The day of embryo transfer affects delivery rate, birth weights, female-to-male ratio, and monozygotic twin rate.

OBJECTIVE: To compare the reproductive outcomes between the transfer of cleavage-stage embryos and blastocysts in two different age groups of patients. The reproductive capacity of women decreases by age. This decrease in capacity is directly related to a lower ovarian reserve and errors in the meiotic spindle of the oocyte, which increase chromosomal abnormalities and the formation of aneuploidy embryos with lower chances of implantation. MATERIALS AND METHODS: A total of 1400 intracytoplasmic sperm injection cycles were analyzed. The study patients were divided into two age groups [aged < 36 years (Group I) and aged ≧ 36 years (Group II)]. The groups were subdivided according to the day of embryo transfer (ET)-Day 3 (ET3) and Day 5 (ET5). RESULTS: In both age groups, transfer of blastocysts resulted in a higher clinical pregnancy rate and deliveries. An increased twin birth rate was observed in patients who were younger than 36 years on both transfer days compared with those who were older than 36 years of age. There was an elevated percentage of newborn males on ET5 in both age groups. Monozygotic twinning (MZT) rate was observed only among younger patients (<36 years of age), specifically on ET5 compared with ET3. There was no significant difference in the mean birth weight of singleton and twins between the ET3 and ET5 subgroups in the younger group of patients except for the triplets who were significantly heavier in the ET5 group compared with the older group (≧36 years of age) where significant difference was found only on the mean birth weight of singleton. CONCLUSION: The study suggests that if a blastocyst can be obtained in patients of advanced age (≧36 years), it improves their baby take-home rates. Younger patients (aged < 36 years) should undergo elective single blastocyst transfers to reduce multiple pregnancy rates.

Impact of active female smoking on controlled ovarian stimulation in intracytoplasmic sperm insemination cycles.

AIM: To examine the impact of smoking among females on controlled ovarian stimulation (COS), at intra-cytoplasmatic sperm injection (ICSI) outcome. METHODS: A prospective analysis of outcomes of 876 women (fresh, non donor cycles) of which 559 (63.8%) were non-smokers, 317 (36.2%) were smokers, underwent standard COS/ICSI treatment. RESULTS: Among smokers, the average time of COS, expressed in days, was significantly longer compared with non-smokers (10.5±2.10 vs. 10±1.90 p less than 0, 05). There were no registered significant differences in the number of retrieved oocytes, (10.4±6.8 vs10.3±6.9), mature oocytes (8.6±5.8 vs. 8.4±5.9), in the group of non-smokers versus smokers. However, smoking and age have a significant impact of the number of high-quality embryos, i.e. older smokers had a lower number of high-quality transferred embryos (non-smokers ≥ 35 years : smokers ≥ 35 years; 1.9±1.1 vs. 1.6±1). On multiple logistic regression analysis, factor that had a significantly negative impact of clinical pregnancy was maternal age. CONCLUSION: Smoking among patients entering the COS and ICSI fertilization process had insignificant negative impact on the final outcome of the process resulting in reduced pregnancy rate. The chance for the pregnancy declines with age, but smoking did not significantly influence the outcome.

Recombinant FSH versus HP-HMG for controled ovarian stimulation in intracitoplasmic sperm injection cycles.

UNLABELLED: The aim of this study was to make a conclusion about aplicability of two differnet gonadothropins in COS (rFSH versus HP-hMG). The primary conclusion for the success as a result of COS are the mean number of retrived oocytes, mature oocytes, fertilization rate, mean number of quality embrios, and criopreverzed embrios. The secondary conclusions were clinical pregnancy rate and delivery rates. METHODS: The study was a retrospective case-control study,. A total of 1238 fresh, non donor, IVF cycles with COS were analyzed, but to minimize the bias, only the first cycle for each patient below 40 yaears old, in that period was analyzed. This selection composed the group of respondents that was analyzed which in total amounted to 760 patients.( rFSH = 422, HP-hMG = 338). The patients underwent COS by long luteal protocol using two differnt inducers of COS (rFSH and HP-hMG). RESULTS: The average starting dose of rFSH used was significantely lower (152.7 +/- 41.1IU), whereas with HMG it was (228.8 +/- _68.7 IU, p=000000). The average number of IU gonadothropin used in therapy, statistically highly is significantly lower when r- FSH is used as an inducer. (1639.2 +/- 476.9 IU, rFSH vs 2356.4 +/- 955.1 IU, HP-hMG, p <0.001). We received significantly higher average number of oocytes and mature oocytes in the group of r-FSH (oocytes; rFSH v HP-hMG-11.8 +/- 7.1 v 10.7 +/- 6.5, p = 0.028 ; mature oocytes: rFSH v HP-hMG 9.9 +/- 6.2 v8.7 +/- 5.5 p = 0.009). However, we did not find a significant difference in the use of the COS inductors regarding the clinical pregnancy rate (rFSH v HP-hMG 49.5% vs 48.9% p=0.92) and delivery rate (rFSH vs HP-hMG 42.9% vs 43.4% p=0.96).CONCLUSIONSs: Our study showed that rFSH is more powerful and more applicable in individualized dosing then HP-hMG and brings better results from COS (more oocytes, more matured oocytes).