Failed In Vitro Fertilization Cycles Research Articles

Delivery rates after in-vitro fertilization following bilateral salpingectomy due to hydrosalpinges: a case control study.

This retrospective case-control study assessed the impact of bilateral salpingectomy due to uni- or bilateral hydrosalpinges on the outcome of in-vitro fertilization (IVF) in a large consecutive series of patients. The effect of bilateral salpingectomy due to hydrosalpinges on pregnancy outcome was compared in 139 patients (263 cycles) and 139 age-matched controls with tubal infertility without hydrosalpinges (296 cycles). The delivery rates per initiated cycle as well as the implantation rates were equal in the two groups (21.7 versus 21.6% and 19 versus 21%). The number of embryos, the cleavage stage, and the embryo morphology score were equal in the two groups. Among 92 patients treated with 182 IVF cycles who underwent salpingectomy between 1.5 and 5 years prior to their first IVF cycle, the delivery and the implantation rates were 22.5 and 20.5% respectively. Of the patients with salpingectomy after an average of 1.7 failed IVF cycles and who re-entered the IVF programme 3 and 6 months subsequent to surgery, 47 were treated with 83 IVF cycles. The live birth and the implantation rates after surgery in this group were 20.5 and 20% respectively. It is concluded that bilateral salpingectomy due to hydrosalpinges restores a normal delivery as well as implantation rate after IVF treatment compared to controls. A favourable outcome is also found in patients operated on after repeated IVF failures. Furthermore, a normal live birth rate as well as a high implantation rate is maintained for at least three IVF cycles subsequent to surgical treatment.

Antiphospholipid antibodies in women having in-vitro fertilization.

Antiphospholipid antibodies have an established association with pregnancy complications such as recurrent miscarriage, growth retardation, placental abruption and stillbirth but their mechanism of action is unclear. We have investigated whether antiphospholipid antibodies occur more frequently in women having in-vitro fertilization (IVF) and whether their presence is associated with the likelihood of failed implantation. We studied 240 women undergoing IVF treatment who were </=38 years and had attempted fewer than three previous IVF cycles. Antiphospholipid antibodies (anticardiolipin and antiphosphatidyl serine immunoglobulin G and immunoglobulin M) were present in 36 out of 240 (15%) of the study population and were not associated with a failed IVF cycle or miscarriage. There was no association between the cause of infertility and the presence of antiphospholipid antibodies. Antiphospholipid antibodies were not detected more frequently in women with previous attempts at IVF compared with women having their first cycle, indicating that the high incidence of these antibodies is not due to the IVF treatment. There was a strong association between the presence of antiphospholipid antibodies and intrauterine growth retardation in singleton pregnancies (P < 0.005). We recommend routine screening for the presence of antiphospholipid antibodies in women having IVF in order to identify those pregnancies at increased risk of intrauterine growth retardation.

Perceived support and counselling needs in relation to in vitro fertilization.

This paper reports findings from a study investigating perceived support and desire for support in a sample of 101 men and 117 women who were consecutive referrals to an in vitro fertilization (IVF) clinic. Both men and women perceived their partners as providing the most support and there were only small gender differences in the extent to which other people were perceived as supportive. There were also only modest gender differences in the types of support participants felt to be desirable and both men and women felt that support would be most desirable after a failed IVF cycle. Both men and women also felt that a routinely provided information booklet about the practical aspects of IVF would improve knowledge of and passage through an IVF cycle. There was a tendency for women who expressed a desire for some form of counselling or support to obtain higher General Health Questionnaire scores. Implications of the results for counselling provision are discussed.

Evidence for maternal predisposition to chromosome aneuploidy in multiple oocytes of some in vitro fertilization patients

To assess the rate of chromosome aneuploidy (e.g., extra or missing chromosomes) in oocytes remaining unfertilized in our in vitro fertilization (IVF) program. To determine whether two parameters of the IVF technique, advanced maternal age and hormonal follicle stimulation, affect this rate. Data on oocyte retrieval, fertilization, and aneuploidy rates are analyzed to test for possible relations with maternal age and two hormonal stimulation regimens. Patients of our IVF program from 119 stimulated cycles over 8 months. In vitro fertilization patients selected for having oocytes (1 to 18) remaining unfertilized after insemination in vitro. Advanced maternal age decreases both the number of retrieved oocytes and the fertilization rate, but hormonal treatments have no effect. Aneuploidy (rate 27%), involving group G most frequently, appears associated with advanced age. Patients who were previously parous produced significantly reduced numbers of aneuploid oocytes compared with the nonparous group. A significant excess (P = 0.01) of patients had multiple oocytes all alike (all haploid or all aneuploid), showing correlation among multiple oocytes of a patient in chromosome status. Maternal age affects reproductive performance and is related to specific chromosomal aneuploidy. Women who were previously parous are more likely to produce normal oocytes than nonparous women; oocyte normality therefore may improve the chance for a future successive pregnancy. Nonrandomness in chromosome abnormality of some patients' multiple oocytes is evidence for maternal predisposition to meiotic nondisjunction. Consequently, these patients are at risk for failed IVF cycles.

IVF pregnancy and delivery following ultrasound scan guided aspiration of a left hydrosalpinx - A case report

The presence of hydrosalpinges is known to significantly reduce the pregnancy and implantation rates following in vitro fertilization (IVF). Salpingectomy or laparoscopic tubal occlusion before IVF have been shown to significantly improve pregnancy rates. Aspiration of the hydrosalpinges at the time of oocyte retrieval for IVF had been proposed as a viable alternative. We present a 36- year old nullipara with unilateral hydrosalpinx who declined salpingectomy prior to IVF treatment and subsequently had two failed IVF cycles. She however became pregnant with the third IVF attempt, following transvaginal ultrasound scan guided aspiration of the hydrosalpinx fluid at the time of oocyte retrieval. Large randomized trials are needed to clearly identify the place of ultrasound scan guided aspiration of hydrosalpinges on IVF outcome.