Effect of endometrial cavity fluid on pregnancy rate of fresh versus frozen In Vitro fertilization cycle

Abstract

Objective:This study aims to study the difference in etiology and outcome in terms of implantation rate and abortion rate in fresh (self-stimulated) versus frozen (oocyte donation cycle) in vitro fertilization (IVF) and in transient versus persistent fluid.Material and Methods:This retrospective study was conducted in the Department of Reproductive Medicine of tertiary care center from January 2012 to November 2015. Data were collected retrospectively from the departmental files. Twenty-four patients from fresh IVF-stimulated cycles and 24 from frozen oocyte donation cycle with their endometrium prepared by hormone replacement treatment were included in the study. All patients selected in the study had grade-A embryo transfer of day 3–4 with maximum three embryo transferred. Pregnancy was defined by rising serum beta-human chorionic gonadotrophin levels performed after 14 days of embryo transfer and further confirmed by ultrasonographic visualization of gestational sac at 6 weeks. All biochemical pregnancies were included in implantation failure. All pregnant patients were followed till the termination of pregnancy and further noted as live birth or abortion.Results:Clinical pregnancy rate was seen more in self-stimulated cycle (62.5%) with live birth rate of 50% than hormone replacement treatment cycle, in which clinical pregnancy rate was 45.83% with live birth rate of 33.33%. Clinical pregnancy rate was highest in group with very less fluid in cavity (1–2 mm) 63% and with live birth of 52.63%. Clinical pregnancy was seen only in two patients of group B with anterior and posterior (AP) diameter of fluid in cavity of 2–3 mm with live birth of only one, whereas in group C, with AP diameter of 3–5 mm, none of the patient conceived. This difference was statistically significant. Clinical pregnancy rate was 65.62% in transient fluid accumulation with live birth rate of 53.25%, which was significantly higher than persistent fluid accumulation (P value − 0.0337 for pregnancy rate and 0.0312 for live birth rate).Conclusion:Fluid accumulation seen in fresh cycles are generally associated with better outcome because it may be associated with good prognostic factors – small AP diameter of fluid, with transient fluid accumulation and more with poly cystic ovarian syndrome as an etiological factor; however, in frozen cycle, it can be associated with poor outcome.

Reduced pregnancy and live birth rates after in vitro fertilization in women with cesarean section scar diverticulum: A retrospective cohort study

“…This result was consistent with the results of the previous studies., which showed that fluid accumulation within the uterine cavity reduced the clinical pregnancy rate in women undergoing IVF. 11,19 However, the study conducted by Lawrenz et al demonstrated the contrary results that showed that the endometrial cavity fluid did not have the impact on the patients with isthmocele. 9 Although the endometrial cavity fluid persisted for the last transvaginal ultrasound examination canceled the frozen embryo transfer in our institute, the deleterious effects of endometrial cavity fluid still exist which include the release of cytokines, prostaglandins, and other inflammatory compounds into the endometrium.…”

Intra-Cavitary Fluid Resulted From Caesarean Section But Not Isthmocele Compromised Clinical Pregnancy After IVF/ICSI Treatment

“…ICF may be cause by many factors, such as hydrosalpinges, polycystic ovarian disease, subclinical uterine infections and endometriosis [10,19]. Our data show that the proportion of ICF associated with hydrosalpinx or OHSS was less than 5%, as uid associated with hydrosalpinx [19] and PCOS [24] has been con rmed to impact clinical outcomes, and most such patients underwent a frozen protocol in our centre. The potential cause of ICF may be explained by endometriosis, a nding that is supported by two other studies in non-tubal factor patients [25,26].…”

“…With the increasing CS rate worldwide, more infertile women are seeking to become pregnant with a scar on their uterus. Many studies have con rmed an uncompromised clinical outcome in patients with a history of CS and reported an even lower pregnancy rate when a niche was mentioned [7,24,30,32,33]. Previous studies agere that there is an impact in clinical outcomes, though some of them focus on isthmocele, and they describe blood or mucus on catheter [34].…”

Endometrial cavity fluid is associated with deleterious pregnancy outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection: a retrospective cohort study

“…Presently, the causes and effects of ECF remain unclear. Previous studies have found that the production of ECF may be related to pathological conditions such as hydrosalpinx, polycystic ovary disease, or subclinical uterine infection, or may be caused by the physiology of the reproductive tract (8). Following COH, ovarian hyperstimulation syndrome (OHSS) is associated with extravasation of secretions and obstruction of the cervix leading to ECF, which can occur when there are cervical canal obstructions and pelvic adhesions (4).…”