Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation

Background The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; however, it is now available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. The primary aim of this paper is to provide a narrative review of the most recent and robust data on the utilization and outcomes of OC in both patient populations. Summary OC results in similar oocyte yield in patients facing gonadotoxic therapies and patients undergoing planned OC. Available data are insufficient to predict the live birth rates or the number of oocytes needed to result in live birth. However, oocyte yield and live birth rates are best among patients < 37.5 years old or with anti-mullerian hormone levels > 1.995 ng/dL, at the time of oocyte retrieval. There is a high ‘no use’ rate (58.9%) in patients using planned OC with 62.5% returning to use frozen oocytes with a spouse. The utilization rate in medical OC patients is < 10%. There is currently no data on the effects of BMI, smoking, or ethnicity on planned OC outcomes. Conclusion It is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; however, preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs. Higher oocyte yield, with fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation. More studies are needed in medical OC and planned OC to help guide counseling and decision-making in patients seeking these services.

Early Serum Progesterone Measurement on 9th Day after Oocyte Retrieval can be used as a Predictor of Fresh Intracytoplasmic Sperm Injection Cycle Success

BACKGROUND: In intracytoplasmic sperm injection (ICSI) infertility treatment cycles, measuring serum Progesterone level at day 9 after oocyte retrieval could be used as a predictor of success. METHODS: Sixty-nine women were prospectively included in this study, treated with fresh embryo transfer ICSI cycles. Progesterone analyses were performed on the day of oocyte pick up (day 0) at serum and follicular fluid, then re-assessment at serum on day 9 after oocyte retrieval. The data were compared to evaluate the correlation among hormones measured on day 0 and day 9 with pregnancy rate. RESULTS: Pregnancy rate of Iraqi women was 22% (n = 15), mean serum progesterone on day 9 among pregnant ladies was (mean ± SD, 39.5 ± 13.0) which was significantly higher than that who failed to get pregnant (mean 23.2 ± 11, p = 0.001), then after adjustment of the baseline readings (day 0) estimated mean = 11.1. The differences were still significant, receiver operating characteristic curve area showed that serum Progesterone on day 9 after pick up can differentiate correctly between those who will conceive and those who will not, with a sensitivity = 0.933 and specificity = 0.519, at cut off point = 22.33 and above, (Area under the curve = 0.822, p = 0.001). CONCLUSION: Serum progesterone on day 9 could be one of the predictors of endometrial receptivity and pregnancy, which is actually of great value for both doctors and patients during that stressful period till the date of confirmation, which might negatively affect treatment outcome, as well as the psychosocial and pharmacological impact of medication and limited activity for a failed one.

Noninvasive Chromosome Screening for Evaluating the Clinical Outcomes of Patients With Recurrent Pregnancy Loss or Repeated Implantation Failure

Background: This retrospective cohort study determines whether noninvasive chromosome screening (NICS) for aneuploidy can improve the clinical outcomes of patients with recurrent pregnancy loss (RPL) or repeated implantation failure (RIF) in assisted reproductive technology.Methods: A total of 273 women with a history of RPL or RIF between 2018 and 2021 were included in this study. We collected data of all oocyte retrieval cycles and single blastocyst resuscitation transfer cycles.Results: For the RPL patients, NICS reduced the miscarriages rate per frozen embryo transfer (FET), improved the ongoing pregnancies rate and live birth rate: 17.9% vs 42.6%, adjusted OR 0.39, 95% CI 0.16–0.95; 40.7% vs 25.0%, adjusted OR 2.00, 95% CI 1.04–3.82; 38.9% vs 20.6%, adjusted OR 2.53, 95% CI 1.28–5.02, respectively. For the RIF patients, the pregnancy rates per FET in the NICS group were significantly higher than in the non-NICS group (46.9% vs. 28.7%, adjusted OR 2.82, 95% CI 1.20–6.66).Conclusions: This study demonstrated that selection of euploid embryos through NICS can reduce the miscarriage rate of patients with RPL and improve the clinical pregnancy rate of patients with RIF. Our data suggested that NICS could be used as a diagnostic test in clinical practice.

Association Between Ambient Air Pollutants Exposure and Preterm Birth in Women Who Underwent in vitro Fertilization: A Retrospective Cohort Study From Hangzhou, China

Objectives: Exposure to air pollutants has been linked to preterm birth (PTB) after natural conception. However, few studies have explored the effects of air pollution on PTB in patients who underwent in vitro fertilization (IVF). We aimed to investigate the association between ambient air pollutants exposure and PTB risk in IVF patients.Methods: This retrospective cohort study included 2,195 infertile women who underwent IVF treatment from January 2017 and September 2020 in Hangzhou Women's Hospital. Totally 1,005 subjects who underwent a first fresh embryo(s) transfer cycle were analyzed in this study. Residential exposure to ambient six air pollutants (PM2.5, PM10, SO2, NO2, CO, O3) during various periods of the IVF timeline were estimated by satellite remote-sensing and ground measurement. Cox proportional hazards models for discrete time were used to explore the association between pollutants exposure and incident PTB, with adjustment for confounders. Stratified analyses were employed to explore the effect modifiers.Results: The clinical pregnancy and PTB rates were 61.2 and 9.3%, respectively. We found that PM2.5 exposure was significantly associated with an increased risk of PTB during 85 days before oocyte retrieval [period A, adjusted hazard ratio, HR=1.09, 95%CI: 1.02–1.21], gonadotropin start to oocyte retrieval [period B, 1.07 (1.01–1.19)], first trimester of pregnancy [period F, 1.06 (1.01–1.14)], and the entire IVF pregnancy [period I, 1.07 (1.01–1.14)], respectively. An interquartile range increment in PM10 during periods A and B was significantly associated with PTB at 1.15 (1.04–1.36), 1.12 (1.03–1.28), and 1.14 (1.01–1.32) for NO2 during period A. The stratified analysis showed that the associations were stronger for women aged &lt;35 years and those who underwent two embryos transferred.Conclusions: Our study suggests ambient PM2.5, PM10, and NO2 exposure were significantly associated with elevated PTB risk in IVF patients, especially at early stages of IVF cycle and during pregnancy.

Emotions towards potential genetic offspring among oocyte donors: a cross-sectional study

Background The presence of maternal emotions towards the offspring resulting from assisted reproductive techniques (ART) has been previously reported in oocyte donors. However, there is limited information about the presence of these emotions in oocyte donors during the ART process and before pregnancy. The aim of this study was to evaluate the emotions of oocyte donor women towards the potential genetic offspring and to compare them with women treated with ART by using own oocytes. Methods A cross-sectional study was conducted on 100 women who were divided into two groups of oocyte donors and those treated with ART and using autologous oocyte. At the time of oocyte retrieval. Using a validated questionnaire, the emotions toward potential offspring (EPO) resulting from ART and its three dimensions (including imagination, sense of ownership, and importance of treatment outcome) were measured and compared in two groups. Results Comparison of the EPO in the two groups showed that the emotions in all three dimensions were lower in oocyte donors than the other group (p < 0.001). Moreover, in oocyte donors, the mean score of the scale of the importance of treatment outcome dimension was higher than the other two scales (p < 0.001). Conclusion The results of the study showed that there is a significant emotion toward the potential offspring in oocyte donors. The presence of these emotions thus should be considered in formulating the ethical charter of ART by using oocyte donation.

The effect of Propofol versus Dexmedetomidine as anesthetic agents for oocyte pick-up on in vitro fertilization (IVF) outcomes

This study aimed to evaluate the effects of propofol and dexmedetomidine over different timescales on the IVF outcomes for transvaginal oocyte retrieval (TVOR). Twenty-four rats included in the study were divided into two main groups and three subgroups were subjected to the ovulation induction process. Group 1 was administered propofol (100 mg/kg i.v.) and group 2 were administered dexmedetomidine (25 µg/kg i.p.) The oviduct collection procedure was completed within 15 min for subgroup Pro15min, Dex15min (n = 4), within 16 to 30 min for subgroup Pro30min, Dex30min (n = 4) and within 31 to 60 min for subgroup Pro60min, Dex60min (n = 4) after euthanasia. The total number of oocytes was counted. After in vitro fertilization, the number and quality of embryos were evaluated. The number of pups born were evaluated after embryo transfer. The embryo number, quality and pup count decreased as the administration time for propofol increased (p < 0.05). No statistically significant difference was found between the dexmedetomidine subgroups for embryo number, quality and pup count(p > 0.05). As the exposure time to propofol increased, the number and quality of embryos obtained, and the pup count, decreased. The use of dexmedetomidine had no negative impacts on the number of embryos, their quality or the number of pups.