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SARS‐:CoV‐:2 pandemic and repercussions for male infertility patients: a proposal for the individualized provision of andrological services
The prolonged lockdown of health facilities providing non‐:urgent gamete cryopreservation –as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS‐:CoV‐:2 pandemic will be detrimental for subgroups of male infertility patients.
Live birth after frozen–thawed embryo transfer-which endometrial preparation protocol is better?
The live birth and clinical pregnancy rates are comparable between mNC and AC with GnRH agonists in frozen thawed embryo transfer cycles. In ovulatory patients with planned double embryo transfer, mNC can be considered. Further well-designed prospective studies are needed to confirm our results.
What Is the Best Regimen for Ovarian Stimulation of Poor Responders in ART/IVF?
Despite anecdotal case reports, no unequivocal treatment proved to be successful for these patients in prospective randomized controlled trials. Nevertheless, the addition of growth hormone (GH) to ovarian stimulation in POR with GH deficiency may improve the results of controlled ovarian hyperstimulation (COH) and the IVF success. In patients with autoimmune etiology for POR/POI, the combination of glucocorticosteroids, pituitary-ovarian suppres
Effect of platelet-rich plasma on pregnancy outcomes in infertile women with recurrent implantation failure: a randomized controlled trial
The CPR (48.3% versus 23.26,p=.001) and OPR(46.7% versus 11.7%,p=.001) and implantation rate (58.3% versus 25%,p=.001) was more significant in the intervention group rather than controls. In conclusion, intrauterine infusion of platelet-rich plasma 48h before freeze-thawed embryo transfer may have more effectiveness in IVF outcomes in recurrent implantation failure.
Autologous activated platelet-rich plasma injection into adult human ovary tissue: molecular mechanism, analysis, and discussion of reproductive respo
Recently, clinical experience with such a technique based on autologous activated platelet-rich plasma (PRP) treatment of the adult human ovary has been reported. This review summarizes the present state of understanding of the interaction of platelet-derived growth factors with adult ovarian tissue, and the outcome of human reproductive potential following PRP treatment.
No effect of ovarian stimulation and oocyte yield on euploidy and live birth rates: an analysis of 12 :298 trophectoderm biopsies
SUMMARY ANSWER. Euploidy rates and LBRs after transfer of euploid embryos are not significantly influenced by gonadotropin dosage, duration of ovarian stimulation, estradiol level, follicle size at ovulation trigger or number of oocytes retrieved, regardless of a woman’s age.
The Bologna criteria for the definition of poor ovarian responders: is there a need for revision? [2014]
The Bologna criteria were published by the European Society of Human Reproduction and Embryology (ESHRE) in 2011 to help address the lack of a clear definition of poor ovarian responders. Since its publication, aspects of the criteria have been cited several times, whilst others have been criticized. In this debate, we re-examine the criteria (which address age, the number of oocytes retrieved and the results of ovarian reserve tests) following n
Cumulative live birth rates for women returning to ART treatment for a second ART-conceived child
This is the first study to report success rates for women returning to ART treatment to have second ART-conceived child. These age-specific success rates can facilitate individualized counseling for the large number of patients hoping to have a second child using ART treatment.
Video Links / [Posted:18/5/2020] / [Source:youtu.be] Viewed: 1005
Comments Linked to this Mailout
Title
Ovarian Stimulation of Poor Responders in ART/IVF?
Summary
Despite anecdotal case reports, no unequivocal treatment proved to be successful for these patients in prospective randomized controlled trials.
Comment
ABSTRACT (open access-see article)|
The infertile patients with aging ovaries—also sometimes referred to as impending premature ovarian insufficiency (POI), impending premature ovarian failure (POF), or poor ovarian responders (POR), constitute a significant and increasing bulk of the patients appealing to IVF/ART. Different causes have been cited in the literature, among the identified etiologies, including chromosomal and genetic etiology, metabolic, enzymatic, iatrogenic, toxic, autoimmune, and infectious causes. Although the most successful and ultimate treatment of POI/POF/POR patients is egg donation (ED), many, if not most, of these infertile women are reluctant to consent to ED upon the initial diagnostic interview, requesting alternative solutions despite the low odds for success. Despite anecdotal case reports, no unequivocal treatment proved to be successful for these patients in prospective randomized controlled trials. Nevertheless, the addition of growth hormone (GH) to ovarian stimulation in POR with GH deficiency may improve the results of controlled ovarian hyperstimulation (COH) and the IVF success. In patients with autoimmune etiology for POR/POI, the combination of glucocorticosteroids, pituitary-ovarian suppression, and COH may be successful in achieving the desired conception|
Title
Does stimulation influence the rate of euploidy?
Summary
In a USA paper in Human Reproduction, it appears stimulation process do NOT effect euploidy rates.
Comment
In an article published in April 2020 in Human Reproduction, the authors from a USA clinic reviewed more than 3100 IVF and FET cycles where 12,298 embryos (that’s a lot) had been tested for aneuploidy. The data they presented explored the incidence of euploidy in relation to the patients age and various stimulation process and ovarian response. In essence they reported that no process or response significantly influences the incidence of euploidy and live birth rate. The main determinant was female age.|
The reason the authors looked at euploidy rates was previous studies in young egg donors demonstrated a wide range in the incidence of euploidy prompting concerns some aspects of stimulation may contribute to abnormal high rates of aneuploidy.|
Their findings from a single clinic over a 4 year period found that for any age group (they divided the groups into <35,35-37,38-40,41-42 and >42), the incidence of euploidy was the same regardless of the amount of gonadotropin administered or the duration of stimulation.|
Furthermore, none of the markers of ovarian response to stimulation, namely the number of oocytes, the maximum oestradiol, and the size of the largest follicle at trigger influenced the rate of euploidy.|
However, the difference in the euploidy rate between <35 year old clients and >42 year old clients was disturbing but not unexpected. For instance, when <10 oocytes were recovered, the euploidy rate for <35 clients was 59.4% compared to 7.3% for women >42 years of age.|
Based upon the data presented in the abstract for this paper, one may feel that subject to other studies, the incidence of aneuploidy is largely a function of the women’s reproductive and lifestyle history and less likely to be due to the stimulation used in almost IVF treatment.|
The large numbers provide confidence in these conclusions remembering that presumably all the tests were from the same clinic and genetics laboratory and the stimulation protocols and rules for mosaicism may have been uniform. Also, the data is only for embryos that were tested and may not reflect the actual aneuploidy rate for all oocytes and embryos. For instance, if only high quality blastocysts were tested, then the data represents the very best euploidy rates that may be obtained. It follows therefore that the euploidy rate of 59.4% for the very young clients still indicated that 4 in 10 good blastocysts (presumed) that were suitable for transfer, were able to develop to day 5 but were not normal (i.e. euploid).|
Title
What is the likelihood of achieving another live birth after their first success treatment
Summary
The asnwer is pretty good if you are younger and have residual frozen embryos.
Comment
This interesting study from the ANZARD unit in Australia asked the question “What is the likelihood of achieving another live birth after their first success treatment”. This is a really great question because IVF is only partly about having a baby, it is really all about completing a family. One of the sad things about IVF management is that it is focused on each individual treatment event and not about designing treatment strategy for helping couples achieve the goal of a complete family. For instance, the industry is so focused on single embryo transfer that the time to return for a second baby may mean the women is older and therefore is less likely to be successful. Maybe heavier stimulation or multiple embryo transfers might allow couple to achieve their dream. Do clinicians even ask how many children the couple want at the start of treatment? This paper in some ways provides information to clinicians and clients on the chance of have their family. |
In essence they have showed that 43% of couples return for subsequent pregnancy and were more likely to return if the woman was nulliparous at the time of their first ART-conceived child. Younger women were more likely to return, as were women who needed three or more complete cycles to achieve their first live birth, to have used a fresh embryo to achieve their first live birth and to have conceived using a single blastocyst. |
‘The patient and treatment factors positively associated with achieving a second ART-conceived live birth included younger female age at the recommencement of ART treatment, commencing with a frozen embryo, having male-factor only infertility, requiring only one complete cycle to achieve the first live birth and achieving their first live birth with a single blastocyst transfer.’ |Interestingly and impressively, the authors showed that after a further SIX treatment cycles including all FET transfers, the cumulative live birth rate was between 51% and 70%. This was higher still if the return cycles first used the residual embryos from the initial conception cycle raising the likelihood of a second baby to between 61% and 88%.|
To summarise, the authors have presented data to allow clinicians to feel confident that if their clients were under 35 years of age and had residual frozen embryo in cryostorage (or has used donor oocytes), when they returned for a second baby their chance of success remain high. This reinforces the importance of female age and embryo quality since even though the woman may be older, her embryos are not. However the tyranny of age does manifest itself if the clients are older than 35 years where the chance of residual frozen embryos is less and thereby forcing the couple to start a new cycle.|
IVF Training - Questions relating to mailout links -
Open Challenge and complete Questions
Question
Type
Options
For women under 35 years, the euploidy rate of total gonadotrophin stimulation under 4000IU was
2
7
For Women over 42 Years, The Euploidy Rate Of Total Gonadotrophin Stimulation Under 4000IU Was
1
7
For Women Under 35 Years, The Euploidy Rate when <10 oocytes and when >20 oocytes were collected was
1
5
For Women over 42 Years, The Euploidy Rate when <10 oocytes and when >20 oocytes were collected was
1
5
For women under 35 years, the euploidy rate when the durations of stimulation was <10 days, 10-12 days and >12 days was?
1
5
For Women over 42 Years, The Euploidy Rate When The Durations Of Stimulation Was <10 Days, 10-12 Days And >12 Days Was?
1
5
What proportion of couples return for a second pregnancy
1
5
The chance of pregnancy was higher if your first transfer was using frozen embryos
1
2
which of the following factors was associated with an increased chanc eof success
2
4
IVFLabOnline - Recent Enteries to IVFLabOnlines product listings.see IVFLabonline
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S-Cryolock is the slimmer version of the original. It is a versatile, simple and efficient vitrification device that is intended for the holding, cryopreservation and storage of oocytes or embryos in liquid nitrogen.
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