جستجوی مقالات مرتبط با کلیدواژه "live birth rate" در نشریات گروه "پزشکی"

Selecting embryos with the highest implantation potential is crucial for in vitro fertilization (IVF) success. Both the timing of blastulation, day 5 (D5) or D6, and the embryo quality have been suggested as influential factors in determining the clinical outcome of single euploid blastocyst transfers. However, evidence supporting the superiority of D5 over D6 blastocysts remains inconclusive. The aim of this study was to compare clinical outcomes following the transfer of euploid blastocysts with different quality and timing of blastulation.

A retrospective cohort study was conducted at our Assisted Reproductive Center, analyzing the outcome of 774 transfers with D5 euploids and 155 transfers with D6 euploids performed between January 2019 and February 2022.

The live birth rate was significantly lower in the euploid D6 group compared to the euploid D5 group (38.71vs. 55.04%, P=0.001). The outcome was significantly influenced by the quality of the embryos. Live birth rates were 62.14 and 53.61% following transfers of D5 and D6 excellent embryos respectively, 45.18 and 32.21% following transfer of D5 and D6 good embryos but only 28.64 and 19.32% following transfer of D5 and D6 fair embryos. The outcome difference was statistically significant across embryo quality categories (P=0.001). The adjusted risk ratios (RR) of clinical outcomes indicated that excellent euploid D5 embryos consistently outperformed other types of embryo quality.

The timing of blastulation and embryo quality are crucial factors in determining the success of single euploid blastocyst transfers. Excellent euploid D5 transfers yielded superior clinical outcomes, providing valuable insights for IVF teams and patients when selecting embryos to be transferred.

Finding the most effective way to improve implantation rate in women who are receiving assisted reproductive technology treatment is still a challenge.

This study aimed to assess the pregnancy outcomes of intrauterine platelet-rich plasma (PRP) therapy in women with a history of at least 2 implantation failures.

In this retrospective cohort study, data of 852 women who were candidates for frozen-thawed embryo transfer was extracted from their medical records from April 2017 to September 2021 at Yazd Reproductive Sciences Institute, Yazd, Iran. Of these, 432 received intrauterine PRP treatment 48 hr before transfer (PRP group), and the results of the pregnancy outcomes compared with 420 of the control group who did not receive the treatment before transfer.

Pregnancy outcomes, including chemical, clinical, ongoing pregnancy, and live birth rate were statistically significant in the PRP group (p < 0.001). However, when categorized according to the implantation history, this significant improvement in all 4 was only seen in women with at least 2 prior implantation failures. In women with a history of only one implantation failure, PRP therapy significantly improved the ongoing pregnancy and live birth rate (19.5%, p = 0.04). Also, in women who received donor eggs and had repeated implantation failure, PRP improved pregnancy outcomes clinically but not statistically (p = 0.15).

PRP seems to be effective in improving the pregnancy rate in women with a history of 2 or more implantation failures and also shows an increase in the live birth rate in women with only one implantation failure.

Overweight and obese people face several health problems. Female obesity has been shown to reduce fertility in the general population. Assisted reproductive technology outcomes in obese cases are widely studied, but the results are inconclusive.

This study aimed to compare live birth rate (LBR) among women with 4 different types of body mass index (BMI).

In this cross-sectional study, data of 1611 women, who were candidates for fresh and frozen embryo transfer cycles, was extracted from 2051 medical files at the Reproductive Sciences Institute, Yazd, Iran from May 2019-May 2021. The participants were divided into 4 groups (underweight, normal, overweight, and obese) according to their BMI, and LBR was considered to be the main outcome.

Of 1611 women, 39 were underweight, 585 were normal, 676 were overweight, and 311 were obese. Underweight women had the lowest LBR (12.8%), but there was no statistically significant difference (p = 0.55). In addition, LBR was compared in the 4 BMI groups according to age, type of transfer cycle (fresh or freeze), and cause of infertility, and there was comparable LBR in the 4 BMI groups. However, metaphase 2 oocyte rate, doses of gonadotropin usage in the cycles, and estradiol level had statistically significant differences (p < 0.001).

According to our study, obesity does not affect LBR in the IVF cycle, regardless of fresh or frozen embryo transfer cycles, different age groups, and causes of infertility.

 Granulosa cells, the endometrium, and the placenta all play a role in the secretion of G-CSF in the reproductive tract. G-CSF affects immunological regulation, which is crucial for enhancing pregnancy viability and maintenance. To evaluate the effects of granulocyte-colony stimulating factor subcutaneous injection on the miscarriage rate, ongoing pregnancy rate, and livebirth rate after single and multiple doses of G-CSF factor.

 At the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies at Al-Nahrain University, a prospective comparison study with a random sample selection was conducted from December 2021 to December 2022. It included 121 infertile women who had previously unsuccessful intracytoplasmic sperm injection (ICSI) procedures and who had finished ICSI protocols and reached the embryo transfer day. Patients were divided into three groups on the day of the embryo transfer: The non-G-CSF group (49 patients) received no additional treatment; the single-G-CSF group (31 patients) received a single subcutaneous injection of granulocyte-colony stimulating factor one hour after embryo transfer; and the multiple-G-CSF group (41 patients) received weekly injections of G-CSF until a fetal heartbeat could be detected, starting one hour after the embryo transfer.

 The multiple G-CSF group had better results in the miscarriage rate, ongoing pregnancy rate, and livebirth rate (23.5%, 34.1%, and 31.7%, respectively) when compared to the single G-CSF group (42.9%, 16.1, and 12.9%, respectively) and the non-G-CSF group (37.5%, 12.2%, and 10.2%, respectively).

Multiple subcutaneous G-CSF doses can improve the miscarriage rate, ongoing pregnancy rate, and live birth rate. A single dose of G-CSF for infertile women has no appreciable benefits.

Endometrial scratching (ES) remains controversial regarding its potential effectiveness in improvingpregnancy rates. The objective of the present study was to assess the impact of endometrial fundal incision (EFI) duringhysteroscopy on reproductive outcomes in a population of oocyte recipients. A randomized controlled trial was conducted between 2020 and 2023 at the Third Departmentof Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessalonikiand “Assisting Nature Centre of Reproduction and Genetics”. The study population consisted of women whounderwent hysteroscopy randomly assigned in a 1:1 ratio to either EFI (one to three months before embryotransferwith donor oocytes) or no intervention throughout office hysteroscopy. Clinical pregnancy and live birth rates werethe primary outcomes. After the exclusion of patients with intraoperative diagnosed endometrial pathology, a total of 124 womenunderwent randomization. The pregnancy test was positive in 79% (n=49/62) of the women in the EFI compared to59.7% (n=37/62) in the hysteroscopy-only group (P=0.019), while the live birth rates did not differ between the twogroups (58.1%, n=36/62 vs. 51.6%, n=32/62, P=0.470). EFI during hysteroscopy seems to improve pregnancy rates in oocyte recipients without intrauterinepathology, while live birth rates are not affected by the EFI. These results should be interpreted with caution beforethe implementation of EFI in the routine in vitro fertilization (IVF) practice (registration number: NCT04580056).

We investigated the impact of the choice of catheter type and tenaculum use on pregnancy related outcomesin intrauterine insemination (IUI) treatments.

A total of 338 consecutive IUI cycles were assessed in this retrospective study. Participantswere divided according to the insemination technique - soft catheter (group 1; n=175), firm catheter (group 2; n=100),or tenaculum (group 3; n=63). Clinical, laboratory, semen parameters and pregnancy related outcomes were compared.

Demographic characteristics and laboratory parameters were similar between the groups (P>0.05). The clinicalpregnancy rate (CPR) was significantly higher in the firm catheter (19%, 19/100) and tenaculum (31.7%, 20/63)groups compared to the soft catheter group (5.1%, 9/175, P<0.001). There were no significant differences betweenthe groups in live birth and miscarriage rates per clinical pregnancy (P>0.05).

Our findings indicate that the use of a firm catheter or tenaculum for IUI might result in a higher CPR, butmight not have a considerable effect on the live birth rate (LBR). Further prospective randomized studies are requiredto determine the long-term effects of the catheter type or tenaculum use on IUI success.

Obesity has been associated to negative effects on natural fertility and a worse prognosis when assisted reproduction techniques are performed. Patients attending for fertility treatments are often advised to optimize their weights to improve outcomes. There are doubts about how effective are weight-loss interventions for improving fertility in women who are overweight or obese.

We conducted a systematic review according to a registered protocol (PROSPERO registration number: CRD42017074964) to evaluate whether weight loss achieved by lifestyle program improves natural or assisted reproduction in obese infertile women. We searched CENTRAL, MEDLINE and EMBASE up to March 2018. Two reviewers selected randomised trials assessing a lifestyle intervention in women with obesity preceding a treatment for infertility and appraised their risk of bias. We extracted data on pregnancy, birth and miscarriage rates as primary outcomes and pooled effect estimates using a random effects model. The primary outcome was live birth rate. The summary measures were reported as relative risk (RR), 95% confidence interval (CI) and percentage of heterogeneity (I2).

We included eight randomised trials with 1175 women. Lifestyle programmes, improved pregnancy rates (RR 1.43, CI 95% 1.02 to 2.01; I2=60%; 8 RCTs; N=1098) but have no impact on live births (RR 1.39, CI 95% 0.90 to 2.14; I2=64%; 7RCTs; N=1034). Our findings suggest that women participating in lifestyle interventions had an increased risk of miscarriage (RR 1.50, CI 95% 1.04 to 2.16; I2=0; 6RCTs; N=543). We rated the quality of evidence for these outcomes as moderate to low.

Lifestyle interventions slightly increase pregnancy rate and it is uncertain that it can improve live birth; furthermore they can increase miscarriage. More research is needed to further explore lifestyle interventions on reproductive outcomes in obese infertile women.

The aim of this study was to assess the impact of total serum E2 on the day of human chronic gonadotropin (hCG) administration and the serum E2 per oocyte ratio on the outcomes of assisted reproductive technology (ART) cycles.

A total of 205 women were categorized into 3 groups according to the serum E2 levels: 1: ≤1500 pg/ml; 2: 1500-3000 pg/ml; 3: >3000 pg/ml. Another categorization included 3 groups according to E2/oocyte ratio: A: ≤150 pg/ml per oocyte; B: 150-200 pg/ml per oocyte; and C: >200 pg/ml per oocyte. The outcome compared between groups included laboratory and clinical characteristics. One-way analysis of variance (ANOVA), chi-square and Kruskal-Wallis, and multiple logistic regression model were performed, and appropriate differences were considered significant at p<0.05.

There was a significant difference between the groups based on the E2 levels with respect to laboratory parameters. In group C, the rates of chemical pregnancy (54.1%), clinical pregnancy (50%) and live birth (45.8%) were significantly higher, when compared to other groups. Moreover, according to E2/oocyte ratio, the rate of live birth was higher in group C compared with group A (18.3%, p=0.04), and group C (29.7%, p<0.0001). Logistic regression showed the number of good quality embryos was a positive predictor for live birth (odds ratio=2.03, 95% CI=1-4.1), but the level of E2 on day of HCG was a negative predictor (odds ratio=0.99, 95% CI=0.99-1).

Supraphysiological levels of E2 had no adverse effects on the quality of the embryos in IVF cycles, but may have adverse effect on live birth in fresh transfer. Also, it is confirmed that both the pregnancy and live birth rates were elevated with E2/oocyte ratio ≥200 pg/ml.

Currently, there is no agreement on the optimal urinary derived human chorionic gonadotropin (u-hCG) dose requirement for initiating final oocyte maturation prior to oocyte collection in in vitro fertilization (IVF), but doses that range from 2500- 15000 IU have been used. We intended to determine whether low dose u-hCG was effective for oocyte maturation in IVF/intracytoplasmic sperm injection (ICSI) cycles independent of body mass index (BMI).
We retrospectively evaluated a cohort of 295 women who underwent their first IVF/ICSI cycles between January 2003 and December 2010 at the Division of Reproductive Endocrinology and Infertility, Wayne State University, Detroit, MI, USA. Treatment cycles were divided into 3 groups based on BMI (kg/ m2): Only maternal age negatively impacted (P Administration of lower dose u-hCG was effective for oocyte maturation in IVF and did not affect the CPRs and LBRs irrespective of BMI. Women’s BMI need not be taken into consideration in choosing the appropriate dose of u-hCG for final oocyte maturation prior to oocyte collection in IVF. Only maternal age at the time of IVF negatively influenced CPRs and LBRs in this study.

Implantation remains a limiting step in IVF/ICSI. Endometrial injury isa promising procedure aiming at improving the implantation and pregnancy rates after IVF/ICSI.

The aim of this study was to evaluate the effect of endometrial injury induced in precedingcycle on IVF/ICSI outcome.

Four hundred patients undergoing their first IVF/ICSI cycle in two IVF units in Minia, Egypt were randomly selected to undergo either endometrial injury in luteal phase of preceding cycle (intervention group) or no treatment (control group). Primary outcome wasthe implantation and live birth ratesWhile the secondary outcome was clinical pregnancy, miscarriage, multiple pregnancy rates, pain and bleeding during and after procedure.

Implantation and live birth rates were significantly higher in intervention compared with control group (22.4% vs. 18.7%, p=0.02 and 67% vs. 28%, p=0.03), respectively. There was also a significant reduction in miscarriage rate in intervention group (4.8% vs. 19.7%, respectively, p

Endometrial injury in preceding cycle improves the implantation rate and live birth rate and reduces the miscarriage rate per clinical pregnancy in patients undergoing their first IVF/ICSI cycle.

To compare the pregnancy outcomes after two embryos versus three embryos transfers (ETs) in women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. This retrospective study was performed on three hundred eighty seven women with primary infertility and with at least one fresh embryo in good quality in order to transfer at each IVF/ICSI cycle, from September 2006 to June 2010. Patients were categorized into two groups according to the number of ET as follows: ET2 and E 3 groups, indicating two and three embryos were respectively transferred. Pregnancy outcomes were compared between ET2 and ET3 groups. Chi square and student t tests were used for data analysis. Clinical pregnancy and live birth rates were similar between two groups. The rates of multiple pregnancies were 27 and 45.2% in ET2 and ET3 groups, respectively. The rate of multiple pregnancies in young women was significantly increased when triple instead of double embryos were transferred. Logistic regression analysis indicated two significant prognostic variables for live birth that included number and quality of transferred embryos; it means that the chance of live birth following ICSI treatment increased 3.2-fold when the embryo with top quality (grade A) was transferred, but the number of ET had an inverse relationship with live birth rate; it means that probability of live birth in women with transfer of two embryos was three times greater than those who had three ET. Due to the difficulty of implementation of the elective single-ET technique in some infertility centers in the world, we suggest transfer of double instead of triple embryos when at least one good quality embryo is available for transfer in women aged 39 years or younger. However, to reduce the rate of multiple pregnancies, it is recommended to consider the elective single ET strategy.