Abstract
The aim of this study was to compare the in vitro fertilization (IVF) cycles ended by miscarriage with subsequent IVF cycles in relation to various IVF cycle parameters and pregnancy termination modalities. Comparison of pre-miscarriage to post-miscarriage IVF cycles parameters demonstrated that lower peak E2 levels (1087 ± 593 versus 1237 ± 676 pg/ml, respectively; p < 0.05) were achieved in the post miscarriage cycles despite higher total gonadotropin consumption (2341 ± 1488 versus 2115 ± 1101 IU; p <0.05). A greater endometrial thickness (10.4 ± 2.16 versus 9.98 ± 1.74 mm, respectively; p < 0.05) and a higher number of embryos (4.62 ± 2.63 versus 3.78 ± 2.54, respectively; p < 0.05) were observed in the pre-miscarriage cycles. A comparison of IVF parameters between the first and second IVF cycles following miscarriage showed an increase in peak estradiol level (954 ± 800 and 1257 ± 838 pg/ml, respectively; p < 0.05), an increased number of retrieved oocytes (7.38 ± 4.2 and 10.49 ± 4.99, respectively; p < 0.05), more fertilized embryos (3.87 ± 2.38 and 5.66 ± 3.64, respectively; p < 0.05), and an increase in the conception rate (34.7% versus 42.2%, respectively) at the second post-miscarriage IVF cycle.
Highlights
The aim of this study was to compare the in vitro fertilization (IVF) cycles ended by miscarriage with subsequent IVF cycles in relation to various IVF cycle parameters and pregnancy termination modalities
There is no solid data to compare the incidence of miscarriage in spontaneous versus IVF pregnancies, but it is generally accepted that the incidence of miscarriage is slightly higher after IVF treatment [2] [3]
The following IVF cycle parameters have been compared between the pre-miscarriage and post-miscarriage cycles: endometrial thickness, peak estradiol (E2) levels, total gonadotropin consumption per cycle, number of oocytes retrieved, number of fertilized eggs, number of cleavage embryos
Summary
Once a spontaneous pregnancy loss has been diagnosed, there are three forms of management: expectant, medical, or surgical. Surgical management involves sharp curettage, vacuum aspiration, or a combination of both [7] It is used in 80% of the cases, and considered the most common procedure used to manage spontaneous miscarriages. Medical management is an excellent alternative for women desiring minimal intervention Such management is successful in 66% to 99% of women with incomplete or delayed pregnancy loss in the first trimester. Little is known about the post-medical miscarriage complications, there are still controversies in different studies. The objective of the present study was to address the widespread discrepancy of outcomes of IVF cycles after miscarriages and to investigate the impact of medical, surgical, and expectant miscarriage management after IVF on the subsequent IVF treatment outcome
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