Blastocyst culture and transfer: lessons from an unselected, difficult IVF population

Weissman, Ariel; Biran, G.; Nahum, H; Glezerman, Marek; Levran, David

doi:10.1016/s1472-6483(10)60198-8

Cited by 7 publications

(6 citation statements)

References 57 publications

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“…These findings are consistent with another recent study [15], which also reported that blastocyst culture and transfer reduced implantation and pregnancy rates in the general ART patient population compared to cleavage-stage embryo transfer. Nevertheless, positive results of blastocyst transfer have been reported by many previous studies, which all revealed higher implantation and pregnancy rates with blastocyst transfer compared to cleavage-stage embryo transfer [16-20].…”

Section: Discussionsupporting

confidence: 93%

Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients

Tong

Cao

et al. 2012

J Ovarian Res

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ObjectivesThis study sought to evaluate the outcome of fresh and vitrified-warmed cleavage-stage and blastocyst-stage embryo transfers in patients undergoing ART treatment within an ethnic Chinese population.Study designWe compared the clinical results of embryo transfer on the 3rd (cleavage stage) or 5th (blastocyst stage) day after oocyte retrieval, including clinical pregnancy rates, implantation rates and multiple pregnancy rates.ResultsOur data showed that blastocyst transfer on day 5 did not significantly increase clinical pregnancy rate (41.07% vs 47.08%, p>0.05) and implantation rate (31.8% vs 31.2%, p>0.05) in patients under 35 years of age, in comparison with day 3 cleavage stage embryo transfer. In patients older than 35 years of age, the clinical pregnancy rate after blastocyst transfer was slightly decreased compared with cleavage stage embryo transfer (33.33% vs 42.31%, p>0.05). Unexpectedly, It was found that vitrified-warmed blastocyst transfer resulted in significantly higher clinical pregnancy rate (56.8%) and implantation rate (47%) compared with fresh blastocyst transfer in controlled stimulation cycles (41.07% and 31.8%, respectively). For patients under 35 years of age, the cumulative clinical pregnancy rate combining fresh and vitrified-warmed blastocyst transfer cycles were significantly higher compared to just cleavage-stage embryo transfer (70.1% versus 51.8%, p<0.05). However, the cumulative multiple pregnancy rates showed no significant difference between the two groups.ConclusionsIn an ethnic Chinese patient population, fresh blastocyst transfer does not significantly increase clinical pregnancy rate. However, subsequent vitrified-warmed blastocyst transfer in a non-controlled ovarian hyperstimulation cycle dramatically improves clinical outcomes. Therefore, blastocyst culture in tandem with vitrified-warmed blastocyst transfer is recommended as a favourable and promising protocol in human ART treatment, particularly for ethnic Chinese patients.

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Section: Discussionsupporting

confidence: 93%

Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients

Tong

Cao

et al. 2012

J Ovarian Res

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“…We noted earlier that eSET produces lower birth rates than two-embryo transfers [ 26 , 27 ]; but eSET is also convincingly associated with declining multiple pregnancies (Table 1 ). Losses in birthrates with eSET can be compensated for by an additional thaw cycle [ 26 , 27 ]. Those compensatory births, however, do not appear in the CDC’s ASRs of fndIVF cycles.…”

Section: Resultsmentioning

confidence: 65%

Time associations between U.S. birth rates and add-Ons to IVF practice between 2005–2016

Gleicher

Mochizuki

Barad

2021

Reprod Biol Endocrinol

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Until 2010, the National Assisted Reproductive Technology Surveillance System (NASS) report, published annually by the Center for Disease Control and Prevention (CDC), demonstrated almost constantly improving live birth rates following fresh non-donor (fnd) in vitro fertilization (IVF) cycles. Almost unnoticed by profession and public, by 2016 they, however, reached lows not seen since 1996–1997. We here attempted to understand underlying causes for this decline. This study used publicly available IVF outcome data, reported by the CDC annually under Congressional mandate, involving over 90% of U.S. IVF centers and over 95% of U.S. IVF cycles. Years 2005, 2010, 2015 and 2016 served as index years, representing respectively, 27,047, 30,425, 21,771 and 19,137 live births in fnd IVF cycles. Concomitantly, the study associated timelines for introduction of new add-ons to IVF practice with changes in outcomes of fnd IVF cycles. Median female age remained at 36.0 years during the study period and center participation was surprisingly stable, thereby confirming reasonable phenotype stability. Main outcome measures were associations of specific IVF practice changes with declines in live IVF birth rates. Time associations were observed with increased utilization of “all-freeze” cycles (embryo banking), mild ovarian stimulation protocols, preimplantation genetic testing for aneuploidy (PGT-A) and increasing utilization of elective single embryo transfer (eSET). Among all add-ons, PGT-A, likely, affected fndIVF most profoundly. Though associations cannot denote causation, they can be hypothesis-generating. Here presented time-associations are compelling, though some of observed pregnancy and live birth loss may have been compensated by increases in frozen-thawed cycles and consequential pregnancies and live births not shown here. Pregnancies in frozen-thawed cycles, however, represent additional treatment cycles, time delays and additional costs. IVF live birth rates not seen since 1996–1997, and a likely continuous downward trend in U.S. IVF outcomes, therefore, mandate a reversal of current outcome trends, whatever ultimately the causes.

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“…No significant difference in demographic data was found between them, but the number of repeated implantation failure (RIF) was significantly higher in A (P= 0.027) than B. Also, comparisons of follicles number by U/S after stimulation cycle and before OPU showed that significant differences were noticed in number of follicles with size of (15)(16)(17) mm in B and P= 0.022. A high number of oocytes retrieved was noticed in B (12.41+5.82) than A (10.57+6.02), while the number of abnormal oocytes retrieved from patients of A were more (1.25+1.75) than those retrieved from patients of B (1.15+1.59), but not significant.…”

Section: Resultsmentioning

confidence: 88%

“…Studies that follow up PRs after continual ICSI attempts showed that the possibility of pregnancy per cycle tends to be stabilized in the first three attempts, and then it declines afterwards. Some specialists considered that after each failed trial, the PRs in subsequent trial decrease by as much as 57%, but the most remarkable decrease is noticed after the third trial (16,17) . The stimulation data of all patients who entered COH were compared (table1).…”

Section: Discussionmentioning

confidence: 99%

Embryo Glue and Clinical Pregnancy Rates in Icsi Embryo Transfer Cycles: A Prospective Study

Fadhil

Selman

Al-Obaidi

2021

JHMN

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Purpose: One of the reasons for failed implantation after transferring good quality embryos in an intracytoplasmic sperm injection cycle is the failure of creation a viscid layer between the embryo and the endometrium. Many modifications have been made in embryo transfer medium to improve implantation and increase pregnancy rates such as adding albumin as a source of energy and adding hyaluronic acid in high concentrations such as in Embryo Glue medium: a human embryo transfer medium. To investigate whether the use of Embryo Glue had any effect on clinical pregnancy rates in intracytoplasmic sperm injection-fresh embryo transfer cycles. Methods: A prospective study included one hundred and twenty-eight infertile Iraqi women who were selected and subjected to a stimulation protocol in an intracytoplasmic sperm injection-fresh embryo transfer cycle. All patients were considered to be eligible for embryo transfer (no visible causes could prevent implantation) and only good quality embryos were transferred to them. Those women were divided randomly into two groups according to type of embryo transfer medium: group A: Embryo Glue medium. group B: Conventional medium. Then group A was subdivided according to age into: AI (34 women with age < 35 years and represented 50.7%) AII (33 women with age ≥ 35 years and represented 49.3%) While group B was subdivided into: BI (41women with age < 35 years and represented 67.3%) BII (20 women with age ≥ 35 years and represented 32.7%). Results: Although there was no significant difference between all groups in causes of infertility, the pregnancy rate was significantly higher in subgroup AII (18 pregnant from 33 women) while only 5 patients became pregnant from 20 patients in subgroup BII. In all women no more than four good quality embryos were transferred, and when total number of transferred embryos was significantly more in group B than group A (P=0.013), the significant increase in pregnancy rates was only observed in subgroup AII (P=0.048). Even though a highly significant difference in number of repeated implantation failure was in group A than group B (P=0.027), the pregnancy rates were significantly higher in group A (P=0.038). Conclusion: This study concluded that using Embryo Glue has a beneficial effect on old women and increase pregnancy rates, also it has a positive effect on pregnancy rates in repeated implantation failure and increases pregnancy rates even if the women is old.

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Blastocyst culture and transfer: lessons from an unselected, difficult IVF population

Cited by 7 publications

References 57 publications

Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients

Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients

Time associations between U.S. birth rates and add-Ons to IVF practice between 2005–2016

Embryo Glue and Clinical Pregnancy Rates in Icsi Embryo Transfer Cycles: A Prospective Study

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