 2017) at Northwest Women's and Children's Hospital after IVF-ICSI cycles. The type of endometrial preparation was determined by the treating physician's preference, based on patients' characteristics. Women with regular ovulation were allocated to natural cycles (n = 1480) or modified natural cycles (n = 196) when the leading follicle was triggered with hCG, while patients who were reluctant to frequently monitoring or living far from the hospital were allocated to artificial cycles (n = 8057). A logistic regression model was used to assess the association between endometrial preparation and clinical outcomes while adjusting for potential confounders. Live birth rate was primary outcome while miscarriage rate, clinical pregnancy rate, preterm birth rate, and ectopic pregnancy rate were secondary outcomes. In the adjusted model, type of endometrial preparation did not affect live birth (OR, 0.89; 95% CI, 0.74-0.96), clinical pregnancy (OR, 0.93; 95% CI, 0.81-1.06), preterm birth (OR, 1.03; 95% CI, 0.84-1.26), and ectopic pregnancy (OR, 0.73; 95% CI, 0.33-1.59), while AC significantly increased the miscarriage rate (OR, 1.49; 95% CI, 1.17-1.89, P=0.001). In conclusions, in women undergoing FET, natural cycles and artificial cycles resulted in comparable live birth rate while miscarriage rate was higher in artificial cycles.
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Liu X, Tian L, Li P, Shi J. Clinical Outcomes of Frozen-Thawed Embryo Transfer in Natural Cycles with Spontaneous or Induced Ovulation: a Retrospective Cohort Study from 1937 Cycles. Reprod Sci 2021; 28:794-800. [PMID: 33034864 DOI: 10.1007/s43032-020-00344-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
Our objective was to assess whether there is a difference in the pregnancy outcomes in the natural cycle (NC) with spontaneous LH rise compared with modified natural cycle controlled by hCG for final oocyte maturation and ovulation after frozen-thawed embryo transfer (FET). In this retrospective cohort study, we analyzed the clinical outcomes of a total of 1937 patients undergoing FET followed by endometrial preparation with the natural cycle and modified natural cycle. The primary outcome was live birth, and secondary outcomes included miscarriage rate, clinical pregnancy rate, preterm birth rate, and ectopic pregnancy rate. The type of endometrial preparation did not impact live birth (adjusted odds ratio [aOR] 0.92; 95% confidence interval [CI], 0.69-1.23), miscarriage (aOR 0.83; 95%CI, 0.50-1.39), clinical pregnancy (aOR 0.88; 95%CI, 0.66-1.18), preterm birth (aOR 0.91; 95%CI, 0.56-1.50), or ectopic pregnancy (aOR 1.06; 95%CI, 0.29-3.94). In conclusion, in women undergoing FET, natural cycles and modified natural cycles resulted in comparable clinical outcomes.
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Konstantinos S, Petroula T, Evangelos M, Polina G, Argyro G, Sokratis G, Anna R, Andrianos N, Agni P, Michael K, Konstantinos P, George M, Mara S. Assessing the practice of LuPOR for poor responders: a prospective study evaluating follicular fluid cfDNA levels during natural IVF cycles. J Assist Reprod Genet 2020; 37:1183-1194. [PMID: 32221790 DOI: 10.1007/s10815-020-01743-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/12/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The aim of this study is to provide data on the practice of Luteal Phase Oocyte Retrieval (LuPOR). The authors assess cell-free DNA levels in follicular fluid (ff cfDNA) from poor responders undergoing natural cycles, and comparing it to respective data originating from follicular phase oocyte retrievals. METHODS Forty-seven women were eligible for this prospective study. Participants were classified as poor responders based on Bologna criteria while being detected with a second follicular wave. Follicular fluid was collected and prepared for cfDNA extraction. Levels of cfDNA were quantified via Q-PCR employing the ALU115 and ALU247 primers. These primers are associated with apoptotic and necrotic events. Levels of ff cfDNA resulting from follicular phase oocyte retrieval (FoPOR) and LuPOR-performed in a single menstrual cycle were associated with the number and maturation status of yielded oocytes and the number and fertilization status of resulting zygotes. Survival rate following thawing of cryopreserved zygotes, along with the resulting number of cleavage stage and blastocyst stage embryos are provided. RESULTS Mean levels of ALU115 were significantly lower during FoPOR when compared to LuPOR (0.79 ± 0.72 vs 1.46 ± 1.59 ng/μl, p = 0.02). Regarding the FoPOR group, a significant positive correlation of serum estradiol and ALU115 concentration (p = 0.04) was revealed. A significant negative correlation between serum estradiol and cfDNA integrity was observed both during FoPOR (p = 0.03) and LuPOR (p = 0.03). A significant lower number of retrieved (1.09 ± 0.28 vs 1.29 ± 0.58, p = 0.02) and MII oocytes (0.77 ± 0.55 vs 1.08 ± 0.61, p = 0.02) was observed when comparing the FoPOR to LuPOR groups respectively. The integrity of cfDNA was observed to be higher in FoPOR originating embryos that arrested either prior to cleavage (0.28 ± 0.13 vs 0.17 ± 0.10, p = 0.006) or prior to blastocyst formation (0.28 ± 0.12 vs 0.13 ± 0.06, p = 0.04). In the case of LuPOR originating embryos, cfDNA integrity was observed to be higher in embryos that arrested only prior to the blastocyst stage (0.27 ± 0.20 vs 0.11 ± 0.07, p = 0.008). Similarly, cfDNA integrity was observed to be lower in top quality blastocysts originating from FoPOR (0.07 ± 0.04 vs 0.17 ± 0.05, p = 0.03) and in top quality cleavage stage embryos (0.09 ± 0.06 vs 0.31 ± 0.22, p = 0.01) and blastocysts (0.06 ± 0.02 vs 0.14 ± 0.06, p = 0.02) originating from LuPOR. CONCLUSIONS Our results indicate that ff originating from LuPOR presents with higher levels of cfDNA. The higher cfDNA levels are attributed to mainly apoptotic events, as the ALU247 levels and DNA integrity did not differ statistically significantly between FoPOR and LuPOR. The absolute mean level of ALU247 corresponding to necrotic events was higher in LuPOR. Regarding embryological data, cfDNA integrity was correlated with both number and quality of cleavage stage embryos in both FoPOR and LuPOR, along with blastocyst stage embryos in LuPOR. Necrotic events were associated with poorer blastocyst formation rate and blastocyst quality in LuPOR. As the comparison between FoPOR and LuPOR results to similar IVF laboratory data, the practice of LuPOR may stand as a promising approach for poor responders, while it merits further investigation.
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Affiliation(s)
| | - Tsioulou Petroula
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maziotis Evangelos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Giannelou Polina
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Glava Argyro
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Grigoriadis Sokratis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Rapani Anna
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nezos Andrianos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Pantou Agni
- Genesis Athens Clinic, Centre for Human Reproduction, Athens, Greece
| | - Koutsilieris Michael
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Mastorakos George
- Assisted Conception Unit, 2nd Department of Obstetrics & Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Simopoulou Mara
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
- Assisted Conception Unit, 2nd Department of Obstetrics & Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Alecsandru D, Pacheco A, Guerrero-Mayo A, Fabris A, Aparicio P, Barrio A, Pellicer A, Garcia-Velasco JA. Ovarian stimulation does not influence the uterine immune environment in healthy infertile women. Reprod Biomed Online 2019; 40:113-123. [PMID: 31761720 DOI: 10.1016/j.rbmo.2019.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/15/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
Abstract
RESEARCH QUESTION There is some controversy regarding the impact of ovarian stimulation on immune cells in women undergoing IVF. The study's aim was to determine whether ovarian stimulation affected immune uterine cells in healthy women undergoing IVF. DESIGN This prospective cohort study included 28 patients undergoing IVF and 47 healthy oocyte donors. Endometrial biopsies were taken in a natural cycle and after ovarian stimulation. All participants had a normal karyotype, pelvic ultrasound and cervical cytology results and thyroid-stimulating hormone concentration, as well as normal glucose and insulin concentrations and inherited and acquired thrombophilia test results. Screening tests including human papillomavirus were normal. Immune cells were analysed using three techniques: fluorescence-activated cell sorting, immunohistochemistry and gene expression. A human leukocyte antigen (HLA)-C tetramer was used as an 'artificial embryo'. The expression of genes including those for tumour necrosis factor (TNF)-α and interleukin-10 (IL-10) was analysed. RESULTS A comparison was made of the percentage and gene expression of CD56brightCD16- uterine natural killer (uNK), CD56dimCD16+ natural killer cells, CD56-CD16+ natural killer cells and TregCD25+CD4+FoxP3+ cells, uNK binding to the HLA-C tetramer, and TNF-α and IL-10 expression. No between- or within-group differences were observed in natural versus ovarian stimulation cycles. CONCLUSIONS Ovarian stimulation does not affect the uterine immune cell population or HLA-C binding in healthy women undergoing ovarian stimulation. Further studies are underway to find out if different responses might be seen in women with previous autoimmune disorders.
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Affiliation(s)
- D Alecsandru
- Department of Immunology, IVI RMA, Madrid, Spain; Rey Juan Carlos University, Madrid, Spain; Health Research Institute La Fe, Valencia, Spain.
| | - A Pacheco
- Health Research Institute La Fe, Valencia, Spain; Department of Andrology, IVI RMA, Madrid, Spain; Alfonso X 'El Sabio' University, Madrid, Spain
| | | | - A Fabris
- Department of Reproductive Endocrinology and Infertility, IVI RMA, Madrid, Spain
| | - P Aparicio
- Department of Immunology, IVI RMA, Madrid, Spain
| | - A Barrio
- Department of Reproductive Endocrinology and Infertility, IVI RMA, Madrid, Spain
| | - A Pellicer
- Health Research Institute La Fe, Valencia, Spain; Universidad de Valencia, IVI Learning Center; Department of Reproductive Endocrinology and Infertility, IVI RMA, Roma, Italy
| | - Juan A Garcia-Velasco
- Rey Juan Carlos University, Madrid, Spain; Health Research Institute La Fe, Valencia, Spain; Universidad de Valencia, IVI Learning Center; Department of Reproductive Endocrinology and Infertility, IVI RMA, Madrid, Spain
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Nuss P, Blengini GA. Towards better monitoring of technology critical elements in Europe: Coupling of natural and anthropogenic cycles. Sci Total Environ 2018; 613-614:569-578. [PMID: 28926811 PMCID: PMC5681708 DOI: 10.1016/j.scitotenv.2017.09.117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 09/12/2017] [Accepted: 09/12/2017] [Indexed: 05/23/2023]
Abstract
The characterization of elemental cycles has a rich history in biogeochemistry. Well known examples include the global carbon cycle, or the cycles of the 'grand nutrients' nitrogen, phosphorus, and sulfur. More recently, efforts have increased to better understand the natural cycling of technology critical elements (TCEs), i.e. elements with a high supply risk and economic importance in the EU. On the other hand, tools such as material-flow analysis (MFA) can help to understand how substances and goods are transported and accumulated in man-made technological systems ('anthroposphere'). However, to date both biogeochemical cycles and MFA studies suffer from narrow system boundaries, failing to fully illustrate relative anthropogenic and natural flow magnitude and the degree to which human activity has perturbed the natural cycling of elements. We discuss important interconnections between natural and anthropogenic cycles and relevant EU raw material dossiers. Increased integration of both cycles could help to better capture the transport and fate of elements in nature including their environmental/human health impacts, highlight potential future material stocks in the anthroposphere (in-use stocks) and in nature (e.g., in soils, tailings, or mining wastes), and estimate anticipated emissions of TCEs to nature in the future (based on dynamic stock modeling). A preliminary assessment of natural versus anthropogenic element fluxes indicates that anthropogenic fluxes induced by the EU-28 of palladium, platinum, and antimony (as a result of materials uses) might be greater than the respective global natural fluxes. Increased combination of MFA and natural cycle data at EU level could help to derive more complete material cycles and initiate a discussion between the research communities of biogeochemists and material flow analysts to more holistically address the issues of sustainable resource management.
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Affiliation(s)
- Philip Nuss
- European Commission, Joint Research Centre (JRC), Directorate D - Sustainable Resources, Ispra 21027, Italy.
| | - Gian Andrea Blengini
- European Commission, Joint Research Centre (JRC), Directorate D - Sustainable Resources, Ispra 21027, Italy; Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
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Wu X, Mao Y, Gao Y, Qian X, Wang W, Ding W, Jiang SW, Liu J. Progesterone rise on hCG day is negatively correlated with IVF-ET outcomes in natural cycles. Clin Chim Acta 2018; 478:194-9. [PMID: 29305844 DOI: 10.1016/j.cca.2017.12.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 12/23/2017] [Accepted: 12/29/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the effect of progesterone rise on hCG day on the laboratory and clinical outcomes in natural cycles and to explore the possible factors related to the occurrence of progesterone elevation. PATIENTS AND STUDY METHODS Retrospective analysis was performed in 1157 infertile women with decreased ovarian reserve. Eligible infertile women undergoing IVF in natural cycles were assigned to four groups according to serum progesterone levels on the day of hCG administration: group 1, P<2nmol/L; group 2, 2<P<2.9nmol/L; group 3, 3<P<3.9nmol/L; group 4, P≥4.0nmol/L. Data on clinical outcomes and LH level were collected and analyzed. RESULTS Number of retrieved oocytes, pronucleus cells, fertilized cells, and good embryos significantly decreased (p<0.05). A significant elevation of cancelled cycle rate, early follicle elimination rate and LH level on hCG day occurred when the serum progesterone levels were higher than 4.0nmol/L on the day of hCG administration (p<0.05). CONCLUSION In natural cycles, progesterone rise on the day of hCG administration (in this study, P≥4.0nmol/L) may negatively correlated with the quality of oocytes and embryos.
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