Pregnancy Rate In Group Research Articles

The impact of low oocyte maturity ratio on blastocyst euploidy rate: a matched retrospective cohort study

ObjectiveTo investigate the association between a low oocyte maturity ratio from in vitro fertilization cycle and blastocyst euploidy.MethodsA total of 563 preimplantation genetic testing (PGT) cycles (PGT cycles with chromosomal structural rearrangements were excluded) were performed between January 2021 and November 2022 at our center (average oocyte maturity rate: 86.4% ± 14.6%). Among them, 93 PGT cycles were classified into the low oocyte maturity rate group (group A, < mean − 1 standard deviation [SD]), and 186 PGT cycles were grouped into the average oocyte maturity rate group (group B, mean ± 1 SD). Group B was 2:1 matched with group A. Embryological, blastocyst ploidy, and clinical outcomes were compared between the two groups.ResultsThe oocyte maturity (metaphase II [MII oocytes]), MII oocyte rate, and two pronuclei (2PN) rates were significantly lower in group A than in group B (5.2 ± 3.0 vs. 8.9 ± 5.0, P = 0.000; 61.6% vs. 93.0%, P = 0.000; 78.7% vs. 84.8%, P = 0.002, respectively). In group A, 106 of 236 blastocysts (44.9%) that underwent PGT for aneuploidy were euploid, which was not significantly different from the rate in group B (336/729, 46.1%, P = 0.753). However, euploid blastocysts were obtained only in 55 cycles in group A (55/93, 59.1%), which was lower than the rate in group B (145/186, 78.0%, P = 0.001). The clinical pregnancy rate in group B (73.9%) was higher than that in group A (58.0%) (P = 0.040).ConclusionOur results suggest that a low oocyte maturity ratio is not associated with blastocyst euploidy but is associated with fewer cycles with euploid blastocysts for transfer, lower 2PN rates, and lower clinical pregnancy rates.

Efficacy of postsurgical medical therapy for infertile patients with deep endometriosis.

Though laparoscopic surgery is effective for the treatment of deep endometriosis (DE), postoperative management remains controversial. Dienogest therapy after surgery may improve spontaneous pregnancy rates and decrease the severity of dysmenorrhea in infertile patients with DE. To determine the efficacy of postsurgical therapy with dienogest for improving fertility and reducing the intensity of dysmenorrhea in infertile patients with DE. This open label, randomized controlled trial was conducted involving 88 women aged 21-38 years with infertility who underwent surgery for DE. Three patients were lost to follow-up. After surgery, eligible patients were randomly divided into two groups. Forty-four patients who received dienogest for three months following surgery were enrolled in group 1. The remaining 41 patients comprised group 2 and did not receive any postsurgical treatment over the same period. The primary outcome measure was the pregnancy rate calculated nine months after surgery, while the mean intensity of dysmenorrhea was measured before and nine months after surgery. The pregnancy rate in group 1 was significantly higher than in group 2 (47.7% vs 22%, p = 0.013) nine months following surgical intervention. Patients in group 1 exhibited a more statistically significant reduction in the mean score of dysmenorrhea intensity compared to group 2, from 8.7 to 2.8 vs 8.76 to 5.63, respectively (p < 0.001). The use of dienogest as an add-on therapy for treating DE may show significantly higher effectiveness compared to surgical intervention alone for improving fertility and reducing the severity of dysmenorrhea.

Immunomodulatory Treatment Impact on IVF Outcomes in KIR AA Genotype: Personalized Fertility Insights.

Background and Objectives: Recurrent implantation failure (RIF) affects 10% of couples undergoing in vitro fertilization (IVF), spurring exploration into tailored treatments to enhance implantation rates. Maternal immune tolerance towards embryos, particularly killer-cell immunoglobulin-like receptors (KIRs) on natural killer (NK) cells, is a focal point in RIF research. Materials and Methods: This retrospective cohort study, conducted at fertility clinic in Oradea, Romania, involved 65 infertile couples undergoing IVF treatment between January 2022 and December 2023. Couples were divided into two groups: KIR AA (Group A) and KIR Bx (Group B). Results: Factors such as age, type of infertility, oocytes retrieved, embryos produced, pregnancy rates in Group A without and with immunomodulatory treatment were documented. Group A, receiving immunomodulatory treatment, achieved a pregnancy rate of 47.8%, significantly higher than the 23.73% rate without treatment (p = 0.008). Group B had a higher mean patient age than Group A. However, miscarriage rates did not significantly differ between Group A with treatment and Group B (p = 0.2457), suggesting comparable outcomes with immunomodulation. Conclusions: The impact of immunological factors on recurrent implantation failure is being more and more emphasized and warrants the attention of specialists in human reproduction. Uterine natural killers and their function though KIR receptors deserve particular attention as immunomodulatory treatment may improve pregnancy rates in patients with KIR AA haplotype.

The Effectiveness of Intrauterine Treatment with Momordica charantia L. on Some Hormone Parameters in Repeat Breeder Cattle

Background: Repeated breeding is a substantial problem in dairy cattle affecting reproductive efficiency. The goal of the current study was to see how intrauterine treatment of phytotherapeutic plant extract affected some hormonal indicators and conception rates in dairy cattle with fertility issues. Methods: In the study, 40 repeat breeder (RB) cattle were randomly divided into two groups. Forty ml (0.25 g/mL) Momordica charantia L. (MC) extract was administered intrauterine to cattle in group I (n=20) and 40 ml of pure olive oil was administered intrauterine to cattle in group II (n=20) at a time. The control group, group III (n=20), was composed of healthy heifers. Endometrial smear samples were taken from all RB cattle for cytological examination before the treatment and all were stained with Giemsa. Estradiol (E2), progesterone (P4) and insulin-like growth factor (IGF-1) levels were assessed by collecting blood samples starting from intrauterine treatment on days 0, 7 and 14. After the last blood sample was collected, the estrus cycles of all cattle were synchronized through a double dose of PGF2α administration at 14-day intervals. GnRH was administered with single insemination at the 60th hour following the second PGF2α treatment. Result: Subclinical endometritis was determined in 82.5% (33/40) of RB cattle. Pregnancy rates in group I, group II and group III were determined as 55%, 35% and 35%.respectively.(P greater than 0.05). There was no significant difference in E2 values according to time and between groups. For P4, there were also no significant differences between three time-dependent measurements, but there was a difference in the 7th and 14th days of the groups (P less than 0.01). For IGF-1, significant differences were found between the three time-dependent measurements of the groups (P less than 0.001). In conclusion, it was observed that the MC extract treatment, especially in RB with SCE, can improve the pregnancy rate by positively affecting the increase in IGF-1 which is a key element of the extremely complex endocrine system.

Clinical application of the endometrial microbiota test combined with personalized treatment in patients with repeated implantation failure

Objective: The objective of this study was to investigate the clinical value of the endometrial microbiota test (EMT) combined with personalized treatment in patients with repeated implantation failure (RIF). Methods: From March 2019 to August 2022, the clinical data of patients with RIF at the Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. A total of 356 patients underwent the EMT using 16S rRNA sequencing and were included in the EMT group. The SPSS statistical software propensity score was set at 1:1 to match the age, anti-Müllerian hormone (AMH), antral follicle count (AFC), years of infertility, and body mass index (BMI) of the women who had not undergone the EMT; subsequently, 354 patients were classified in the non-EMT group. We compared the clinical characteristics of the two groups and analyzed the clinical pregnancy outcomes after personalized treatment. Results: The clinical pregnancy rate (CPR) of the EMT group was significantly higher than that of the non-EMT group (47.81% vs. 13.38%, P &lt;0.05). Among 356 patients who underwent the EMT, 55 patients (15.45%) in group A with normal endometrial microbiota composition did not test positive for the pathogenic bacteria causing chronic endometritis, 34 patients (9.55%) in group B with abnormal endometrial microbiota composition did not test positive for the pathogenic bacteria causing chronic endometritis, 35 patients (9.83%) in group C with normal endometrial microbiota composition tested positive for the pathogenic bacteria causing chronic endometritis, and 232 patients (65.17%) in group D with abnormal endometrial microbiota composition tested positive for the pathogenic bacteria causing chronic endometritis. After administration of probiotics or antibiotic plus probiotics treatment, the pregnancy rates of groups C and D were higher than those of group A (44.00% vs. 20.00% and 55.03% vs. 20.00%, respectively; both P &lt;0.05). Conclusion: The EMT combined with personalized treatment in patients with RIF has solid clinical value as a new treatment strategy.

Effects of localization of uterine adenomyosis on clinical features and pregnancy outcome

The purpose of this study was to implore the association among clinical features, long-term fertility outcomes and the anatomical location of adenomyosis identified by ultrasound. We collected data of non-pregnant patients between 20 and 40 years old who had undergone surgical exploration for benign gynecological conditions at our institution between January 2010 and December 2017. A total of 158 women met the inclusion criteria and were allocated into three groups according to the ultrasound-determined adenomyosis anatomical location: anterior (Group A), posterior (Group B), both posterior and anterior (Group C). 44.3% (70/158) adenomyosis was located at the posterior side. History of miscarriage and parity were significantly higher in Group C (p = 0.036 and 0.001 respectively). Group C also had a higher concurrence rate of ovarian endometrioma (OEM) (80.4%, p = 0.002), pelvic adhesion (80.4%, P = 0.003) and the revised American Fertility Society (rAFS) Score (median64, range2-100, P < 0.001), while a significantly lower rate of concurrent peritoneal endometriosis (P = 0.01). Group B showed a relative higher rate of coexistent heavy menstrual bleeding (28.6%, p = 0.04) and oviduct obstruction (24.3%, P = 0.038). Group A had a higher proportion of coexistent leiomyoma (53.1%, P = 0.002). There were no significant differences between group A, B, and C in terms of pain symptoms, endometrial polyps, operation time, and endometriosis fertility index score and other basic characters (p > 0.05). During the follow-up, 59.2% (61/103) patients had clinical pregnancies, and 26.2% (16/61) of them experienced pregnancy loss. Total in vitro fertilization and embryo transfer pregnancy rate was 64.6% (42/65) and spontaneous pregnancy rate was 50.0% (19/38). The Kaplan–Meier curves demonstrated significant lower cumulative pregnancy rate in Group C than Group A and Group B (p = 0.01). Severe obstetric complications such as placenta previa, placenta accreta, preeclampsia, and preterm birth were only found in women with adenomyosis located in the posterior side. In conclusion, types of adenomyosis based on sonographic location had different clinical features and pregnancy outcome. Patients with adenomyosis lesion in both anterior and posterior sides had higher combination of OEM, pelvic adhesion and rAFS score.

P-314 PlasmaShotting: a new method of treating “thin” endometrium

Abstract Study question Is a new method of subendometrial platelet-rich plasma (PRP) injection (PlasmaShotting) effective in patients with “thin” endometrium? Summary answer PlasmaShotting showed higher efficiency in the group of patients with “thin” endometrium compared to conventional intrauterine infusion of platelet-rich plasma What is known already The problem of “thin” endometrium is one of the urgent challenges of modern reproductive medicine. In patients suffering from this condition, there is a decrease in the pregnancy rate and an increase in miscarriage rates. “Thin” endometrium is less than 7 mm according to ultrasound. To correct this condition, many methods have been proposed: hormone replacement therapy with high doses of estrogens, aspirin, GnRH agonists, vitamin E, pentoxifylline, sildenafil, intrauterine infusion of colony-stimulating factors (G-CSF) and PRP, but none of the proposed methods has shown enough effectiveness. Study design, size, duration To evaluate the effectiveness of PlasmaShotting we organized a study that included 72 people. Inclusion criteria were age less than 40 years, endometrial thickness less than 6.5 mm on days 8-10 of hormone replacement therapy, and 3 or more unsuccessful embryo transfers of excellent quality embryos before. Participants/materials, setting, methods The patients were divided into 2 groups: Group 1 (23 patients) underwent hysteroscopy with submucosal injections of platelet-rich plasma (PRP - PlasmaShotting) on days 10-12 of the cycle. Group 2 (49 patients) underwent intrauterine infusion of platelet-rich plasma (PRP) on days 10-12 of the cycle Main results and the role of chance The clinical pregnancy rate in group 1 was 47.8% (n = 11), and in group 2 was 34.6% (n = 17). The live births rate in group 1 was 34.7% (n = 8), and in group 2 was 20.4% (n = 10). The miscarriage rate was in group 1 was 13.1% (n = 3), and in group 2 was 14.2% (n = 7) Limitations, reasons for caution The research on the effectiveness of PlasmaShotting should be continued Wider implications of the findings PlasmaShotting as a new method of treating “thin” endometrium can be used in patients who can't achieve pregnancy Trial registration number not applicable

Early Detection of Isolated Severe Congenital Heart Defects Is Associated with a Lower Threshold to Terminate the Pregnancy

Introduction: Early detection of isolated severe congenital heart defects (CHDs) allows extra time for chromosomal analysis and informed decision making, resulting in improved perinatal management and patient satisfaction. Therefore, the aim of this study was to assess the value of an additional first-trimester screening scan compared to only a second-trimester scan in fetuses diagnosed with isolated severe CHDs. Prenatal detection rate, time of prenatal diagnosis, and pregnancy outcome were evaluated in the Netherlands after implementation of a national screening program. Materials and Methods: We performed a retrospective geographical cohort study and included 264 pre- and postnatally diagnosed isolated severe CHD cases between January 1, 2007, and December 31, 2015, in the Amsterdam region. Severe CHD was defined as potentially life threatening if intervention within the first year of life was required. Two groups were defined: those with a first- and second-trimester anomaly scan (group 1) and those with a second-trimester anomaly scan only (group 2). A first-trimester scan was defined as a scan between 11 + 0 and 13 + 6 weeks of gestation. Results: Overall, the prenatal detection rate for isolated severe CHDs was 65%; 63% were detected before 24 weeks of gestation (97% of all prenatally detected CHDs). Prenatal detection rate was 70.2% in the group with a first- and second-trimester scan (group 1) and 58% in the group with a second-trimester scan only (group 2) (p < 0.05). Median gestational age at detection was 19 + 6 (interquartile range [IQR] 15 + 4 – 20 + 5) in group 1 versus 20 + 3 (IQR: 20 + 0 – 21 + 1) in group 2 (p < 0.001). In group 1, 22% were diagnosed before 18 weeks of gestation. Termination of pregnancy rate in group 1 and group 2 were 48% and 27%, respectively (p < 0.01). Median gestational age at termination did not differ between the two groups. Conclusion: Prenatal detection rate of isolated severe CHDs and termination of pregnancy rate was higher in the group with both a first- and second-trimester scan. We found no differences between timing of terminations. The additional time after diagnosis allows for additional genetic testing and optimal counseling of expectant parents regarding prognosis and perinatal management, so that well-informed decisions can be made.

Construction and evaluation of intrauterine adhesion model in rats by different methods of mechanical injury.

The study aimed to establish a stable and effective animal model for the experimental study of intrauterine adhesion (IUA) by evaluating various mechanical injury methods. A total of 140 female rats were divided into four groups according to the extent and area of endometrial injury: group A (excision area: 2.0 × 0.5 cm2), group B (excision area: 2.0 × 0.25 cm2), group C (endometrial curettage) and group D (sham operation). On the 3rd, 7th, 15th and 30th day after the operation, the tissue samples of each group were collected, and the uterine cavity stenosis and histological changes were recorded by HE and Masson staining. Immunohistochemistry of CD31 was applied to visualize microvessel density (MVD). The pregnancy rate and the number of gestational sacs were used to evaluate the reproductive outcome. The results showed that endometrium injured by small-area endometrial excision or simple curettage could be repaired.The ratio of fibrosis in groups A and B was higher than that in groups C and group D 30days after modeling (P < 0.001). The number of endometrial glands and MVD in group A was significantly lower than those in groups B, C and D (P < 0.05). The pregnancy rate in group A was 20%, which was lower than that in groups B (33.3%), C (89%) and D (100%) (P < 0.05). Full-thickness endometrial excision has a high rate of success in constructing stable and effective IUA models in rats.

The success rate of intrauterine insemination in sperm preparation swim-up method at room temperature compared to the incubator temperature

HIGHLIGHTS There were no significant differences in TMSC, sperm motility, sperm morphology, and DFI in sperm preparation using the swim-up method at 27°C and 37°C. However, this study provided an overview of the average improvement of DFI at 27°C compared to 37°C. There was no significant difference in the pregnancy rate of IUI in sperm preparation using the swim-up method at 27°C and 37°C. ABSTRACT Objective: This study aimed to determine the effect of temperature during sperm preparation on total sperm motile count (TMSC), sperm motility, sperm morphology, DNA fragmentation index (DFI), and pregnancy rate. Materials and Methods: A quasi-experimental laboratory study with pre- and post-test control group was conducted at Sekar Fertility Clinic, Dr. Moewardi General Hospital, Surakarta, Indonesia. A total of 20 sperm samples from infertile patients were prepared using the swim-up method at 27°C (group 1) and 37°C (group 2). TMSC, motility, morphology, and DFI examinations were performed. In addition, IUI was performed to confirm pregnancy rate. Sperm DNA fragmentation was determined using Sperm Chromatin Dispersion/SpermFunc DNAf test. Sperm DNA fragmentation was characterized by a halo &lt;30% of the volume of the sperm head. Results: Group 1 had mean TMSC of 13.77 ± 9.30, while group 2 had 14.82 ± 8.82; p=0.218. Group 1 had a motility value 82.25+12.77 and group 2 had 82.55 ± 11.69; p=0.968. The morphological value for group 1 was 11.25 ± 5.15 and group 2 was 11.6 ± 5.34; p=0.626. The mean DFI for group 1 was 17.79 ± 10.88 and group 2 was 18.18 ± 12.95; p=0.765. Pregnancy rate in group 1 was 10% and group 2 was 20%; p=1.000. Conclusion: There were no significant differences in TMSC, sperm motility, sperm morphology, DFI, and pregnancy rate in sperm preparation using the swim-up method at 27°C and 37°C.

Intracervical Artificial Insemination using Frozen Semen of Boer buck on Pote Does at Different Times of Estrus

Pote goats are kept by the rural community in Bangkalan Regency, Madura Island, Indonesia. Estrus symptoms in goats are usually unclear, causing low fertility. This study aimed to determine the intracervical artificial insemination at early and mid-estrus on the Pote does. The 24 the does were randomly divided into two groups and estrous synchronization with PGF2α of 200 µg intramuscularly, twice injections with 11 days intervals. The T1 groups of estrus the Pote does were inseminated at early estrus (0-12 hours). Meanwhile, T2 groups of estrus the Pote does were inseminated at mid-estrus (12-24 hours after signs of estrus appeared. The insemination conducted artificially using post-thawed Boer semen. The observed variables were non-return rate at day 21 post-insemination (NRR21), and pregnancy rate (PR) based on abdominal palpation diagnosis. The result showed that post-thawed Boer buck was qualified (sperm motility more than 40%) for artificial insemination. All of the Pote does were estrus after twice PGF2α intramuscular injection with 11 days intervals. The onset of estrus was 48-72 hours after the second injection PGF2α. The NRR21 and PR ranged from 66.66-100% and 37.50-66.66%, respectively. The NRR21 and PR of the T2 group were higher than those of the T1 group. It could be concluded that intracervical artificial insemination on Pote the does at mid-estrus were more effective, resulting in higher NRR21 and PR than those at early estrus.

Intracervical Artificial Insemination using Frozen Semen of Boer buck on Pote Does at Different Times of Estrus

Pote goats are kept by the rural community in Bangkalan Regency, Madura Island, Indonesia. Estrus symptoms in goats are usually unclear, causing low fertility. This study aimed to determine the intracervical artificial insemination at early and mid-estrus on the Pote does. The 24 the does were randomly divided into two groups and estrous synchronization with PGF2α of 200 µg intramuscularly, twice injections with 11 days intervals. The T1 groups of estrus the Pote does were inseminated at early estrus (0-12 hours). Meanwhile, T2 groups of estrus the Pote does were inseminated at mid-estrus (12-24 hours after signs of estrus appeared. The insemination conducted artificially using post-thawed Boer semen. The observed variables were non-return rate at day 21 post-insemination (NRR21), and pregnancy rate (PR) based on abdominal palpation diagnosis. The result showed that post-thawed Boer buck was qualified (sperm motility more than 40%) for artificial insemination. All of the Pote does were estrus after twice PGF2α intramuscular injection with 11 days intervals. The onset of estrus was 48-72 hours after the second injection PGF2α. The NRR21 and PR ranged from 66.66-100% and 37.50-66.66%, respectively. The NRR21 and PR of the T2 group were higher than those of the T1 group. It could be concluded that intracervical artificial insemination on Pote the does at mid-estrus were more effective, resulting in higher NRR21 and PR than those at early estrus.

Effect of acupuncture on the opening time of implantation window and endometrial receptivity in controlled ovarian hyperstimulation rats during peri-implantation period.

To investigate the effect of acupuncture for improving the pregnancy rate of COH rats from the viewpoint of regulating the opening time of the implantation window and endometrial receptivity. Experimental rats were randomly divided into normal group (N), model group (M) and acupuncture group(A), and samples were collected on Day 4, 5 and 6 after mating. COH rats were treated with acupuncture at SP6, LR3, and ST36 once a day for 7 times. The pinopodes were observed under a scanning electron microscope. Serum estrogen and progesterone levels were measured via ELISA. The protein and mRNA levels of estrogen receptor (ER), progesterone receptor (PR), leukemia inhibitory factor (LIF), integrin β3, vascular endothelial growth factor (VEGF), and fibroblast growth factor 2 (FGF-2) in the endometrium were evaluated via West-blot, immunohistochemistry, and PCR. Compared with group N, the pregnancy rate of group M was significantly decreased (P<0.05), and the abnormal serum hormone levels and implantation window advancement were observed. Compared with group M, the pregnancy rate of group A was significantly increased (P<0.05), the supraphysiological serum progesterone levels were restored to normalcy (P<0.05), and the advanced implantation window was restored to a certain extent. Further, the abnormal ER, PR, LIF, integrin β3, VEGF, and FGF-2 expression levels of the endometrium got recovered to varying degrees. Acupuncture may restore the estrogen and progesterone balance in COH rats and the forward shift of the implantation window to a certain extent, improving the endometrial receptivity and finally improving the pregnancy rate of COH rats.

Intrauterine instillation of autologous platelet-rich plasma in infertile females with thin endometrium undergoing intrauterine insemination: an open-label randomized controlled trial

Thin endometrium in infertile female patients has always been a clinical challenge for the treating reproductive physicians. This study aimed to evaluate the effect of intrauterine instillation of autologous platelet-rich plasma on endometrial thickness and vascularity in infertile female patients with thin endometrium undergoing ovarian stimulation with intrauterine insemination. This prospective randomized control study included 120 women undergoing ovarian stimulation with intrauterine insemination, aged between 21 and 37 years, with persistent thin endometrium (<7 mm) on ≥1 cycle in previous ovarian stimulation cycles, even after conventional treatment with estradiol valerate. The women were randomly assigned to study group A and control group B. Baseline endometrial thickness and endometrial vascularity were noted. Intrauterine instillation of autologous platelet-rich plasma was done on the day of trigger in group A, whereas estradiol valerate was given in group B. Another evaluation of endometrial parameters was done on the day of intrauterine insemination. The cycle was repeated for 3 cycles or until the pregnancy was achieved, whichever occurred earlier. Parameters were noted for both groups. Primary outcomes were the change in endometrial thickness and endometrial vascularity. Secondary outcomes were positive pregnancy rate and clinical pregnancy rate. In group A, mean pre-platelet-rich plasma endometrial thickness was 4.66±0.79 mm, which significantly increased to 7.47±0.85 mm after platelet-rich plasma instillation (P<.05) after 3 cycles. This increase was significantly greater than that observed in group B. There was significant increase in endometrial vascularity in group A compared with group B (P<.05). The positive pregnancy rate and clinical pregnancy rate in group A were 23.73% and 18.64%, respectively, and significantly higher than those in group B. Autologous platelet-rich plasma is a promising, easily procurable, and novel option for management of infertile females with thin endometrium not responding to conventional treatment. Using it in intrauterine insemination cycles can reduce costs and psychological burden of this subgroup of women by reducing the need for resorting to advanced options such as in vitro fertilization and surrogacy.

Does Endometrial Compaction Predict Clinical Pregnancy Rate after Cleavage Stage Frozen Embryo Transfer?

Objectives: This study aimed to determine the relationships between endometrial compaction and pregnancy outcome in patients receiving artificial endometrial preparation for frozen embryo transfer (FET) cycles. Materials and Methods: This prospective cohort study was performed in a university-affiliated fertility clinic from March 2020 to March 2021. The eligible women undergoing their first or second FET cycle and having the top grading cleavage stage embryos were enrolled. All patients received the same endometrial preparation regime. The alteration in endometrial thickness (EMT) between the day of progesterone initiation and the day of embryo transfer (ET) was measured using consecutive transvaginal sonography. The patients were divided into three groups based on the percentage of endometrial compaction (i.e., the difference of EMT at end of the estrogen-only phase and after three days of progesterone administration (ET day) divided by the EMT on the terminal day of the estrogen-only exposure). Results: Overall, 300 eligible women were evaluated and only 27.3% (82/300) of the studied cycles showed ≥5% compaction, whereas 72.6% (218/300) either expanded or showed minimal compaction. The clinical and ongoing pregnancy rates in group 2 (any expansion) were significantly higher than those in groups 1 and 3 (P=0.002 and P=0.01, respectively). Multivariable logistic regression test indicated that the cycles with any expansion in ET were independently associated with 3.1 times improvement in clinical pregnancy rate in comparison to those with any compaction (P=0.002). Conclusion: Gross endometrial compaction occurred in one-third of FET cycles with no significant positive effect on pregnancy outcomes after cleavage-stage ET.

Treatment of repeat breeding of Iraqi native river buffaloes (Bubalus bubalis) south of Baghdad using different hormonal treatment – a field study

This study aimed to evaluate the effects of hormonal treatment ( GnRH and PGF2α) with and without antibiotics in the treatment of repeat breeders (RB) of Iraqi native river buffaloes (Bubalus bubalis) in private dairy farms located in the south of Baghdad for improving the reproductive performance in addition to find the ratio of repeat breeder. The study included (112) Buffalo cows suffering from repeat breeding for more than three unfertile insemination estrus cycles. Buffalo cows were divided into 4 groups according to programs treatment (G1=PGF2α, G2=GnRH , G3= PGF2α+GnRH and G4=PGF2α+Iodine+Oxytetracyclen) respectively.Results of the study revealed that the using of (GnRH and PGF2α) hormones with and without antibiotic (Oxytetracycline+Iodine) are useful in improving the reproductive performance of Buffalo cows. The pregnancy rate after the application of the proposed treatments , measured after (60-65) days by rectal palpation, in the four groups proposed as follows ( 60.0% , 46.6 % , 71.8 % , 75.0 % ) respectively . The pregnancy rates in groups (G3 and G4) were significantly higher than in (G1and G2) groups (P&lt;0.05) and the treatment with (GnRH+PGF2α) hormones or (PGF2α+Iodine+Oxytetracyclen) was more useful in improving the reproductive performance of these animals, the ratio of repeated breeding in Iraqi native river buffaloes (Bubalus bubalis) was about 44.8% (112 out of 250 animal examined in this study). In conclusion, the application of treatments with (GnRH+PGF2α) or (PGF2α+Iodine+Oxytetracyclen) is useful and highly efficient in improving reproductive performance in buffalo cows suffering from repeat breeding.

Pregnancy outcomes in infertile patients undergoing intracytoplasmic sperm injection and two interval programs of hCG-to-oocyte aspiration

This study aimed to determine the outcomes of intracytoplasmic sperm injection (ICSI) if oocyte retrieval was done 32-34 hours or 34:05-36 hours after human chorionic gonadotropin (hCG) injection. A randomized sample involving 186 patients with tubal failure was divided into groups A (96 patients) and B (90 patients). Intracytoplasmic sperm injection was performed on all patients according to described protocols. The number of oocytes retrieved, oocyte cumulus complex quality, number of fertilized eggs, and pregnancy rates were compared between groups. The total of oocytes retrieved in group B was significantly higher than in group A but not significant (P=0.068). The oocyte maturation rate was also significantly higher in the long interval group B than in the short interval group A (P=0.039). There was a significant difference between the two groups in terms of fertilization rate (0.040), and the pregnancy rate in group B was higher than that in group A, but it was not significant (P=0.055). The prolonged interval could also increase the pregnancy rate, but it was not significant. It seems that if the interval between hCG priming and oocyte retrieval is prolonged, the percentage of the number of oocytes retrieved, mature oocytes (MII), and fertilized oocytes increases.

Severity of intrauterine adhesions and pregnancy success rates after treatment: Comparison of adhesions obtained from open myomectomy versus uterine curettage.

Intrauterine adhesions (IUA) are rare. A retrospective comparative study was conducted between January 1, 2015, and December 31, 2018. Group A comprised 117 women who developed IUAs after open myomectomy, while Group B comprised 113 women who developed IUAs following uterine trauma caused by uterine instrumentation after a termination of pregnancy (TOP) or spontaneous miscarriage. The IUA grade and pregnancy rates and outcomes were compared using the March classification system. All patients underwent hysteroscopic adhesiolysis. The adhesions tended to be more severe (45/117, 38.5%) in Group A than in Group B (29/113, 25.7%); however, this difference was not statistically significant (Chi-Suare 5.047; p = .080). The period of observation was 24 months from the last hysteroscopy. The pregnancy rate in Group A (26, 22.2%) was significantly lower than in Group B (46, 40.7%) (OR: 2.403, 95% CI: 1.352-4.271; p = .003). Open myomectomy was the preceding aetiological factor in a greater proportion of women with IUA in our study. In cases where pregnancy is desired after open myomectomy, especially where the endometrial cavity is breached, postoperative hysteroscopy to exclude IUAs is recommended.

Effect of oral estrogen supplement on gonadotropin-induced intrauterine insemination: A retrospective cohort study

Aim: The effect of estrogen on gonadotropin-induced intrauterine insemination (GI-IUI) is not well studied. Furthermore, risk factors for clinical pregnancy rates are not clearly defined. This study aimed to evaluate the effects of oral estrogen supplementation and clinical pregnancy rates on GI-IUI.&#x0D; Material and Method: Patients treated with primary and secondary infertility were retrospectively analyzed between September 2016 and September 2019. IUI session was performed after ovarian stimulation with human chorionic gonadotropin. Patients were supplemented with a vaginal gel containing progesterone and oral estrogen (Group A) or only the vaginal gel (Group B). The differences between the groups in pregnancy rate and endometrial thickness and the risk factors associated with clinical pregnancy were determined as primary and secondary outcomes, respectively.&#x0D; Results: A total of 112 couples were evaluated, where the mean age for females was 31.3±6.1 years. Group A and Group B had 33 (29.5%) and 79 patients (70.5%), respectively. Duration of infertility, number of follicles, and endometrial thickness were significantly different between the two groups. The rate of pregnancy was significantly higher in Group A (51.5%) than in Group B (19%) (p=0.001). There were significant differences between positive and negative pregnancy cases in terms of age, type and duration of infertility, estradiol level, motile sperm number and morphology, number of follicles, and endometrial thickness. The follicle count and estradiol levels were significant risk factors for clinical pregnancy.&#x0D; Conclusion: Estrogen has a positive effect on pregnancy rates in GI-IUI. The follicle number and estradiol level can be used as a risk factor for IUI.

P-763 effect of duration of cryo-storage of vitrified embryos on obstetric and perinatal outcomes

Abstract Study question Does the duration of cryo-storage of vitrified embryos affect obstetric and perinatal outcomes? Summary answer Duration of cryo-storage with an open vitrification system did not affect obstetric and perinatal outcomes. What is known already Frozen-thawed blastocyst transfer has been performed widely with improvement of embryo culture conditions and cryopreservation techniques. Although blastocyst vitrification has become an essential method to improve clinical outcomes of IVF, there has been little study into the relationship between a long duration of cryo-storage in liquid nitrogen and obstetric and perinatal outcomes. Study design, size, duration This retrospective study was conducted at Kyono ART Clinic from January 2007 to December 2020. This study includes a total of 1053 singletons derived from 2461 frozen-thawed blastocyst transfers in 2461 patients. Steel’s multiple comparison test was performed for clinical and perinatal outcomes with cases of cryo-storage of less than 3 months as a control group. P &amp;lt; 0.05 was considered statistically significant. Participants/materials, setting, methods The subjects are patients who underwent their first single frozen-thawed blastocyst transfer (FBT) with an open vitrification system. Females &amp;gt;40 years old at cryopreservation and those who underwent preimplantation genetic testing were excluded. According to cryo-storage duration, patients were grouped as follows: group A, 0-3 months (1255 cycles); group B, 3-6 months (1008 cycles); group C, 6-12 months (162 cycles), group D, 12-24 months (36 cycles). Main results and the role of chance Both the mean maternal age at blastocyst cryopreservation (A: 33.7±3.6, B: 34.1±3.5, C: 34.8±3.2, D: 35.1±3.3) and the mean maternal age at FBT (A: 33.8±3.6, B: 34.4±3.5, C: 35.5±3.1, D: 36.4±3.3) in groups B, C, and D were significantly higher compared to those in group A.. There was no significant difference in the survival rate after blastocyst thawing [A: 97.4% (1256/1290), B: 98.3% (1010/1027), C: 99.4% (163/164), D: 97.2% (35/36)]. The pregnancy rate in group C was significantly lower compared to group A [A: 60.0% (752/1254), B: 61.4% (619/1008), C: 48.1% (78/162), D: 63.9% (23/36)] The gestational age of group C was significantly lower compared to group A (A: 39.5±1.8, B: 39.4±1.8, C: 38.4±3.1, D: 39.8±1.6), but there were no significant differences in live birth weight or height. There were no significant differences in congenital abnormality rate [A: 1.3% (7/541), B: 2.5% (11/440), C: 1.8% (1/56), D: 0.0% (0/16)], placental abnormalities such as placenta previa [A: 1.3% (7/541), B: 1.6% (7/440), C: 1.8% (1/56), D: 0.0% (0/16)], perinatal abnormalities such as hypertensive disorders of pregnancy or gestational diabetes [A: 6.1% (33/541), B: 8.6% (38/440), C: 1.8% (1/56), D: 6.3% (1/16)] among the four groups. Limitations, reasons for caution We could not provide sufficient information on confounding factors such as smoking habits, and the sample size was too small for multivariate analysis. The safety of longer storage will need to be verified as this has not been clarified in this study. Wider implications of the findings The pregnancy rate in group C was significantly lower than that in group A, but the effect was small: 0.065, power of 0.78. Our data suggested that the duration of cryopreservation with an open vitrification system in liquid nitrogen did not affect obstetric or perinatal outcomes. Trial registration number not applicable