scholarly journals Impact of Transferring a Poor Quality Embryo Along with a Good Quality Embryo on Pregnancy Outcomes in IVF/ICSI Cycles: a Retrospective Study

2020 ◽  
Vol 80 (08) ◽  
pp. 844-850
Author(s):  
Oya Aldemir ◽  
Runa Ozelci ◽  
Emre Baser ◽  
Iskender Kaplanoglu ◽  
Serdar Dilbaz ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Poor Quality ◽  
Blastocyst Stage ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Cleavage Stage ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Good Quality Embryo

Abstract Background The number and the quality of embryos transferred are important predictors of success in in vitro fertilization (IVF) cycles. In the presence of more than one good quality embryo on the transfer day, double-embryo transfer (DET) can be performed with these embryos, but generally, different quality embryos are present in the available transfer cohort. We aimed to investigate the effect of transferring a poor quality embryo along with a good quality embryo on IVF outcomes. Methods In this study, 2298 fresh IVF/intracytoplasmic sperm injection (ICSI) cycles with two good quality embryos (group A), one good and one poor quality embryo (group B), and single good quality embryo (group C) transfers were examined. All groups were divided into two subgroups according to the transfer day as cleavage or blastocyst stage. Clinical pregnancy and live birth rates were the primary outcomes. Results In the cleavage stage transfer subgroups, the clinical pregnancy rates were lower in the single-embryo transfer (SET) subgroup compared with DET subgroups, but the difference was not statistically significant compared with DET with mixed quality embryos. The live birth rates were comparable between the three groups. In the blastocyst transfer subgroups, the clinical pregnancy and live birth rates were significantly higher in DET with two good quality embryos than DET with mixed quality embryos and SET groups. Multiple pregnancy rates were higher in both DET groups in terms of transfer day (p = 0.001). Conclusion DET with mixed quality embryos results with lower clinical pregnancy and live birth rates compared with DET with two good quality embryos at the blastocyst stage. At cleavage stage transfer, there is no difference in live birth rates between the two groups.

scholarly journals Cumulative live birth rates after fresh and vitrified cleavage-stage versus blastocyst-stage embryo transfer in the first treatment cycle

2016 ◽  
Vol 31 (11) ◽  
pp. 2442-2449 ◽  
Author(s):  
Anick De Vos ◽  
Lisbet Van Landuyt ◽  
Samuel Santos-Ribeiro ◽  
Michel Camus ◽  
Hilde Van de Velde ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Treatment Cycle ◽  
Blastocyst Stage ◽  
Stage Versus ◽  
Cleavage Stage ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
Stage Embryo

scholarly journals Cleavage Stage versus Blastocyst Stage Embryo Transfer in Oocyte Donation Cycles

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 293 ◽  
Author(s):  
Kontopoulos ◽  
Simopoulou ◽  
Zervomanolakis ◽  
Prokopakis ◽  
Dimitropoulos ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Oocyte Donation ◽  
Blastocyst Stage ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Cleavage Stage ◽  
Sonographic Guidance ◽  
Stage Embryo ◽  
Day 3 Embryo ◽  
Cryopreserved Embryos

Background and Objective: During the last few years, a trend has been noted towards embryos being transferred at the blastocyst stage, which has been associated with improved rates regarding implantation and clinical pregnancy in comparison to cleavage stage embryo transfers. There is a limited number of studies investigating this notion in oocyte donation cycles employing cryopreserved embryos. The aim of this study is to evaluate the implantation potential and clinical pregnancy rates between the day 3 cleavage stage and blastocyst stage embryo transfers in oocyte donation cycles employing vitrified embryos. Methods: This is a retrospective evaluation of oocyte donation frozen–thawed transfers completed in our clinic from January 2017 to December 2017. Intracytoplasmic sperm injection was conducted for all oocytes. Following fertilization, all embryos were cryopreserved either at the cleavage or blastocyst stage. Embryo transfer of two embryos was performed under direct sonographic guidance in all cases. Results: Our results confirmed a 55.6% clinical pregnancy (CP) resulting from day 3 embryo transfers, a 68.8% CP from day 5, and 71.4% CP from day 6. Significantly improved pregnancy rates were related to embryo transfers at the blastocyst stage when compared to cleavage stage transfers (68.9% and 55.6% respectively, p = 0.016). The risk with regards to multiple pregnancies was similar. Conclusion: Our findings indicate that in oocyte donation cycles employing vitrified embryos, embryo transfer at the blastocyst stage is accompanied with a significant improvement in pregnancy rates and merits further investigation.

scholarly journals Reduced pregnancy and live birth rates after in vitro fertilization in women with previous Caesarean section: a retrospective cohort study

2020 ◽  
Vol 35 (3) ◽  
pp. 595-604 ◽  
Author(s):  
J Vissers ◽  
T C Sluckin ◽  
C C Repelaer van Driel-Delprat ◽  
R Schats ◽  
C J M Groot ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Embryo Transfer ◽  
Vaginal Delivery ◽  
Live Birth ◽  
Clinical Pregnancy ◽  
Fertility Treatment ◽  
Previous Caesarean Section ◽  
Birth Rates ◽  
Caesarean Scar ◽  
Live Birth Rates

Abstract STUDY QUESTION Does a previous Caesarean section affect reproductive outcomes, including live birth, in women after IVF or ICSI? SUMMARY ANSWER A previous Caesarean section impairs live birth rates after IVF or ICSI compared to a previous vaginal delivery. WHAT IS KNOWN ALREADY Rates of Caesarean sections are rising worldwide. Late sequelae of a Caesarean section related to a niche (Caesarean scar defect) include gynaecological symptoms and obstetric complications. A systematic review reported a lower pregnancy rate after a previous Caesarean section (RR 0.91 CI 0.87–0.95) compared to a previous vaginal delivery. So far, studies have been unable to causally differentiate between problems with fertilisation, and the transportation or implantation of an embryo. Studying an IVF population allows us to identify the effect of a previous Caesarean section on the implantation of embryos in relation to a previous vaginal delivery. STUDY DESIGN, SIZE, DURATION We retrospectively studied the live birth rate in women who had an IVF or ICSI treatment at the IVF Centre, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands, between 2006 and 2016 with one previous delivery. In total, 1317 women were included, of whom 334 had a previous caesarean section and 983 had previously delivered vaginally. PARTICIPANTS/MATERIALS, SETTING, METHODS All secondary infertile women, with only one previous delivery either by caesarean section or vaginal delivery, were included. If applicable, only the first fresh embryo transfer was included in the analyses. Patients who did not intend to undergo embryo transfer were excluded. The primary outcome was live birth. Multivariate logistic regression analyses were used with adjustment for possible confounders ((i) age; (ii) pre-pregnancy BMI; (iii) pre-pregnancy smoking; (iv) previous fertility treatment; (v) indication for current fertility treatment: (a) tubal, (b) male factor and (c) endometriosis; (vi) embryo quality; and (vii) endometrial thickness), if applicable. Analysis was by intention to treat (ITT). MAIN RESULTS AND THE ROLE OF CHANCE Baseline characteristics of both groups were comparable. Live birth rates were significantly lower in women with a previous caesarean section than in women with a previous vaginal delivery, 15.9% (51/320) versus 23.3% (219/941) (OR 0.63 95% CI 0.45–0.87) in the ITT analyses. The rates were also lower for ongoing pregnancy (20.1 versus 28.1% (OR 0.64 95% CI 0.48–0.87)), clinical pregnancy (25.7 versus 33.8% (OR 0.68 95% CI 0.52–0.90)) and biochemical test (36.2 versus 45.5% (OR 0.68 95% CI 0.53–0.88)). The per protocol analyses showed the same differences (live birth rate OR 0.66 95% CI 0.47–0.93 and clinical pregnancy rate OR 0.72 95% CI 0.54–0.96). LIMITATIONS, REASONS FOR CAUTION This study is limited by its retrospective design. Furthermore, 56 (16.3%) cases lacked data regarding delivery outcomes, but these were equally distributed between the two groups. WIDER IMPLICATIONS OF THE FINDINGS The lower clinical pregnancy rates per embryo transfer indicate that implantation is hampered after a caesarean section. Its relation with a possible niche (caesarean scar defect) in the uterine caesarean scar needs further study. Our results should be discussed with clinicians and patients who consider an elective caesarean section. STUDY FUNDING/COMPETING INTEREST(S) Not applicable. TRIAL REGISTRATION NUMBER This study has been registered in the Dutch Trial Register (Ref. No. NL7631 http://www.trialregister.nl).

scholarly journals Is Endometrial Scratching Beneficial for Patients Undergoing a Donor-Egg Cycle with or without Previous Implantation Failures? Results of a Post-Hoc Analysis of an RCT

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1167
Author(s):  
Alexandra Izquierdo ◽  
Laura de la Fuente ◽  
Katharina Spies ◽  
David Lora ◽  
Alberto Galindo
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Multiple Pregnancy ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Birth Rates ◽  
Ongoing Pregnancy Rate ◽  
Live Birth Rates ◽  
Egg Donor ◽  
Endometrial Scratching

Endometrial scratching (ES) has been proposed as a useful technique to improve outcomes in in vitro fertilization (IVF) cycles, particularly in patients with previous implantation failures. Our objective was to determine if patients undergoing egg-donor IVF cycles had better live birth rates after ES, according to their previous implantation failures. Secondary outcomes were pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, and multiple pregnancy rate. We analysed the results of 352 patients included in the Endoscratch Trial (NCT03108157). A total of 209 were patients with one or no previous implantation failures (105 with an ES done in the previous cycle, group A1, and 104 without ES, group B1), and 143 were patients with at least two previous failed implantations (71 patients with ES, group A2, and 72 without ES, group B2). We found an improvement in pregnancy rates (62.9% in group A1 vs. 55.8% in group B1 vs. 70.4% in group A2 vs. 76.4% in group B2, p = 0.028) in patients with at least two previous implantation failures, but this difference was not statistically different when we compared clinical pregnancy rates (59.1% vs. 51.0% vs. 64.8% vs. 68.1% in groups A1, B1, A2 and B2, respectively, p = 0.104) and live birth rates (52.4% vs. 43.3% vs. 57.8% vs. 55.6% in groups A1, B1, A2 and B2, respectively, p = 0.218). According to these results, we conclude that there is no evidence to recommend ES in egg-donor IVF cycles, regardless of the number of previous failed cycles.

scholarly journals Effect of Age and Morphology on Live Birth Rate After Cleavage Stage Embryo Transfer

2020 ◽  
Vol 28 (1) ◽  
pp. 43-51
Author(s):  
Michael Awadalla ◽  
Nicole Vestal ◽  
Lynda McGinnis ◽  
Ali Ahmady
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Cleavage Stage ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Cleavage Stage Embryo ◽  
Stage Embryo ◽  
Best Fit

AbstractAccurate knowledge of the live birth rate for cleavage stage embryos is essential to determine an appropriate number of embryos to transfer at once. Results from previous studies lack details needed for practical use. This is a mathematical analysis and model building study of day 3 cleavage stage embryo transfers. A total of 996 embryos were transferred in 274 fresh and 83 frozen embryo transfers. Embryo morphology was divided into 4 groups based on number of cells and fragmentation percentage. Each embryo transfer was modeled as an equation equating the sum of the live birth rates of the transferred embryos to the number of live births that resulted. The least squares solution to the system of embryo transfer equations was determined using linear algebra. This analysis was repeated for ages 35 to 42 years old at oocyte retrieval. The best fit live birth rates per embryo in the age group centered on 35 years old were 29%, 13%, 10%, and 9% for embryos in the 8-cell with ≤ 5% fragmentation, 8-cell with > 5% fragmentation, 9–12 cell, and 6–7 cell groups, respectively. Cleavage stage embryos with fewer than 6 cells on day 3 had very low best fit live birth rates close to 0% at age 39 years and were excluded from the primary analysis to prevent overfitting. These live birth rates can be used with a simple embryo transfer model to predict rates of single and multiple gestation prior to a planned cleavage stage embryo transfer.

scholarly journals Clinical Pregnancy after Elimination of Embryo Fragments Before Fresh Cleavage-Stage Embryo Transfer

2020 ◽  
Author(s):  
Luis H. Sordia-Hernandez ◽  
Felipe A. Morales-Martinez ◽  
Lorna M. Frazer-Moreira ◽  
Lilith Villarreal-Pineda ◽  
María Ofelia Sordia-Piñeyro ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Poor Quality ◽  
Abortion Rate ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Cleavage Stage ◽  
Fresh Embryo Transfer ◽  
Vitro Fertilization ◽  
Stage Embryo

Objective: To determine if the elimination of fragments in cleavage-stage embryos, before fresh transfer, improves pregnancy rates in in vitro fertilization cycles. Materials and methods: This is a Prospective observational case-control study carried out at a University Reproductive Center. We included Twenty-six infertile patients divided into two groups. Group one: 13 patients with embryos classified as grade B and C (embryos with fragments) according to the Hill classification, and Group two: 13 patients with grade A embryos (embryos with no fragments). Embryo Defragmentation was performed in embryos of group one 65 to 68 hours after conventional fertilization. Fresh embryo transfer was made after two hours post fragments removal. Reproductive results were evaluated and compared between both groups. Results: The total number of clinical pregnancies was nine. In group one there were 5 (38.5 %); in group two, there were 4 (30.8%). The difference was not statistically significant (p = 0.68). Two abortions were reported in the study, both in group one; were fragment elimination was performed. This represents an abortion rate of 40% in patients who got pregnant in this group. These patients had twice the probability of suffering an abortion (OR 2.1; 95% CI 1.4-3.37). Ongoing pregnancies were similar in both groups. Conclusion: Removal of fragments in freshly transferred day three embryos could be an alternative to increase clinical pregnancy and ongoing pregnancy rates in patients who have only poor-quality embryos. Despite the relationship with a higher abortion rate, this strategy could represent a real alternative for this type of patient.

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