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We compared the accuracy, consistency, time, comfort, and cost of probing with a conventional hand probe (CP) with 3-mm banded markings, a manual pressure-regulated probe (MP), and two electronic probes (IP and FP). Twenty (20) examiners used all four probes on a test block to determine accuracy; measurements compared favorably to the reference block. Two calibrated examiners probed the Ramfjord teeth of 10 periodontal patients on maintenance regimens, six sites per tooth (n = 708), with all four probes; measurements were repeated after one week. Wilcoxon signed-rank test showed the CP measured more deeply (P < 0.0001) than MP, FP, and IP with mean differences of 0.40, 0.67, and 0.58 respectively. MP measured more deeply (P < 0.001) than FP and IP, with mean differences of 0.27 and 0.18 mm. There was no difference between FP and IP. Time (min:sec) required by one examiner to perform full mouth probing on six subjects (minimum of 26 teeth each) was CP = 3:59; MP = 4:18; FP = 6:16; and IP = 7:23. Subjects rated FP and IP as slightly more uncomfortable than CP or MP. Cost per 1,000 uses was computed based on available data. The IP and FP took longer to perform and cost more per procedure than did the CP and MP. Spearman rank-order correlation revealed that only probe depths measured by CP and MP were well correlated (rs = 0.67). Although some statistically significant differences were found between probes, no differences were considered to be of clinical significance when probing periodontally healthy or maintenance patients.(ABSTRACT TRUNCATED AT 250 WORDS)

We demonstrate that one fresh cycle with high oocyte yield is an optimal way to plan IVF treatment. With modern cryopreservation methods, the concept of "one-and-done" could safely achieve ≥2 live births with just one stimulation cycle in almost a quarter of our patients.

STUDY QUESTION What are the cohort trends of women undergoing oocyte cryopreservation (OC)? SUMMARY ANSWER There has been a dramatic increase in OC cycles undertaken each year since 2010, and the demographics of women accessing OC has shifted to a younger age group, but so far very few women have returned to use their cryopreserved oocytes in treatments. WHAT IS KNOWN ALREADY Although OC, as a method of fertility preservation, is offered around the world, global data are lacking on who is accessing OC, who is returning to thaw oocytes and whether these trends are changing. STUDY DESIGN, SIZE, DURATION A trinational retrospective cohort study was performed of 31 191 OC cycles and 972 oocyte thaw (OT) cycles undertaken in the USA (2010–2016) and 3673 OC and 517 OT cycles undertaken in Australia/New Zealand (Aus/NZ; 2010–2015). PARTICIPANTS/MATERIALS, SETTING, METHODS Data were obtained from the USA Society for Assisted Reproductive Technology (SART) national registry and the Australian and New Zealand Assisted Reproduction Database (ANZARD). De-identified data were requested on all autologous oocyte freeze-all cycles and all cycles where autologous oocytes were thawed to be used in a treatment cycle for the time periods of interest. MAIN RESULTS AND THE ROLE OF CHANCE In both the USA and Aus/NZ, there has been a dramatic rise in the number of OC cycles performed each year (+880% in the USA from 2010 to 2016 and +311% in Aus/NZ from 2010 to 2015). Across both regions, most women undergoing OC were aged in their late 30s, but the average age decreased over time (USA: 36.7 years vs 34.7 years in 2010 and 2016, respectively). The number of women returning for thaw cycles was low (USA: 413 in 2016, Aus/NZ: 141 in 2015) and most thaw cycles (47%) across both regions involved oocytes that were frozen for &lt;6 months. In the USA, a higher proportion of cycles resulted in a live birth when only thawed oocytes were used, compared to cycles that combined thawed oocytes with fresh oocytes (25% vs 11%, respectively; P &lt; 0.001). Age at retrieval influenced live birth rate in the USA; 38% of thaw cycles started in women who stored oocytes when aged ≤35 years resulted in a live birth, whereas only 16% resulted in a live birth for women who stored oocytes when aged ≥36 years. Similar data were unobtainable from Aus/NZ. LIMITATIONS, REASONS FOR CAUTION There were limitations associated with both the SART and ANZARD data outputs received. The format in which the ANZARD data were provided, and the inconsistencies seen amongst cycle reporting in the SART dataset, restricted data interpretation. For example, both datasets did not provide a clear indication as to why women were undergoing OC and it was not possible to accurately calculate duration of storage for thaw cycles in the USA. We also did not obtain details on embryo quality from either database and acknowledge that embryo quality and subsequent outcome (embryo freezing or discard) would be of interest, especially when considering the efficacy of OC. WIDER IMPLICATIONS OF THE FINDINGS The data show that there is widespread demand for OC, and it is increasingly undertaken by younger women; however, the limitations encountered in the dataset support the need for a shift to a more uniform approach to data collection and presentation by large databases, worldwide. STUDY FUNDING/COMPETING INTEREST(S) This study received funding from the Fertility Society of Australia to support the ANZARD data extraction. M.J. is supported by an Australian Government Research Training Program Scholarship stipend. The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.

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BACKGROUND: Surmounting evidence suggests that frozen embryo transfer results in higher pregnancy and live birth rates compared to fresh transfer during in vitro fertilization (IVF) (1, 2). There is conflicting data regarding neonatal outcomes: preterm birth, pre-eclampsia and birth weight (3, 4). The effect of embryo cryopreservation on the placental morphology is not well understood. OBJECTIVE: To evaluate differences in placental morphology from infants conceived with cryothaw compared to fresh transfer in IVF. MATERIALS AND METHODS: A retrospective cohort study from 2009 through 2015 of live births resulting from IVF with autologous oocytes. The placentas were divided into two groups, those from cryothaw embryo transfers and those from fresh embryo transfers. Gross and histologic placental specimens were examined. Morphologic pathology was categorized into anatomic (e.g. cord malinsertion or circumvallate), infectious (choramnionitis), inflammatory (e.g. villitis of unknown etiology, deciduitis), and vascular/thrombotic (placental abruption, intervillous thrombus, maternal and fetal vascular malperfusion). T-tests and Chi square were used for analysis with 95% confidence intervals (CIs). Logistic regression modeling was used to control for age, race, body mass index, fertility diagnosis and gestational age gestational age at delivery. RESULT(S): A total of 838 placentas were reviewed; 13% from cryothaw transfers and 87% from fresh transfers. Gestational age was similar between the two groups, (38.5 vs. 37.7 weeks p¼ 0.2). The mean birth weight of singleton infants was higher in the cryothaw group (3241.6 grams) than in the fresh group (3099.5 grams, p¼0.001). There was no difference in the proportion of placentas submitted to pathology in frozen vs. fresh group (36% vs. 40%, p>0.05). Controlling for regression modeling, there were fewer vascular/thrombotic morphologies in the cryothaw transfers when compared to the fresh (aOR¼0.31, CI¼0.11-0.81, p<0.05). There were also fewer anatomic morphologies in the cryothaw group as compared to the fresh group (aOR¼ 0.24.

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