Factors associated with spontaneous abortion following intracytoplasmic sperm
            injection (ICSI)

Basirat, Zahra; Kashifard, Mehrdad; Golsorkhtabaramiri, Masoumeh; Mirabi, Parvaneh

doi:10.5935/1518-0557.20190028

Cited by 6 publications

(7 citation statements)

References 25 publications

(27 reference statements)

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“…Pre-pregnancy BMI is an important indicator of pregnancy outcomes (12,13). Nevertheless, studies on the associations between pre-pregnancy BMI and miscarriages are limited, and the conclusions are inconsistent for pregnant women receiving ART treatment (14)(15)(16)(17)(18). Although some studies have reported that pre-pregnancy underweight and obesity both increase the miscarriage rate of pregnant women receiving ART treatment (19,20), other studies have reported no adverse effects of prepregnancy underweight, overweight, or obesity on the miscarriage rate of ART (14,18).…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, studies on the associations between pre-pregnancy BMI and miscarriages are limited, and the conclusions are inconsistent for pregnant women receiving ART treatment ( 14 – 18 ). Although some studies have reported that pre-pregnancy underweight and obesity both increase the miscarriage rate of pregnant women receiving ART treatment ( 19 , 20 ), other studies have reported no adverse effects of pre-pregnancy underweight, overweight, or obesity on the miscarriage rate of ART ( 14 , 18 ). Thus, the objective of the present study was to analyze the influence of pre-pregnancy BMI on miscarriage in women receiving ART treatment.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Pre-Pregnancy Body Mass Index and Miscarriage in an Assisted Reproductive Technology Population: A 10-Year Cohort Study

Yan

Zhao

et al. 2021

Front. Endocrinol.

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ObjectiveTo investigate the association between pre-pregnancy body mass index (BMI) and miscarriages in women who required assisted reproductive technology (ART) for conception.MethodsA retrospective cohort study was conducted using a 10-year (2006–2015) sample of 14,994 pregnancy cycles with ART treatment in Northwest Women’s and Children’s Hospital, Xi’an, China. The effects of women’s BMI before pregnancy on early miscarriage and miscarriage were assessed using generalized estimating equation models.ResultsThe risks of early miscarriage and miscarriage were higher in the obese group than in the normal weight group [early miscarriage: relative risk (RR) = 1.36, confidence interval (CI): 1.12–1.65; miscarriage: RR = 1.40, 95% CI: 1.17–1.68]. Pre-pregnancy underweight was not associated with an increased risk of early miscarriage or miscarriage. We observed interactions between pre-pregnancy BMI and singleton or twin pregnancy in early miscarriage and miscarriage (P = 0.017 and P = 0.003, respectively). Twin pregnancy increased the effects of pre-pregnancy BMI on early miscarriage and miscarriage (early miscarriage: a. singleton pregnancy: RR = 1.02, 95% CI: 1.01–1.04; b. twin pregnancy: RR = 1.08, 95% CI: 1.03–1.13; miscarriage: a. singleton pregnancy: RR = 1.02, 95% CI: 1.01–1.04; b. twin pregnancy: RR = 1.08, 95% CI: 1.05–1.13).ConclusionsPre-pregnancy obesity was associated with higher risks of early miscarriage and miscarriage in the ART population, and twin pregnancy increased the effects of pre-pregnancy BMI on early miscarriage and miscarriage. Women should maintain a normal BMI before ART initiation to prevent adverse pregnancy outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between Pre-Pregnancy Body Mass Index and Miscarriage in an Assisted Reproductive Technology Population: A 10-Year Cohort Study

Yan

Zhao

et al. 2021

Front. Endocrinol.

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“…The older the male, the higher the reproductive cell mutation rate of the offspring. Various factors associated with increasing age will destroy the DNA replication and repair mechanism and increase the possibility of DNA breakage, thus leading to the occurrence of abortion 29 , 30 . Although a consensus has been reached on the age of advanced mothers, which is agreed to be 35 years old, there is currently no agreement on the definition of the age of elderly fathers.…”

Section: Discussionmentioning

confidence: 99%

The threshold effect of factors associated with spontaneous abortion in human-assisted reproductive technology

Niu

Feng

et al. 2021

Sci Rep

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We explored the independent risk factors associated with cases of spontaneous abortion in infertile patients treated with human-assisted reproductive technology (ART) and established a smooth curve fit and perform a threshold effect analysis can provide guidance and a valuable reference for predicting the probability of spontaneous abortion. This was a retrospective cohort study of 16,097 patients successfully conceived with ART in Shangqiu First People's Hospital from June 2013 to December 2018. Overall, 2,378 (14.77%) had an abortion and 13,719 (85.23%) did not have an abortion. Multivariate logistic regression analysis showed that female age (OR 1.050; 95% CI 1.032–1.069; P < 0.001), male age (OR 1.100; 95% CI 1.086–1.115; P < 0.001), follicular-stimulating hormone (OR 1.049; 95% CI 1.022–1.076; P < 0.001), anti-Mullerian hormone (OR 0.893; 95% CI 0.862–0.925; P < 0.001) and the number of fetuses at pregnancy diagnosis were independent factors associated with spontaneous abortion. The threshold effect analysis found that when female age > 32 years (cut-off point) old, age and the risk of spontaneous abortion were positively correlated. When follicular-stimulating hormone > 6.1 IU/L (cut-off point), follicular-stimulating hormone was positively correlated with the occurrence of spontaneous abortion, When anti-Mullerian hormone ≤ 3.1 ng/mL (cut-off point), anti-Mullerian hormone was negatively correlated with the occurrence of spontaneous abortion and there was a linear positive correlation between antral Follicle Counting and live birth. In addition, the older the male age, the higher the incidence of abortion. The smooth curve fit and threshold effect analyses can provide a more detailed estimate of the probability of spontaneous abortion for pregnant couples.

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“…Total fertilization failure (TFF) occurs in 1–5% of ICSI cases ( Kyono et al , 2012 ; Montag et al , 2012 ; Vanden Meerschaut et al , 2014b ; Kashir et al , 2018 ; Basirat et al , 2019 ; Bassiri et al , 2020 ). Moreover, associations have been identified between embryo grading and congenital malformations, endocrine profile changes and deficient hearing in ICSI-conceived babies ( Abel et al , 2019 ; Belva et al , 2019 ; Yasemin Sert et al , 2019), while age, antimullerian hormone levels and antral follicle counts are associated with live birth rates following ICSI, with other hormones currently under investigation ( Metello et al , 2019 ; Zheng et al , 2019 ; Song et al , 2020 ; Tarín et al , 2020 ; Tiegs et al , 2020 ; Wang et al , 2020 ; Ye et al , 2020 ; Zanetti et al , 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Oocyte activation deficiency and assisted oocyte activation: mechanisms, obstacles and prospects for clinical application

Kashir

Ganesh

Jones

et al. 2022

Human Reproduction Open

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Background Oocyte activation deficiency (OAD) is attributed to the majority of cases underlying failure of intracytoplasmic sperm injection (ICSI) cycles, the standard treatment for male factor infertility. Oocyte activation encompasses a series of concerted events, triggered by sperm-specific phospholipase C zeta (PLCζ), which elicits increases in free cytoplasmic calcium (Ca2+) in spatially and temporally specific oscillations. Defects in this specific pattern of Ca2+ release is directly attributable to most cases of OAD. Ca2+ release can be clinically mediated via assisted oocyte activation (AOA), a combination of mechanical, electrical and/or chemical stimuli which artificially promote an increase in the levels of intracytoplasmic Ca2+. However, concerns regarding safety and efficacy underlie potential risks that must be addressed before such methods can be safely widely used. Objective and Rationale Recent advances in current AOA techniques warrant a review of the safety and efficacy of these practices, to determine the extent to which AOA may be implemented in the clinic. Importantly, the primary challenges to obtaining data on the safety and efficacy of AOA must be determined. Such questions require urgent attention before widespread clinical utilisation of such protocols can be advocated. Search Methods A literature review was performed using databases including PubMed, Web of Science, Medline etc. using assisted oocyte activation, oocyte activation deficiency, calcium ionophores, intra-cytoplasmic sperm injection, phospholipase c zeta, oocyte activation, failed fertilisation, and fertilisation failure as keywords. Relevant articles published until June 2019 were analysed and included in the review, with an emphasis on studies assessing large scale efficacy and safety. Outcomes Contradictory studies on the safety and efficacy of AOA do not yet allow for the establishment of AOA as standard practice in the clinic. Heterogeneity in study methodology, inconsistent sample inclusion criteria, non-standardised outcome assessments, restricted sample size and animal model limitations render AOA strictly experimental. The main scientific concern impeding AOA utilisation in the clinic is the non-physiological method of Ca2+ release mediated by most AOA agents, coupled with a lack of holistic understanding regarding the physiological mechanism(s) underlying Ca2+ release at oocyte activation. Limitations, reasons for caution The number of studies with clinical relevance using AOA remains significantly low. A much wider range of studies examining outcomes using multiple AOA agents are required. Wider Implications In addition to addressing the five main challenges of studies assessing AOA safety and efficacy, more standardized, large-scale, multi-centre studies of AOA, as well as long term follow-up studies of children born from AOA, would provide evidence for establishing AOA as a treatment for infertility. The delivery of an activating agent that can more accurately recapitulate physiological fertilisation, such as recombinant PLCζ, is a promising prospect for the future of AOA. Further to PLCζ, many other avenues of physiological oocyte activation also require urgent investigation to assess other potential physiological avenues of AOA. Study Funding/Competing Interests DG was supported by Stanford University’s Bing Overseas Study Program. JK was supported by a Healthcare Research Fellowship Award (HF-14-16) made by Health and Care Research Wales (HCRW), alongside a National Science, Technology, and Innovation plan (NSTIP) project grant (15-MED4186-20) awarded by the King Abdulaziz City for Science and Technology (KACST). The authors have no competing interests to declare. Lay Summary At fertilisation, oocyte activation is triggered by sperm-specific phospholipase C zeta (PLCζ) by releasing calcium in specific patterns within the oocyte. A deficiency in this process underlies most cases of fertilisation failure in mammals. This process of calcium release can be clinically mimicked via assisted oocyte activation (AOA), involving a combination of mechanical, electrical and/or chemical stimuli. Recent advances in AOA techniques warrant a review of the safety and efficacy of these practices and of how AOA may be clinically implemented in the clinic. Herein, following a detailed literature review examining studies assessing large scale efficacy and safety, the main concern impeding clinical AOA implementation is its non-physiological nature, coupled with a lack of holistic understanding of physiological mechanism(s) underlying calcium release at fertilisation. We find that numerous questions require urgent attention before widespread clinical utilisation of such protocols can be advocated. We hope that this article will be able to aid the burgeoning number of researchers investigating the clinical efficacy of such methodology in further refining the practice until large scale utilisation can be achieved and accepted.

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Factors associated with spontaneous abortion following intracytoplasmic sperm injection (ICSI)

Cited by 6 publications

References 25 publications

Association Between Pre-Pregnancy Body Mass Index and Miscarriage in an Assisted Reproductive Technology Population: A 10-Year Cohort Study

Association Between Pre-Pregnancy Body Mass Index and Miscarriage in an Assisted Reproductive Technology Population: A 10-Year Cohort Study

The threshold effect of factors associated with spontaneous abortion in human-assisted reproductive technology

Oocyte activation deficiency and assisted oocyte activation: mechanisms, obstacles and prospects for clinical application

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