ABSTRACT
A retrospective review of 237 initial, fresh nondonor IVF cycles in which all embryos generated during the cycle were transferred on either day 2 (n = 109) or day 3 (n = 128) were evaluated with regards to reproductive outcomes. Patients who underwent a day 2 ET had similar conception (18% vs. 16%; relative risk [RR], 1.1; 95% confidence interval [CI], 0.64-1.95), clinical pregnancy (13% vs. 16%; RR, 0.8; 95% CI, 0.44-1.55), implantation (6% vs. 7%; RR, 0.9; 95% CI, 0.50-1.68), and live-birth (10% vs. 16%; RR, 0.7; 95% CI, 0.32-1.29) rates as those who underwent a day 3 ET.
Subject(s)
Embryo Transfer/methods , Fertilization in Vitro , Pregnancy Outcome , Pregnancy Rate , Adult , Cleavage Stage, Ovum , Embryo Transfer/statistics & numerical data , Female , Humans , Pregnancy , Pregnancy Outcome/epidemiology , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
Because spermatocyte meiotic error results in embryonic sex chromosomal aneuploidy, it is speculated that teratospermia correlates with increased embryonic sex chromosomal abnormalities. Our findings contradict this theory, suggesting that morphology does not correlate with sex chromosomal genotype.
Subject(s)
Aneuploidy , Chorionic Gonadotropin/therapeutic use , Fertilization in Vitro/statistics & numerical data , Preimplantation Diagnosis/methods , Sex Chromosome Aberrations/statistics & numerical data , Spermatozoa/abnormalities , Adolescent , Adult , Estradiol/blood , Female , Fertility Agents, Female/therapeutic use , Follicle Stimulating Hormone/blood , Genotype , Humans , Leuprolide/therapeutic use , Male , Maternal Age , Oocyte Retrieval/methods , Ovulation Induction/methods , Paternal Age , Pregnancy , Treatment FailureABSTRACT
In this prospective, randomized study, waiting for the lead follicle to reach 14 mm before initiating GnRH antagonist administration effectively prevents an LH surge and ovulation during an IVF cycle. Furthermore, delaying GnRH start until the dominant follicle reaches 14 mm neither impacts the clinical pregnancy, implantation, or live birth rates nor increases the incidence of severe ovarian hyperstimulation syndrome.
Subject(s)
Embryo Implantation , Fertilization in Vitro/methods , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Ovarian Follicle/anatomy & histology , Pregnancy Outcome , Adult , Birth Rate , Female , Humans , Infant, Newborn , Luteinizing Hormone/metabolism , Ovarian Hyperstimulation Syndrome/prevention & control , Ovulation/drug effects , Pregnancy , Prospective Studies , Time FactorsABSTRACT
OBJECTIVE: To evaluate the impact on the rates of clinical pregnancy and live birth of polyploidy after intracytoplasmic sperm injection (ICSI). DESIGN: Retrospective cohort study. SETTING: University-based IVF center. PATIENT(S): One hundred forty-three patients undergoing their first IVF-embryo transfer cycle requiring ICSI. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Patients were divided into two groups on the basis of the proportion of post-ICSI triploid fertilization that was observed at the time of fertilization assessment: group 1 included patients with
Subject(s)
Fertilization in Vitro/methods , Fertilization , Polyploidy , Sperm Injections, Intracytoplasmic/methods , Embryo Implantation/physiology , Embryonic Development/physiology , Female , Fertilization in Vitro/standards , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome , Pregnancy, Multiple/statistics & numerical data , Sperm Injections, Intracytoplasmic/standards , TwinsABSTRACT
OBJECTIVE: To determine if ethnicity influences IVF birth outcome. DESIGN: Retrospective cohort study. SETTING: University-based IVF program. PATIENT(S): All African American women (n = 71) and Caucasian women (n = 180) who underwent initial fresh, nondonor IVF/embryo transfer (ET) cycles between January 1, 2004 and December 31, 2005. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Gonadotropin dose, duration of stimulation, peak estradiol levels, oocyte yield, implantation, clinical pregnancy, and live birth rates. RESULT(S): African American women generated significantly fewer embryos than Caucasian women (5.3 +/- 3.7 vs. 6.6 +/- 4.8) despite having similar ages, day 3 FSH, peak estradiol levels, length of stimulation, and number of oocytes retrieved. In addition, compared with Caucasian women, African American had significantly greater body mass indices (26.5 +/- 5.2 vs. 23.7 +/- 4.8) and required significantly more total gonadotropin (IU) (4,791 +/- 2,161 vs. 3,725 +/- 2,005) for ovarian stimulation. African American women were more likely to have uterine fibroids (21% vs. 3%) and tubal factor infertility (23% vs. 9%). Caucasian women were more likely to have unexplained infertility (53% vs. 32%). Differences in embryo yield between patient groups persisted after accounting for differences in infertility diagnosis and prevalence of fibroids. Biochemical, clinical pregnancy, and live birth rates as well as implantation rates (number of sacs visualized/number of embryos transferred) did not significantly differ between groups. CONCLUSION(S): Although African Americans yield fewer embryos than Caucasian women with IVF, these ethnic groups do not seem to differ with regard to IVF pregnancy outcomes.
Subject(s)
Ethnicity , Fertilization in Vitro/statistics & numerical data , Pregnancy Outcome , Adult , Black People , Cohort Studies , Embryo Transfer , Estradiol/blood , Female , Humans , Oocytes/cytology , Oocytes/physiology , Ovulation Induction/methods , Pregnancy , Retrospective Studies , White PeopleABSTRACT
OBJECTIVE: To evaluate the impact of abnormal sperm morphology on the rates of aneuploidy, implantation, and clinical pregnancy. DESIGN: Retrospective cohort study. SETTING: University-based IVF center. PATIENT(S): Fifty-two patients undergoing their first IVF-preimplantation genetic diagnosis (PGD) cycle. INTERVENTION(S): The PGD analysis of embryos. MAIN OUTCOME MEASURE(S): Patients were divided into two groups based on sperm morphology: teratospermic group (TSG) and normal sperm group (NSG). The primary outcome measures of rates of aneuploidy, implantation, clinical pregnancy rate (PR) per cycle, and clinical PR per embryo transfer were compared between TSG and NSG according to PGD analysis results. RESULTS: A higher percentage of normal embryos was seen in the NSG (32%) versus the TSG (20%). Overall, 30% of IVF-PGD cycles had no normal embryos for transfer. The clinical PR per cycle was 44% in the NSG compared to 14% in the TSG (relative risk [RR] = 3.19; 95% confidence interval [CI] 1.1-9.0). A similar trend was noted with the clinical PR per embryo transfer with 57% patients becoming pregnant in the NSG versus 20% patients in the TSG (RR = 2.76; 95% CI 1.2-7.2). Implantation was twice as likely to occur in the NSG as compared to TSG (RR = 2.5; 95% CI 1.1-7.2). CONCLUSION(S): Rates of euploidy, implantation, clinical PR per cycle, and clinical PR per embryo transfer were higher in the NSG compared to the TSG, suggesting that sperm morphology plays an important role in the outcome of IVF-PGD cycles.
Subject(s)
Preimplantation Diagnosis/methods , Spermatozoa/cytology , Adult , Aneuploidy , Blastocyst/pathology , Blastocyst/physiology , Embryo Implantation , Embryo Transfer/statistics & numerical data , Embryo, Mammalian/cytology , Embryo, Mammalian/physiology , Female , Fertilization in Vitro/methods , Humans , Male , Oocyte Retrieval , Oocytes/cytology , Pregnancy , Pregnancy Rate , Preimplantation Diagnosis/statistics & numerical data , Spermatozoa/abnormalities , Spermatozoa/physiologyABSTRACT
Poor responders continue to be vexing in infertility therapy. By using GnRH antagonists before ovarian stimulation, we demonstrate an improvement in oocyte, embryo, and zygote yield in patients with a prior poor response.
Subject(s)
Fertilization in Vitro/methods , Follicular Phase/physiology , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Hormone Antagonists/pharmacology , Adult , Female , Follicular Phase/drug effects , Gonadotropin-Releasing Hormone/physiology , Humans , PregnancyABSTRACT
The objective of this study was to assess the impact of assisted hatching (AH) on pregnancy rate (PR), clinical pregnancy rate (CPR), and implantation rate (IR) after a single failed, fresh, nondonor IVF cycle. Accordingly, we report that patients with one prior implantation failure benefit from AH with improved PR, CPR, and IR in a subsequent cycle.