ABSTRACT
RESEARCH QUESTION: Can predictors of twin and high-order multiple pregnancy among women with multiple cycles of ovarian stimulation intrauterine insemination (IUI) be identified? DESIGN: Retrospective cohort study of IUI cycles carried out between January 2014 and December 2015 in a private clinic in Spain. The 4879 women and 6552 cycles analysed in this study include single IUI with ovarian stimulation using recombinant FSH. RESULTS: Number of follicles and follicle size were the only factors with a significant effect (P < 0.001) on the likelihood of achieving a twin or multifetal pregnancy. Follicles 12 mm or wider greatly increase the chances of achieving a twin or multifetal pregnancy. A total of 73 out of 127 (57.5%) twin pregnancies occurred in cycles with at least one additional follicle measuring 12 mm or wider, and 102 out of 127 twin pregnancies (80.3%) occurred in cycles with at least one additional follicle measuring 14 mm or wider. Cancellation criteria should consider the presence of follicles 12 mm or wider. CONCLUSION: Follicles measuring 12 mm or wider increase the risk of having a twin or a high-order multiple pregnancy rate. These data may help clinicians balance decision-making between cancelling and performing the cycle within an IUI procedure.
Subject(s)
Insemination, Artificial/methods , Ovarian Follicle/cytology , Pregnancy, Multiple , Adult , Female , Humans , Odds Ratio , Ovarian Follicle/diagnostic imaging , Pregnancy , Pregnancy Rate , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: The effect of repeated controlled ovarian stimulation in young, healthy women who consented to donate their oocytes was assessed through a retrospective study. METHODS AND RESULTS: Between March 1994 and February 2000, 284 donors consented to at least two controlled ovarian stimulation cycles, with four donors undergoing up to nine cycles. Through an intra-group analysis we studied the oocyte retrieval rate, controlled by the duration and doses of stimulation, as well as the interval between cycles, finding that the number of retrieved oocytes was maintained during repeated controlled ovarian stimulation cycles. The oocyte quality, assessed as fertilization, implantation and pregnancy rates, was similar through five repeated controlled ovarian stimulation cycles. The same result was obtained when the interval in days was analysed as a continuous variable or categorized in <90 and > or =90 days. CONCLUSIONS: The analysis of the data suggests that successive stimulation cycles do not impair ovarian response in terms of quantity and quality of the oocytes obtained in this group of women. Furthermore, the interval between cycles does not influence the result of the stimulations.
Subject(s)
Oocyte Donation , Ovulation Induction , Tissue Donors , Adolescent , Adult , Embryo Implantation , Embryo Transfer , Female , Fertilization in Vitro , Humans , Infertility, Male/physiopathology , Male , Oocytes/physiology , Pregnancy , Retrospective Studies , Spermatozoa/physiologyABSTRACT
Objetivo: Determinar el impacto de la técnica de ICSI sobre el desarrollo embrionario, estudiando el desarrollo preimplantatorio hasta el estadio de blastocisto, comparando embriones obtenidos mediante FIV convencional con los obtenidos mediante ICSI con muestras de semen con alteraciones severas o aparentemente normales. Métodos: Se estudió el desarrollo preimplantatorio de un total de 900 embriones humanos de día 2 que se sometieron a co-cultivo y transferencia en estadio de blastocisto. Primero, se analizaron 852 embriones derivados de ovocitos donados de mujeres jóvenes y fértiles en los cuales la técnica de inseminación artificial (FIV o ICSI) se decidió en base a las características del semen del marido de la receptora. Se dividieron los embriones en los obtenidos mediante FIV convencional (n = 311), y embriones obtenidos mediante ICSI (n = 541). Segundo, se compararon con un total de 48 embriones de día dos obtenidos de ovocitos hermanos y muestras de esperma normales. Resultados: El porcentaje de formación de blastocistos fue significativamente mayor en los embriones obtenidos mediante FIV convencional (67,1 por 100) comparado con aquellos obtenidos mediante ICSI (59,0 por 100) (p < 0,05). La tasa de embarazo, implantación y aborto fueron similares en las receptoras de ambos grupos (ya que se transfirió el mismo número de blastocistos). Además, evaluamos la tasa de formación de blastocistos obtenidos por FIV (45,2 por 100) e ICSI (53,3 por 100), provenientes de ovocitos hermanos y muestras de esperma normales, y no encontramos diferencia estadísticamente significativa.Conclusiones: Este estudio indica que el desarrollo preimplantatorio, demostrado por el porcentaje de formación de blastocistos es superior en los embriones obtenidos por FIV que por ICSI. Además, este estudio sugiere que este efecto es debido a la calidad del esperma, y no a las condiciones técnicas del procedimiento de ICSI (AU)
