A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

Labarta, Elena; Bosch, Ernesto; Mercader, Amparo; Alamá, Pilar; Mateu, Emilia; Pellicer, António

doi:10.1155/2017/5637923

Cited by 31 publications

(35 citation statements)

References 32 publications

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“…Nine studies analyzing the impact of COS on euploidy rates have been published (Baart et al 2007, Verpoest et al 2008, Rubio et al 2010, Massie et al 2011, Ata et al 2012, Labarta et al 2012, 2017, Barash et al 2017, Sekhon et al 2017. Labarta et al recently maintained that aneuploidy rate did not increase with ovarian response or gonadotropin dosage (Labarta et al 2017). Also, the authors observed that the number of euploid embryos was inversely related to the ovarian sensitivity index (Huber et al 2013), which correlates the amount of gonadotropins needed per oocyte obtained (Labarta et al 2017).…”

Section: Association Of Ovarian Stimulation and Aneuploidymentioning

confidence: 97%

“…Labarta et al recently maintained that aneuploidy rate did not increase with ovarian response or gonadotropin dosage (Labarta et al 2017). Also, the authors observed that the number of euploid embryos was inversely related to the ovarian sensitivity index (Huber et al 2013), which correlates the amount of gonadotropins needed per oocyte obtained (Labarta et al 2017). Several non-randomized studies have also determined that aneuploidy rate was not associated with the number of embryos generated (Ata et al 2012, Barash et al 2017, Sekhon et al 2017.…”

Section: Association Of Ovarian Stimulation and Aneuploidymentioning

confidence: 97%

“…More recently it has been published that a total of 3.4 metaphase II (MII) oocytes were needed to obtain one euploid embryo in patients <35 years (Labarta et al 2017), and, considering the median value as a reference point, the authors observed that the mean of euploid embryos was 5.0 ± 2.4 (median 5.0) when the number of oocytes obtained was ≥median (17 oocytes), and it was 2.6 ± 1.4 (median 2.5) when ovarian response was below it (P < 0.001). Furthermore, when the number of euploid embryos was segregated by ovarian response, the authors observed ~2 euploid embryos with 1-12 oocytes, ~3 euploid embryos with 13-16 oocytes, ~5 euploid embryos with 17-23 oocytes and ~6 euploid embryos with >23 oocytes.…”

Section: Number Of Blastocysts Needed To Obtain One Euploid Embryomentioning

confidence: 99%

“…In conventional IVF, retrieving less than four oocytes is considered a POR, and the risk of POR increases when there is a low ovarian reserve (Ferraretti et al 2011), whereas for PGT, the retrieval of <10 oocytes had been previously considered insufficient (Vandervorst et al 1998). The cumulative probability of achieving a LB does not plateau at any level of ovarian response, reaching in the extreme high response (>30 oocytes) values above 75% and that the number of euploid embryos increases as the number of retrieved oocytes does (Ata et al 2012, Labarta et al 2017. Therefore, in PGT cycles, the preferred strategy is a stimulation protocol aiming to exploit the ovarian response as much as possible without incurring in adverse effects to the patient.…”

Section: Treatment-related Variables In Pgt Cyclesmentioning

confidence: 99%

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Ovarian stimulation for preimplantation genetic testing

Rodriguez-Purata

Martínez

2019

Reproduction

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A narrative review of the management of controlled ovarian stimulation in patients undergoing preimplantation genetic testing is presented. An electronic search was performed to identify research publications that addressed ovarian stimulation and preimplantation genetic testing published until December 2017. Studies were classified in decreasing categories: randomized controlled trials, prospective controlled trials, prospective non-controlled trials, retrospective studies and experimental studies. The aim of controlled ovarian stimulation has shifted from obtaining embryos available for transfer to yielding the maximum embryos available for biopsy to increase the odds of achieving one euploid embryo available for transfer, without the distress of inducing ovarian hyperstimulation syndrome or inadequate endometrium receptivity as vitrification and deferred embryo transfer usually will be planned. The present narrative review summarizes all treatment-related variables as well as stimulation strategies after controlled ovarian stimulation that could help patients undergoing an in vitro fertilization cycle coupled with preimplantation genetic testing, including the number of oocytes needed to achieve one healthy live birth, oral contraceptive pill usage, the role of mild ovarian stimulation or random-start stimulation, the stimulation protocol and type of gonadotropin of choice, the novel progesterone protocols, agonist or dual trigger as a final oocyte maturation trigger, the accumulation of oocytes/embryos and the optimal interval before proceeding with a subsequent controlled ovarian stimulation or the optimal medication to link stimulation cycles. The discussion is being presented according to how questions are posed in clinical practice. The aim of ovarian stimulation has shifted from obtaining embryos available for transfer to yielding the maximum embryos available for biopsy to increase the odds of achieving one euploid embryo available for transfer.

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Section: Association Of Ovarian Stimulation and Aneuploidymentioning

confidence: 97%

Section: Association Of Ovarian Stimulation and Aneuploidymentioning

confidence: 97%

Section: Number Of Blastocysts Needed To Obtain One Euploid Embryomentioning

confidence: 99%

Section: Treatment-related Variables In Pgt Cyclesmentioning

confidence: 99%

See 2 more Smart Citations

Ovarian stimulation for preimplantation genetic testing

Rodriguez-Purata

Martínez

2019

Reproduction

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“…A recent study in a population of young normovulatory women showed that a high ovarian response after controlled ovarian stimulation with moderate gonadotropin doses did not increase the embryo aneuploidy rate. Indeed, the higher the ovarian response, the more the euploid embryos obtained [80]; the remaining question is whether this can also be extrapolated to infertile patients with good ovarian reserve.…”

Section: Ovarian Stimulation and The Incidence Of Embryo Aneuploidymentioning

confidence: 99%

Aneuploidy Rates Inversely Correlate with Implantation during In Vitro Fertilization Procedures: In Favor of PGT

Schaeffer¹,

Porchia²,

López-Luna³

et al. 2019

Modern Medical Genetics and Genomics

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Aneuploidy, the hold of an abnormal number of chromosomes that differs from the normal karyotype, is a recognized leading cause of miscarriage and congenital disabilities. In human gametes and embryos, aneuploidy rates are prevalent, and these rates increase with advanced maternal age; additionally, it has been suggested that hormonal stimulation for achieving in vitro fertilization (IVF) protocols further increases aneuploidy rates. Although about 65% of chromosomally abnormal embryos culminate in spontaneous miscarriages, there is still evidence of live births harboring crucial aneuploidies. Furthermore, although some frequent aneuploidies are consistent, others differ between countries, making it harder to focus on a specific set of anomalies but vital to focus regionally on those more prevalent. Preimplantation genetic testing (PGT) is a highly endorsed technique in assisted reproductive treatments to evaluate possible embryo aneuploidies, genetic defects, and congenital disorders. On this subject, this study shows that IVF aneuploidy rates in embryo cohorts of high morphological quality are inversely associated with implantation rates. In its entirety, this study reinforces the utility of PGT for embryo evaluation.

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Individualised gonadotropin dose selection using markers of ovarian reserve for women undergoing in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI)

Lensen

Wilkinson

Leijdekkers

et al. 2018

Cochrane Database of Systematic Reviews

119

122

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We did not find that tailoring the FSH dose in any particular ORT population (low, normal, high ORT), influenced rates of live birth/ongoing pregnancy but we could not rule out differences, due to sample size limitations. In predicted high responders, lower doses of FSH seemed to reduce the overall incidence of moderate and severe OHSS. Moderate-quality evidence suggests that ORT-based individualisation produces similar live birth/ongoing pregnancy rates to a policy of giving all women 150 IU. However, in all cases the confidence intervals are consistent with an increase or decrease in the rate of around five percentage points with ORT-based dosing (e.g. from 25% to 20% or 30%). Although small, a difference of this magnitude could be important to many women. Further, ORT algorithms reduced the incidence of OHSS compared to standard dosing of 150 IU, probably by facilitating dose reductions in women with a predicted high response. However, the size of the effect is unclear. The included studies were heterogeneous in design, which limited the interpretation of pooled estimates, and many of the included studies had a serious risk of bias.Current evidence does not provide a clear justification for adjusting the standard dose of 150 IU in the case of poor or normal responders, especially as increased dose is generally associated with greater total FSH dose and therefore greater cost. However, a decreased dose in predicted high responders may reduce OHSS.

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A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

Cited by 31 publications

References 32 publications

Ovarian stimulation for preimplantation genetic testing

Ovarian stimulation for preimplantation genetic testing

Aneuploidy Rates Inversely Correlate with Implantation during In Vitro Fertilization Procedures: In Favor of PGT

Individualised gonadotropin dose selection using markers of ovarian reserve for women undergoing in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI)

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