Significant Difference In Pregnancy Rate Research Articles

Very low anti-müllerian hormone concentrations are not an independent predictor of embryo quality and pregnancy rate.

Is anti-Müllerian hormone (AMH) serum concentration a useful tool to predict the outcome of assisted reproductive treatment? Retrospective cohort study involving 2971 patients who underwent 5570 IVF cycles. Patients were classified into six groups according to their AMH levels and analysed for associations with reproductive outcome. Several parameters of ovarian response and clinical outcome were compared between groups. Cancellation rate and clinical pregnancy rate varied by AMH group, with highest cancellation rates (32.8%, P = 0.021) and lowest clinical pregnancy rates (9.8%, P < 0.001) in the group with lowest AMH. When these patients achieved embryo transfer, the implantation rate (30.5%) did not significantly differ from the other groups, and retained a low, but reasonable, clinical pregnancy rate per transfer (45.9%). When this group was classified into three female age groups, the clinical pregnancy rate was found to be significantly higher in the patients younger than 37 years (58.1%) compared with patients aged between 37 and 39 years (48.9%) and those aged over 39 years (27%, P < 0.001). Although significant differences in pregnancy rates were observed among the different AMH groups, even in the lowest AMH level group, the probability of achieving pregnancy was reasonable, especially if the patient's age is not very advanced.

The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and meta-analysis

ObjectiveTo assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART).DesignA systematic review and meta-analysis.SettingDepartment of reproductive medicine at teaching university hospital, UK.PatientsSubfertile women with endometrioma undergoing ART.InterventionsSurgical removal of endometrioma or expectant management.Main outcome measuresClinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins.ResultsAn extensive search of electronic databases for articles published from inception to September 2016 yielded 11 eligible studies for meta-analysis. Meta-analysis was conducted comparing surgery versus no treatment of endometrioma. There were no significant differences in pregnancy rate per cycle, clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not.ConclusionCurrent evidence suggests that women with endometriosis-related infertility have similar cycle outcomes to other patients going through ART. It is pertinent for clinicians to assess the risks of surgical intervention on ovarian reserve prior to initiating therapy.

Embryo development until blastocyst stage with and without renewal of single medium on day 3.

ObjectiveThis study aimed to assess the effects of using a single culture medium not renewed on day 3 on the development of the embryo up to the blastocyst stage.MethodsThe study was carried out in the Assisted Reproduction Laboratory of Clínica Miraflores in the period ranging from April to December of 2016. The study included 589 human embryos obtained from 82 couples submitted to IVF/ICSI with donor oocytes. The couples were randomly divided into two groups: group 1 (medium renewed on day 3) and group 2 (medium not renewed on day 3).ResultsSignificant differences in pregnancy rates, implantation rates, and blastocyst formation were not observed.ConclusionNo statistically significant difference was found between the groups with respect to the analyzed parameters. However, a non-significant trend was observed in favor of the group without medium renewal for clinical pregnancy and positive pregnancy rates (β-hCG).

77 Monozygotic Twin Calves Production by Blastomere Separation Technique with Commercial Well-of-the-Well Culture Dish

Monozygotic twin bovine embryos can be produced by blastomere separation of 2-cell embryos and commercial well-of-the-well (WOW) culture dish (Hashiyada et al. 2016 Reprod. Fertil. Dev. 28, 178) obtaining 60% and 48% of blastocyst formation and monozygotic blastocyst pairs, respectively. The present study was conducted to evaluate the fertility of blastocysts derived from this production system in Japanese Black beef cattle. Embryos were produced using oocytes collected by ovum pick-up technique. TCM-199 supplemented with 5% calf serum (CS), Brackett-Oliphant solution supplemented with 10 mg mL−1 BSA, and CR1aa containing 5% CS, were used for each culture step: in vitro maturation, fertilization, and culture (IVM,IVF, and IVC). Two-cell stage embryos were obtained 24 to 27 h post-insemination. Zonae pellucidae were removed by exposure to 0.25% pronase. Then, embryos were separated into blastomeres by gentle pipetting in IVC medium. Each blastomere was introduced into a single conical microwell of 25 wells, each having a diameter and depth of ~287 μm and 168 μm (Dai Nippon Printing, Tokyo, Japan). Blastomeres in wells were cultured covered with a droplet of 2.5 μL of IVC medium/well. The developed blastocysts in pairs on 7 days post-insemination were used for transfer. Single embryos of monozygotic twin embryos were transferred to Japanese Black cattle with a generally small body frame to produce twin calves from a set of recipients. Twin embryos were transferred in pairs to unilateral of uterus of non-lactating Holstein cows. Pregnancy and twin pregnancy were determined at 30 days of gestation by ultrasonography and were reconfirmed at 60 days with detection of fetal loss. Statistical significance was analysed by Fisher’s exact test. There was no significant difference in pregnancy rate or twin pregnancy rate between single embryo transfer (7/14, 50% and 2/7, 28.6%) and twin embryo transfer (9/21, 42.9% and 4/21, 19%). In either transfer method, fetal loss was not observed in diagnosis carried out at 60 days by ultrasonography. To date, 2 pairs of twin calves have been obtained from twin pregnant cows by twin embryo transfer within the normal range of gestation length (286 and 288 days) and birth weight (31-40 kg). These results indicate that blastocysts developed from blastomeres separated from 2-cell embryos by culturing with commercial WOW culture dish had fertility similar to that of intact embryos derived from standard in vitro culture and further demonstrate the possibility of production of normal twin calves.

Divergent breeding values for fatness or residual feed intake in Angus cattle. 1. Pregnancy rates of heifers differed between fat lines and were affected by weight and fat

The pregnancy rate of heifers affects the efficiency and profitability of beef herds. Heifers extreme in rib fatness (Fat) or post-weaning residual feed intake (RFI) estimated breeding values (EBVs) were evaluated for their pregnancy rates at two locations in the southern agricultural regions of Australia (Struan and Vasse) as part of the Beef Cooperative Research Centre Maternal Productivity Project. Heifers divergent in Fat (High-Fat and Low-Fat) had differences in fat depth pre-joining at the 12/13th rib (4.4 mm vs 3.5 mm) and P8 rump site (6.1 mm vs 4.8 mm). This was associated with significant differences in pregnancy rates over a 9-week joining period (91.5% vs 83.0%) and an even larger difference when calculated over a 6-week joining period (77.3% vs 65.0%). Heifers divergent in RFI (Vasse only) also differed in rib fat (7.6 mm vs 6.4 mm) and P8 fat (11.0 vs 9.2 mm), but not significantly in pregnancy rates between the two RFI (High-RFI and Low-RFI) genotypes following a 9-week (92.4% vs 88.5%) or 6-week (81.2% vs 73.7%) joining period. The phenotypic analysis of the Fat and RFI heifers together indicated that weight and fat depth were the largest contributing factors to variation in pregnancy rates, and age and pre-joining weight gain were not significant. These phenotypic characteristics indicated that producers can manage heifers to particular weight and fat combinations to improve heifer conception rates. Associations of BREEDPLAN EBVs with heifer fertility showed that a shorter days-to-calving EBV had the biggest impact (P &lt; 0.001) on heifer pregnancy rates and rib fat and scrotal size EBVs were close to significant (P &lt; 0.10).

Pregnancy outcomes in women with recurrent pregnancy loss and recurrent implantation failure diagnosed with chronic endometritis

To report the obstetrical outcomes in women with recurrent pregnancy loss (RPL) or recurrent implantation failure (RIF) diagnosed with chronic endometritis (CE). Prospective study from 2014-2017 in a university setting. After IRB approval, 88 patients undergoing RPL or RIF workup were enrolled. A hysteroscopy and endometrial biopsy (EMB) were performed on all patients. Diagnosis of CE was confirmed with immunochemistry stains for CD138 (>5 plasma cells per HPF1). Diagnosed patients were treated with a course of antibiotics followed by a repeat EMB to confirm response to treatment. Pregnancy rates (PR), live birth rates (LBR) and mean time to pregnancy (TTP) were observed. The overall incidence of CE was 45.5% (40/88). After a first course of antibiotics, the CE incidence was significantly reduced to 13.6% (P = 0.00000817). In the RIF and RPL groups, CE was present in 45.2% (14/31) and 46.6% (28/60) respectively. In the RIF group, PR were similar in the treated CE group compared to those with normal biopsies (85.7% (12/14) vs 64.7% (11/17); P = 0.1834). However, in the RPL group, there was a statistically significant difference in PR between patients with treated CE and normal biopsies (60.7% (17/28) vs. 84.4% (27/32); P = 0.038). There was also a trend towards higher LBR in the RPL group with normal biopsies compared to those with treated CE (46.9% (15/32) vs 25.5% (7/28), P = 0.0793). Mean TTP overall was 7.33 months in the treated CE group compared to 7.92 months for patients with a normal initial biopsy. Within the RPL group, the mean TTP was higher in women with treated CE compared to women with initial normal biopsies (8.30 vs 7.13, P=0.512). However, within the RIF group, the mean TTP was lower in women with treated CE compared to women with initial normal biopsies (6.57 vs 9.24, P=0.352). This report suggests that CE may influence pregnancy rates in patients with RPL. Furthermore, not only was CE associated with a trend towards lower LBR in RPL patients, it also seems to extend the mean TTP in patients with RPL. Further research with a higher sample size would be necessary to corroborate these findings.

Effects of embryo cryopreservation and thawing on clinical outcomes of transplantable embryos after cleavage-stage preimplantation genetic diagnosis or screening

To investigate the effects of embryo cryopreservation and thawing on clinical outcomes of transplantable embryos after preimplantation genetic diagnosis (PGD) or preimplantation genetic screening (PGS) in cleavage-stage. The clinical data of 302 cases (including 118 cases using frozen/thawing embryos and 184 cases using fresh embryos) undergoing PGD/PGS in Women's Hospital, Zhejiang University School of Medicine during January 2011 and December 2016 were retrospectively analyzed. The pregnancy rate, implantation rate, live birth rate and abortion rate of fresh and frozen-thawed embryo transfer (FET) cycles were compared. And the influencing factors for pregnancy outcome was analyzed by multivariate logistic regression. The rate of normal or balanced translocation embryos in fresh cycle was higher than that in FET cycle (23.52% vs 16.67%, P<0.05), and the average number of transplanted embryos was more than that in FET cycle (1.54±0.56 vs 1.33±0.51, P<0.05). But there were no significant differences in pregnancy rate (36.42% vs 40.00%, P>0.05), implantation rate (26.62% vs 32.91%, P>0.05), abortion rate (19.44% vs 8.33%, P>0.05) and live birth rate (25.96% vs 28.33%, P>0.05) between fresh cycle and FET cycle. Multivariate logistic regression showed that, parent ages, embryo status (fresh or frozen), the mode of PGD/PGS and the findings of PGD/PGS had no impact on pregnancy outcome (all P>0.05). Cryopreservation do not have significant effects on the clinical outcomes of transplantable embryos after PGD/PGS in cleavage-stage.

Does in vitro maturation (IVM) have an impact on morphokinetic parameters in comparison with IVF?

Polycystic ovarian syndrome (PCOS) patients are at higher risk of ovarian hyper stimulation syndrome (OHSS) due to the high dose of gonadotropin in IVF. To avoid the possibility of OHSS, IVM techniques have been developed and employed in clinical settings. However, IVM delivers lower pregnancy rates and birth rates than IVF. The objective of this study was to assess whether IVM treatment affects embryo development events together with morphokinetic parameters compared with IVF, and to identify the morphokinetic parameters specific to embryos that were suitable for implantation in IVM cycles. Retrospective study. The subjects were 41 couples who underwent 50 cycles of IVM at our clinic, from May, 2013 to Nov., 2015. After the failure of IVM treatment, 12 couples underwent standard IVF treatment. We assessed 194 embryos derived from IVM-ICSI and 48 embryos derived from IVF-ICSI. Their treatment outcomes were analyzed with morphokinetic events (cell division and interval of cell cleavage) by Primovision (vitrolife Sweden), and rate of clinical outcome. Moreover in IVM cycles, these time points were also compared between transferred embryos that implanted or did not implant. IVM zygotes showed significantly lower good quality embryo on day3, blastocyst formation, and good blastocyst rates compared with IVF. There were no differences in time points of cell division (tPNa to t8), pregnancy and abortion rates between the two groups. However, there were significant differences in synchrony of the second cell cycles (t4-t3:S2) (S2:4.5±5.0h vs. 1.4±2.3h, P=0.0002), and the rate of direct cleavage of one to three, or there to five cells was significantly higher in the IVM group (90/194 46.4% vs. 9/48 18.8%, P=0.0016). In the IVM group, there were no differences in development time points between implanted and non-implanted embryos. IVM zygotes showed increased abnormal cleavage compared with IVF; however, there were no significant differences in pregnancy rate or abortion rate between IVM and IVF. We rejected these abnormal cleaved embryos for transfer, indicating that in order to improve the pregnancy rate it is important to exclude the abnormal cleaved embryo, such as direct cleavage, from embryo transfer in IVM treatment.

Pregnancy Rate by Human Chorionic Gonadotropin Administration Versus Urinary Luteinizing Hormone Surge Method in Patients Undergoing Intrauterine Insemination

Background: Infertility is becoming a world-wide concern in developed and developing countries. Multiple causes are responsible for the situations and various therapies have been developed to overcome this problem in infertile couples, as in the case of intrauterine insemination (IUI), with considerable variations between pregnancy rates in relation to the method employed. Objectives: To compare pregnancy rate, by human chorionic gonadotropin (HCG) administration and urinary luteinizing hormone (LH) surge method, for insemination in patients undergoing IUI. Patients and Methods: The present study included 309 infertile women, candidate for IUI, randomly divided into LH surge and HCG groups (each participant was assigned a number from 1 to 309, of which odd numbers were for LH and even numbers for HCG groups, respectively). All patients were subjected to baseline ultrasound and received clomiphene citrate before undergoing serial transvaginal sonography. The LH was measured using LH kit, when 2 - 5 follicles (18 - 20 mm) appeared in LH surge group, and, if positive, IUI was performed after 24 hours. In HCG group, the patients received HCG 1000 units and underwent IUI after 36 hours. The pregnancy rate was then compared in LH and HCG groups. Results: We found no significant differences in pregnancy rates between the two groups. Also, we compared pregnancy rates between the two groups based on age, infertility cause, number of follicles, number of previous IUI and previous abortions. We found no significant differences between the subgroups, in terms of pregnancy rate. Conclusions: The urinary LH surge and HCG administration methods for IUI timing are similar and none had any considerable advantages over the other. However, the use of the urinary LH surge has no side effects or injection pain, in relation to HCG administration methods

Fertility and flow cytometry study of frozen-thawed sperm in cryopreservation medium supplemented with soybean lecithin

Semen cryopreservation can provide genetic resources for a large number of females from a small number of superior males. Optimization of cryopreservation media to achieve the highest quality of post-thaw semen is crucial. Soybean lecithin has evaluated as a plant-based cryoprotectant for substitution of egg yolk in ram semen extender. Flow cytometric and fertility assessments were applied following cryopreservation procedure in two experimental groups (SL group: extender containing 1% w/v soybean lecithin and EY group: extender containing 20% v/v egg yolk). The higher percentage of live sperm and the lower percentage of dead sperm were obtained in SL (47.66 ± 1.38, 52.33 ± 1.69, respectively) extender compared to EY (41.16 ± 1.38, 58.83 ± 1.69). For motion characteristics, plasma membrane integrity, acrosome integrity and mitochondria activity, no significant difference was observed between SL and EY extenders. In artificial insemination experiment, there was no significant difference in pregnancy rate, lambing rate and twining rate between SL and EY extenders. It can be concluded that SL extender can be an efficient alternative extender to preserve ram sperm during cryopreservation procedure without adverse effects.

Effective embryo production from Holstein cows treated with gonadotropin-releasing hormone during early lactation

The low efficiency of embryo production in Holstein cows during early lactation presents many challenges for animal production. To improve its efficiency, the outcomes of single GnRH injections 48 hours before each of three cycles of ovum pick up (OPU; weeks 2, 4, and 6) were compared with three cycles of unstimulated OPU (controls; weeks 1, 3, and 5) in 35 Holstein cows during 6 weeks of early lactation (40–80 days postpartum). More total follicle numbers (19.5 vs. 16.0; P < 0.05) but fewer dominant follicles (0.5 vs. 1.4; P < 0.01) were observed by ultrasound, and more cumulus–oocyte complexes were collected in a single OPU in the treatment cycles compared with controls (15.3 vs. 11.5; P < 0.05). The numbers of morphologically “good” cumulus–oocyte complexes graded A and B in the stimulated OPUs were significantly greater than in controls (2.8 vs. 1.7 and 5.8 vs. 4.2, respectively; P < 0.05). Significantly, more oocytes stained positively with brilliant cresyl blue after GnRH treatment compared with the control cycles (13.7 vs. 9.6; P < 0.05). After in vitro fertilization, embryos in the treatment cycles had improved development (P < 0.01) during each developmental stage compared with the controls (9.0 vs. 6.2 two-cell embryos; 4.7 vs. 3.0 four-cell embryos; 3.3 vs. 2.0 morulae; and 3.0 vs. 1.7 blastocysts, respectively). Moreover, there was no significant difference in pregnancy rate of the recipient cows after embryo transfer (57.1% vs. 42.1%; P > 0.05) no matter if the embryos came from the GnRH-treated cycles or not. Thus, GnRH-stimulated OPUs improved the efficiency of embryo production in Holstein cows during early lactation. This novel method for in vitro embryo production should benefit the dairy industry.

The Role of Saline Sonohysterography Prior to IVF/ICSI and its Impact on Assisted Reproduction Program Outcome in Egyptian Community

Aim: To assess the incidence of undiagnosed intrauterine pathology based on saline sonohysterography in women with normal transvaginal ultrasound and their impact on the success rate of Intracytoplasmic sperm injection in Egyptian community. Patients and methods: Two hundred qualified patients scheduled for first time Intracytoplasmic sperm injection treatment were divided into 2 groups each containing 100 patients. Group 1 did saline sonohysterography and cases with intrauterine lesions were treated by hysteroscopy prior to undergoing Intracytoplasmic sperm injection, while group 2 did Intracytoplasmic sperm injection without prior saline sonohysterography. The main outcome measures were undiagnosed intrauterine abnormalities as uterine anomalies and polyps, in addition to, pregnancy, miscarriage and on-going pregnancy rates. Results: Uterine lesions were found in 35% of cases undergoing sonohysterography, and 27 out of the 35 cases were treated by hysteroscopy. A significant difference in pregnancy rate and on-going pregnancy rate in favour of the sonohysterography group (P=0.04) and (P=0.031) respectively. Conclusion: Saline sonohysterography is a non-invasive method for the diagnosis of uterine abnormalities improving the outcome of IVF/ICSI cycles.

108 FACTORS AFFECTING PREGNANCY RATES IN RECIPIENTS RECEIVING IN VITRO-PRODUCED EMBRYOS BY FIXED TIME EMBRYO TRANSFER

A retrospective analysis of factors that affect pregnancy rates from 4214 fresh in vitro-produced (IVP) embryos that were transferred at a fixed-time (FTET) in 20 different farms. Recipients were all cycling cows or heifers that were synchronized with 1 of 3 treatments: 1) treatments with progesterone (P4) devices and 2 mg of oestradiol benzoate (EB) on Day 0 (day of insertion) and 24 h after device removal (Day 8); 2) treatments with P4 devices and EB on Day 0, but with 0.5 mg of oestradiol cypionate (ECP) at device removal (Day 8); or 3) treatments with P4 devices and GnRH on Day 0 and a second GnRH 60 h after device removal (Day 5). Cows in all treatment groups also received 500 µg of cloprostenol (prostaglandin F2α) at the time of P4 device removal and 400 IU of eCG either at device removal or 3 days before device removal. All embryos were transferred 7 or 8 days after the expected time of oestrus (24 h after EB, 48 h after ECP or at the time of the second GNRH for each synchronization treatment, respectively). On the day of embryo transfer, recipients were examined by ultrasonography and those with corpus luteum &gt;14 mm in diameter received a fresh, IVP embryo in the uterine horn ipsilateral to the corpus luteum. Pregnancy rates were determined by ultrasonography 35 days after FTET. Data were analysed by logistic regression. Independent variables were classified into the following three categories. 1) Factors related to the recipient and the environment; there were no significant differences in pregnancy rates for corpus luteum diameter (≥14 and &lt;16 mm, ≥16 and &lt;18 mm, or ≥18 mm; P = 0.46), number of corpus luteum (1 or ≥2; P = 0.26), and category of recipient (cow or heifer; P = 0.21). However, there were significant effects of farm (P = 0.01) and body condition score (BCS; P = 0.01). Cows with BCS ≥4.5 (1 to 5 scale) resulted in lower pregnancy rates (4/20, 20.0%) than those with BCS 2 (74/225, 32.9%), 2.5 (502/1434, 35.0%), 3 (570/1467, 38.9%), 3.5 (193/532, 36.3%), and 4 (44/118, 37.3%). 2) Factors related to the synchronization treatment; there were no significant differences between recipients receiving eCG at device removal (84/209, 40.2%) or 3 days before device removal (874/2291, 38.1%; P = 0.35). However, recipients synchronized with P4 devices and ECP had higher (P = 0.01) pregnancy rates (232/483, 48.0%) than those treated with EB (679/1888, 36.0%) or gonadotropin-releasing hormone (47/129, 36.4%). 3) Factors related to the embryo transfer technique; day of the recipient’s oestrous cycle (P = 0.36), stage of embryo transferred (IETS stages 6 or 7; P = 0.62), and operator (P = 0.57) did not affect pregnancy rates. However transfers made in the anterior third of the uterine horn resulted in higher (649/1545, 42.0%) pregnancy rates than those in the mid-third (845/2511, 33.6%) or in the distal third (6/35, 17.1%; P = 0.01). It was concluded that factors related to the recipient and the environment (farm and BCS), the synchronization treatment (ECP), and the embryo transfer technique (site of deposition) affect pregnancy rates in recipients of embryos produced in vitro and transferred at a fixed time.

Clinical significance of subclinical varicocelectomy in male infertility: systematic review and meta-analysis

Recent meta-analysis by the Cochrane collaboration concluded that treatment of varicocele may improve an infertile couple's chance of pregnancy. However, there has been no consensus on the management of subclinical varicocele. Therefore, we determine the impact of varicocele treatment on semen parameters and pregnancy rate in men with subclinical varicocele. The randomised controlled trials that assessed the presence and/or treatment of subclinical varicocele were included for systematic review and meta-analysis. Random effect model was used to calculate the weighted mean difference of semen parameters and odds ratio of pregnancy rates. Seven trials with 548 participants, 276 in subclinical varicocelectomy and 272 in no-treatment or clomiphene citrate subjects, were included. Although there was also no statistically significant difference in pregnancy rate (OR 1.29, 95% CI 0.99-1.67), surgical treatment resulted in statistically significant improvements on forward progressive sperm motility (MD 3.94, 95% CI 1.24-6.65). However, the evidence is not enough to allow final conclusions because the quality of included studies is very low and further research is needed.

The Diagnosis and Treatment of Ectopic Pregnancy

Extrauterine pregnancy is a complication of the first trimester of pregnancy that arises in 1.3-2.4% of all pregnancies. This review is based on articles and guidelines retrieved by a selective PubMed search. The presentation of extrauterine pregnancy is highly variable, ranging from an asymptomatic state, to pelvic pain that is worse on one side, to tubal rupture with hemorrhagic shock. 75% of tubal pre gnancies can be detected by transvaginal ultrasonography. In patients with a vital extrauterine pregnancy, the human chorionic gonadotropin concentration generally doubles within 48 hours. Laparoscopy is the gold standard of treatment. Two randomized, controlled trials comparing organ-preserving treatment with ablative surgery revealed no significant difference in pregnancy rates after the intervention, but precise details of the surgical procedures were not provided, and long-term fertility data are lacking. Metho - trexate therapy should be used only for strict indications. Further randomized, controlled trials with longer follow-up will be needed to answer currently open questions about the potential for individualized surgical treatment and the proper role of pharmacotherapy.

Relationship of polar bodies morphology to embryo quality and pregnancy outcome

The aim of this study was to explore whether the morphology of polar bodies (PBs) estimated at 16-18 h after insemination can be used as an additional marker for predicting human embryo quality or pregnancy outcome. The data from 355 patients who received standard in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment after controlled ovarian hyperstimulation were recruited. Normal fertilized 3048 zygotes from 382 cycles were divided into two groups, PBs intact or fragmented, according to the morphology of PBs assessed at 16-18 h after insemination. Embryo quality and pregnancy outcome were compared between the two groups. It was shown that the day 3 (D3) good embryo rate, good quality blastocyst rate and available embryo rate of the PBs intact group were all significantly higher than that of the corresponding fragmented groups. However, no significant differences in pregnancy rate (PR) or implantation rate (IR) were observed between the intact and fragmented groups. Although PBs morphology estimated at 16-18 h after insemination had little effect on PR or IR in fresh embryo transfer cycles, a better embryo quality can be achieved in the PB-intact group, which is valuable for embryo selection.

Human Papillomavirus Positivity in Women Undergoing Intrauterine Insemination Has a Negative Effect on Pregnancy Rates

Background: Sexually transmitted infections are a major cause of infertility. Human papillomavirus (HPV) infection is one of the most common viral infections of the female genital tract. Only a limited number of studies have investigated the influence of HPV on fertility and its impact remains controversial. Objective: We investigated the relationship between cervical HPV infection and pregnancy outcome after intrauterine insemination (IUI). Since other sexually transmitted infections could also influence outcome, we also analyzed the influence of Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) on pregnancy outcome. Methods: We performed a retrospective analysis of 590 women who underwent 1,529 IUI cycles at AML between 2010 and 2014. Positivity of 18 different HPV types (6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, 68) and TV was assessed by PCR in cervical cytology specimens. CT status was ascertained by detection of IgA/IgG antibodies on serum samples or by PCR on cervical swabs. Results: The HPV prevalence per IUI cycle was 11.0 and 6.9% for CT; none of the women tested positive for TV. HPV-positive women were six times less likely to become pregnant after IUI (1.87 vs. 11.36%; p = 0.0041). There was no significant difference in pregnancy rates between women with or without a history of CT (8.51 vs. 11.10%; p > 0.05). Conclusion: Detection of HPV is associated with a negative IUI outcome.

Influencia de la criptozoospermia y la azoospermia obstructiva en la calidad embrionaria tras microinyección intracitoplasmática de espermatozoides

IntroductionAzoospermia and cryptozoospermia are relatively common diseases among men, who may have to resort to assisted reproduction if they wish to have children. In this work, an assessment is made of the kinetic behavior and morphology in the early days of embryo development as regards whether the semen sample is normal, azoospermic or cryptozoospermic. Material and methodsA retrospective analysis was performed on 396 treatments, which included 40 cryptozoospermic males, 17 obstructive azoospermic males, and the remainder normozoospermic (according to the criteria of the WHO, 2010). Patients had normal ovarian response and to avoid the effect of maternal age, only women under 38 years old were included. In all cases, the oocytes were fertilized by intracytoplasmic sperm injection (ICSI) and embryo quality as defined by the ASEBIR criteria (The Istanbul consensus workshop on embryo assessment, 2011). ResultsFertilization rate was lower when testicular sperm was used (although not significant) and there were no differences in cryptozoospermic males. No significant changes were observed in the rate of embryo cleavage. As regards embryo quality in day 2, results are comparable between normozoospermic and azoospermic group, while it decreased in the cryptozoospermic group (the percentage of embryos type C was higher). However, the results found in day 3 were similar between groups. Clinically, there were no significant differences in pregnancy rates or miscarriage. DiscussionThe use of cryptozoospermic seminal samples affects the embryo quality after ICSI. On the other hand, the results were comparable between the groups of normozoospermic males and obstructive azoospermia.

Gonadotropin Alone is a Better Drug for Ovarian Stimulation than in Combination with Clomiphene in Intrauterine Insemination.

This study compares the efficacy of sequential clomiphene citrate (CC)+Gonadotropin to that of Gonadotropin alone with ultrasound monitoring. It is a retrospective analytic study done on a total of 100 couples to compare two groups receiving CC+Gonadotropin and Gonadotropin alone for ovarian stimulation followed by intrauterine Insemination (IUI). We studied the cycle performance parameters. Cumulative pregnancy rates and ovulation rates were the primary outcomes. Results were analyzed following the intention-to-treat principle. There were no significant differences with respect to indications and the numbers of dominant follicles recruited. The endometrial thickness was significantly better in Gonadotropin-alone group (P<0.05). Ovulation rate was better for CC+Gonadotropin at 95.91%. Nine pregnancies were in the CC+Gonadotropin group (18.36%) and 17 in Gonadotropin-alone group (33.3%). Significant differences in pregnancy rates and endometrial thickness were seen. Gonadotropin alone thus appears to give better results, but CC+Gonadotropin seems to be a cost-effective drug.

Association between endometrial thickness in oocyte donation cycles and pregnancy success rates.

Endometrial receptivity is a primary concern for embryo implantation success in fertility treatments. The present study was a retrospective analysis of 4070 cycles with donor oocytes and hormone-replacement therapy. Endometrial thickness was assessed once with transvaginal ultrasound. Patients were allowed to continue when endometrial thickness was ?5mm and had triple line morphology. Pregnancy rates, the number of gestational sacs and miscarriage rates were analysed in relation to endometrium status. Regression models were used to analyse associations, taking the day of embryo transfer into account. All patient parameters were homogeneous. Mean endometrial thickness was 7.24±1.66mm, the mean number of embryos transferred was 2.04±0.43, the pregnancy rate was 48.06% and sacs were present in 42.3% of cycles. There were no significant differences in pregnancy rates, number of gestational sacs and miscarriage rates for different endometrial thickness measurements. The present study is, to our knowledge, the largest study evaluating the role of endometrial thickness in oocyte donation cycles. Endometrial thickness >5mm is a reasonable parameter for determining treatment success, and once it is observed in a single ultrasonographic evaluation there is no need for subsequent monitoring and embryo transfer can be scheduled over the following 1-16 days, because the results are not compromised. This may lead to a significant reduction in time and cost in fertility clinics.