A sharing oocyte donation program: a 15-year cohort stud.

OBJECTIVE: To evaluate clinical and laboratory outcomes of oocyte donation cycles and compare the results from donors and recipients. METHODS: A retrospective cohort study was conducted at a reproductive medicine center. A 586 first fresh oocyte donation cycles, performed from 01/2002 to 12/2017 were included. The outcomes of 290 cycles from donors and 296 from recipients, resulting in 473 fresh embryo transfers, were analyzed. The oocyte division was equally made, whereas, at an odd amount, the donor always had a preference. The data were collected from an electronic database, and analyzed using Chi-square test, Fisher's exact test, Mann-Whitney U-test or Student t-test depending on the data distribution, and multivariate logistic regression, considering p<0.05. RESULTS: The main results comparing donor and recipient, were, respectively: fertilization rate (72.0±21.4 vs. 74.6±24.2, p<0.001), implantation rate (46.2% vs. 48.5%, p=0.67); clinical pregnancy rate (41.9% vs. 37.7%, p=0.39), live birth rates by transfer (33.3 vs. 37.7, p=0.54). CONCLUSIONS: Oocyte donation is often the way donors can access in vitro fertilization, and for recipients seems to be a good option for pregnancy. Demographic and clinical characteristics have a secondary role in oocyte donors under 35 years and patient without comorbidities under 50 years and were not associated with pregnancy outcomes, emphasizing the power of oocyte quality on the success of intracytoplasmic sperm injection treatment. An oocyte-sharing program that offers good and comparable results is fair and worth being encouraged.

The impact of body mass index on laboratory, clinical outcomes and treatment costs in assisted reproduction: a retrospective cohort study.

BACKGROUND: The aim of this study was to evaluate the influence of the body mass index (BMI) on laboratory, clinical outcomes and treatment costs of assisted reproduction, as there are still controversial and inconclusive studies on this subject. METHODS: This research was retrospective cohort study, including women undergoing assisted reproduction in a Reproductive Medicine Center between 2013 and 2020. The participants were divided into groups according to BMI (kg/m2): Group 1 < 25; Group 2, 25-29.9 and Group 3, ≥ 30. A total of 1753 in vitro fertilization (IVF) fresh embryo transfer (ET) cycles were included for assisted reproduction outcomes analysis and 1869 IVF-ET plus frozen embryo transfer (FET) for cumulative pregnancy analysis. RESULTS: As higher the BMI, higher was the proportion of canceled IVF cycles (G1 (6.9%) vs. G2 (7.8%) vs. G3 (10.4%), p = 0.002) and gonadotropin's total dose (IU) and treatment costs (G1 (1685 ± 595, U$ 683,02) vs. G2 (1779 ± 610, U$ 721,13) vs. G3 (1805 ± 563, U$ 764,09), p = 0.001). A greater number of mature oocytes was observed in G1 and G2 (6 [6.4-7.0] vs. 6 [5.6-6.6] vs. 4 [4.6-6.7], p = 0.011), which was not found in oocyte maturity rate (p = 0.877). A significant linear tendency (p = 0.042) was found in cumulative pregnancy rates, pointing to worse clinical outcomes in overweight and obese patients. CONCLUSION: These findings highlight the importance of considering the higher treatment costs for these patients, beyond all the well-known risks regarding weight excess, fertility, and pregnancy, before starting IVF treatments.

Is there a better evolutionary outcome in a 4-cell tetrahedron embryo?

With the growing understanding of in vitro fertilization and reproductive technology, the magnitude of studies related to embryonic evolution has also increased. The optimization of embryo selection is crucial to minimize the risk of multiple pregnancies and to guarantee successful implantation and pregnancy. On the second day of culture, the four-cell embryo can be shaped into different arrangements, such as tetrahedral and planar. Previous studies have shown that mammalian embryos have a tetrahedral shape and that any deviation from this ideal configuration can negatively affect blastocyst development. A few studies have also found that planar embryos would be linked to negative predictors of success for reaching the blastocyst stage and its good quality. Therefore, it seems that tetrahedral should be preferred over planar-shaped embryos for embryonic transfers, but there is still little understanding and evidence about this subject. Thus, the objective of the present paper was to review the available literature on study tendencies to compare tetrahedral and planar-shaped embryos considering their effect on implantation and pregnancy results.