Donor Oocyte In Vitro Fertilization Research Articles

Outcomes of Frozen Oocyte Donor In Vitro Fertilization (IVF) Cycles Using Fresh Versus Frozen Sperm.

The ability to use frozen sperm for insemination during in vitro fertilization (IVF) is crucial for patients and for reproductive endocrinologists. However, concerns exist regarding the effects of cryopreservation on sperm quality and IVF outcomes. This study compares outcomes of frozen donor oocyte IVF cycles with intracytoplasmic sperm injection (ICSI) of good quality fresh versus frozen ejaculated sperm. Patients who underwent their first frozen donor oocyte IVF cycle between 2013 and 2019 at Mayo Clinic were identified. The primary outcome was live birth rate (LBR). Secondary outcomes included fertilization rate (FR), blastocyst development rate (BR), and clinical pregnancy rate (CPR). Twenty-six patients used fresh sperm and 19 patients utilized frozen sperm; there were no significant demographic differences between the groups. There were no significant differences noted in CPR, FR, and BR. Although the LBR was not statistically different when frozen versus fresh sperm was utilized (52.6% vs. 61.5%, p = 0.55), there was a distinct trend towards improved outcomes with fresh sperm that may be clinically significant. This data suggests that frozen sperm may be an alternative to a fresh sample, however fresh sperm may ultimately be a better option. This finding should be further explored with studies utilizing a larger sample size.

Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline

To provide evidence-based recommendations to practicing physicians and others regarding the efficacy of oocyte cryopreservation (OC) for donor oocyte invitro fertilization and planned OC. The American Society for Reproductive Medicine conducted a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1986 to 2018. The American Society for Reproductive Medicine Practice Committee and a task force of experts used available evidence and through consensus developed evidence-based guideline recommendations. Outcomes of interest included live birth rate, clinical pregnancy rate, obstetrical and neonatal outcomes, and factors predicting reproductive outcomes. The literature search identified 30 relevant studies to inform the evidence base for this guideline. Evidence-based recommendations were developed for predicting the likelihood of live births after planned OC, autologous OC in infertile women, and donor OC, as well as factors that may impact live birth rates. Recommendations were developed regarding neonatal outcomes after using fresh vs. cryopreserved oocytes in cases of autologous or donor oocytes. There is insufficient evidence to predict live birth rates after planned OC. On the basis of limited data, ongoing and live birth rates appear to be improved for women who undergo planned OC at a younger vs. older age. Although there are no significant differences in per transfer pregnancy rates with cryopreserved vs. fresh donor oocytes, there is insufficient evidence that the live birth rate is the same with vitrified vs. fresh donor oocytes. Neonatal outcomes appear similar with cryopreserved oocytes compared with fresh oocytes. Future studies that compare cumulative live birth rates are needed.

Pregnancy in Older Women: Analysis of Outcomes in Pregnancies from Donor oocyte In- vitro Fertilization.

Background:As the number of older women attempting to conceive through donor oocyte-in vitro fertilization (DO-IVF) rises, their safety in pregnancy needs to be judiciously considered.Aims:This study aims to review the obstetric and perinatal outcomes of pregnancies achieved by DO-IVF.Study Setting and Design:A retrospective study design conducted at a private health facility with services for assisted reproduction and gynecologic endoscopy.Methods:A retrospective comparative study of all pregnancies achieved using DO-IVF and that using Self oocyte In-vitro fertilization (SO-IVF) treatment over a 3 years' period was performed.Statistical Analysis:Comparative analysis of demographic variables, major obstetric, and perinatal complications was done with Chi-square test and Student's t-test as appropriate. Regression analysis was done to determine a significant predictor variable for pregnancy and delivery outcome. The significance level was set at P < 0.05.Results:A total of 343 completed IVF treatment cycles was reviewed; there were 238 DO-IVF and 105 SO-IVF cycles, with clinical pregnancy rate of 41.6% and 37.1%, respectively. The DO-IVF group was significantly older than the SO-IVF group (46.1 years vs. 34.1 years, P < 0.001). Major obstetric complications identified, were hypertensive disorders in pregnancy (23.9%), preterm labor (16.7%), antepartum hemorrhage (11.6%). There was no statistically significant difference between the two groups in terms of obstetric complications and adverse maternal or perinatal outcomes. There were 97 (77.6%) singleton and 28 (22.4%) multiple pregnancies. Pregnancy complications were significantly associated with fetal plurality, P < 0.001. Multiple pregnancy had higher odds of experiencing adverse perinatal 4.96 (1.95–12.58) and maternal 7.16 (2.05–25.03) outcomes compared to singleton pregnancies, P < 0.001.Conclusion:Key obstetric outcomes did not differ between DO or SO IVF achieved pregnancy. Even for older women, satisfactory outcomes can be expected for pregnancies achieved by DO-IVF. It is, however, instructive that for multiple pregnancies, obstetricians should institute appropriate surveillance strategies during pregnancy and delivery period and also to develop institutional capacity for quality neonatal care.

Cost-effectiveness of preimplantation genetic testing for aneuploidy for fresh donor oocyte cycles

ObjectiveTo determine whether in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) is cost effective to achieve a live birth compared with IVF alone in fresh donor oocyte cycles.DesignTheoretical cost-effectiveness study.SettingNot applicable.Patient(s)None.Intervention(s)Comparison between the cost of IVF with PGT-A vs. IVF alone to achieve a live birth. The model analyzed a hypothetical single fresh oocyte donor IVF cycle with PGT-A vs. IVF alone and followed the progression of a single embryo through the different decision nodes. Cost estimates assigned to each clinical event were based on data obtained from the literature and institutional costs.Main Outcome Measure(s)Cost per live birth.Result(s)In the base-case analysis, IVF with PGT-A was not cost effective in fresh donor oocyte cycles when compared with IVF alone to achieve a live birth. The cycles using PGT-A cost an additional $6,018.66. The incremental cost-effectiveness ratio was found to be $119,606.59 per additional live birth achieved with IVF with PGT-A. Monte Carlo simulations demonstrated that IVF with PGT-A was not cost effective in nearly all iterations.Conclusion(s)PGT-A in fresh donor oocyte IVF cycles is not cost effective compared with IVF alone over a wide range of probabilities and costs.

Impact of male partner characteristics and semen parameters on in vitro fertilization and obstetric outcomes in a frozen oocyte donor model

To examine the degree to which paternal variables of age, body mass index (BMI), and sperm parameters affect vitrified donor oocyte IVF outcomes. Previous studies examining the impact of male partner characteristics on in-vitro fertilization (IVF) have found conflicting results. Concerns are rising over the potential effects of paternal factors, such as age and obesity, on pregnancy and child health. Frozen donor oocyte IVF offers an ideal model to study these effects. Retrospective chart review. Private fertility clinic. Nine hundred forty-nine recipients undergoing transfer of blastocyst embryo(s) from a vitrified oocyte donor bank between 2008-2015. None. Implantation rate, clinical pregnancy rate, live birth rate, rate of low birth weight singleton infants (≤2500g), and preterm deliveries (PTD) of singleton infants (<37wk). After adjusting for covariates known to affect oocyte donation cycle success, male age, BMI and sperm parameters were not associated with differences in IVF outcomes. There were higher PTD rates for men ≥51years and BMI ≥35kg/m2, however, these were not significant after adjustment. There were no differences in rates of low birth weight infants with men >35years or BMI >25kg/m2. Lastly, there were no differences in rates of PTD or low birth weight infants with abnormal sperm parameters. Neither advancing male age, elevated BMI, nor poor sperm quality were associated with outcomes in frozen donor oocyte IVF cycles in this study. Intracytoplamic sperm injection and "oocyte quality" likely mitigate some of the effects of male variables on outcomes following cryopreserved oocyte donation.

Comparison of Obstetric Outcomes of Pregnancies after Donor-Oocyte In vitro Fertilization and Self-Oocyte In vitro Fertilization: A Retrospective Cohort Study.

Aims:The aim of this study is to evaluate and compare multiple obstetric and perinatal outcomes between donor-oocyte in vitro fertilization (IVF) and self-oocyte IVF group.Settings and Design:This study was done in a tertiary care center with ART unit. This was a retrospective comparative cohort study.Materials and Methods:The present study comprised all women between 20 and 45 years who conceived from oocyte donation (n = 78) between December 1, 2010, and December 31, 2016, and compared with all women who underwent self-oocyte IVF (n = 112). The process involved controlled ovarian stimulation and retrieval of the donor oocytes, preparation of recipient endometrium, and pregnancy management. Obstetric and perinatal outcomes were compared.Statistical Analysis Used:Chi-square test was used for categorical variables. Analysis for confounding variables was performed using multivariable linear and logistic regression analysis.Results:Baseline characteristics between the two groups were comparable. Miscarriage, first-trimester bleeding, pregnancy-induced hypertension (PIH), and gestational diabetes mellitus were significantly higher in donor-oocyte IVF group compared to self-oocyte cycles (P = 0.001). Using multiple logistic regression analysis, age class adjusted PIH incidence was significantly higher in donor-oocyte group as compared to self-oocyte group (P = 0.010). There was no significant variation in perinatal outcomes between the donor- and self-oocyte IVF cycles (P > 0.05).Conclusion:Oocyte donation should be treated as an independent risk factor for PIH.

Pregnancy outcomes decline in recipients over age 44: an analysis of 27,959 fresh donor oocyte in vitro fertilization cycles from the Society for Assisted Reproductive Technology

To use a large and recent national registry to provide an updated report on the effect of recipient age on the outcome of donor oocyte in vitro fertilization (IVF) cycles. Retrospective cohort study. United States national registry for assisted reproductive technology. Recipients of donor oocyte treatment cycles between 2008 and 2010, with cycles segregated into five age cohorts: ≤34, 35 to 39, 40 to 44, 45 to 49, and ≥50 years. None. Implantation, clinical pregnancy, live-birth, and miscarriage rates. In donor oocyte IVF cycles, all age cohorts ≤39 years had similar rates of implantation, clinical pregnancy, and live birth when compared with the 40- to 44-year-old reference group. Patients in the two oldest age groups (45 to 49, ≥50 years) experienced statistically significantly lower rates of implantation, clinical pregnancy, and live birth compared with the reference group. Additionally, all outcomes in the ≥50-year-old group were statistically significantly worse than the 45- to 49-year-old group, demonstrating progressive decline with advancing age. Recent national registry data suggest that donor oocyte recipients have stable rates of pregnancy outcomes before age 45, after which there is a small but steady and significant decline.

Pregnancy outcomes decline in recipients over age 44: an analysis of 27,959 fresh donor oocyte in vitro fertilization (IVF) cycles from the society for assisted reproductive technology (SART)

To use a large and recent national registry to provide an updated report on the effect of recipient age on the outcome of donor oocyte IVF cycles. Retrospective cohort study. We utilized data from the 2008-2010 SART registry. A total of 27,959 donor oocyte IVF cycles were analyzed. Donor oocyte recipients were segregated into 5 age cohorts: ≤34, 35-39, 40-44, 45-49, and ≥50. We compared implantation, clinical pregnancy (CP), and live birth (LB) rates between all groups. Multivariate logistic regression and independent t-test were used. Odds ratios were calculated using 40-44yo as the reference group (RG). Results were adjusted for donor age, number of oocytes retrieved and number of embryos transferred. In donor oocyte IVF cycles, all age cohorts ≤39yo had similar rates of implantation, CP and LB when compared to the 40-44yo RG. Patients in the two oldest age groups (45-49yo, >50yo) experienced significantly lower rates of implantation, CP and LB compared to the RG. Additionally, all outcomes in the >50yo group were significantly worse than the 45-49yo group, demonstrating progressive decline with advancing age.Tabled 1Pregnancy outcomes of donor oocyte recipients stratified by age≤34yo35-39yo40-44yo [reference]45-49yo≥50yon2,9875,92012,2185,872962Implantation % [OR]46.5 [1.06]145.5 [1.02]145.843.4 [0.89]340.9 [0.81]3Clinical Pregnancy % [OR]64.9 [1.02]165.4 [1.04]164.762.8 [0.92]259.9 [0.81]3Live Birth % [OR]56.7 [1.05]155.7 [1.00]155.852.7 [0.88]348.6 [0.75]3Key: 1=Not significant; 2=p≤0.01; 3=p≤0.002. Open table in a new tab Key: 1=Not significant; 2=p≤0.01; 3=p≤0.002. Recent national summary data suggests that donor oocyte recipients have stable rates of pregnancy outcomes prior to age 45, after which there is a small but steady and significant decline. For patients in their 40s considering donor egg therapy, it is reasonable to discuss timely intervention, not only to minimize maternal morbidities, but also to avoid the decline in pregnancy outcomes that begins at age 45 and worsens with increased age.

Low utilization of extra embryos in donor oocyte in vitro fertilization cycles: an ethical dilemma to donor management

To explore outcomes of donor In Vitro Fertilization (IVF) cycles with regards to cryopreservation and utilization of extra embryos after fresh transfer. A database search was performed to identify all consecutive fresh donor oocyte cycles from January 1, 2000 to December 31, 2010 at a private fertility laboratory. Parameters analyzed included: number of oocytes retrieved, number of patients choosing embryo cryopreservation, number of patients returning for frozen embryo transfer (FET), and pregnancy outcomes. A total of 1070 fresh oocyte donor cycles were identified. Average number of oocytes retrieved was 16.9 ± 7.9, and average number of embryos transferred was 2.3 ± 0.96. Sixty-six percent of patients cryopreserved excess embryos following fresh transfer, and only 40 % of these patients ultimately returned for FET. Patients who conceived in their fresh cycle were much less likely to return for FET than those who did not (25 % v 65 %, p < 0.001), however chance of conceiving with FET was no different between these two groups (38 % v 38 %, NS). An unexpectedly low number of patients undergoing a donor oocyte IVF cycle will ultimately return to utilize extra embryos from their fresh cycle. This is concerning considering the high numbers of oocytes retrieved and the known complications from hyperstimulation, especially in light of the relatively high pregnancy rates associated with donor cycles. This raises concerns not only for donor management, but also raises ethical dilemmas when considering the large numbers of remaining embryos that will never be utilized.

Is the use of a GnRH antagonist stimulation protocol inferior to a GnRH agonist in donor oocyte IVF?

OBJECTIVE: Our hypothesis was that Gonadotropin-releasing hormone antagonist (GnRHant) protocols are not inferior to Gonadotropin-releasing hormone agonist (GnRHa) protocols in terms of in vitro fertilization (IVF) outcomes using donor oocytes. GnRHa have reduced the incidence of premature LH surges and cancelled IVF cycles, while increasing pregnancy rates. They are, however, associated with an increased duration of stimulation and dosage requirement for gonadotropins. The use of GnRHant has offered an alternative strategy to reducing the incidence of premature LH surges and ovarian hyperstimulation syndrome (OHSS).

Familial recurrent molar pregnancy: a case report

Familial recurrent molar pregnancy: a case report