In vitro fertilization in women under 35: counseling should differ by age

Humm, K.C.; Dodge, Laura E.; Wu, Liang; Penzias, Alan S.; Malizia, B.A.; Sakkas, Denny; Hacker, Michele R.

doi:10.1007/s10815-015-0570-7

Cited by 10 publications

(6 citation statements)

References 14 publications

(23 reference statements)

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“…The clinical pregnancy rate in our study is comparable to published results for the 25- to 35-year age group (35%–36%) [ 24 ]. The clinical pregnancy rate in the thinning group did not differ between age groups (36.7% in those ≤34 years of age vs. 35.1% in those ≥35 years of age).…”

Section: Discussionsupporting

confidence: 90%

Thinning and drilling laser-assisted hatching in thawed embryo transfer: A randomized controlled trial

Lê

Nguyen

et al. 2018

Clin Exp Reprod Med

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ObjectiveIn frozen and thawed embryos, the zona pellucida (ZP) can be damaged due to hardening. Laser-assisted hatching (LAH) of embryos can increase the pregnancy rate. This study compared thinning and drilling of the ZP before frozen embryo transfer (FET).MethodsPatients were randomly allocated into two groups for LAH using thinning or drilling on day 2 after thawing. Twenty-five percent of the ZP circumference and 50% of the ZP thickness was removed in the thinning group, and a hole 40 µm in diameter was made in the drilling group.ResultsA total of 171 in vitro fertilization/intracytoplasmic sperm injection FET cycles, including 85 cycles with drilling LAH and 86 cycles with thinning LAH, were carried out. The thinning group had a similar β-human chorionic gonadotropin-positive rate (38.4% vs. 29.4%), implantation rate (16.5% vs. 14.4%), clinical pregnancy rate (36.0% vs. 25.9%), miscarriage rate (5.8% vs. 2.4%), ongoing pregnancy rate (30.2% vs. 23.5%), and multiple pregnancy rate (7.0% vs. 10.6%) to the drilling LAH group. There were no significant differences in pregnancy outcomes between subgroups defined based on age (older or younger than 35 years) or ZP thickness (greater or less than 17 µm) according to the LAH method.ConclusionThe present study demonstrated that partial ZP thinning or drilling resulted in similar outcomes in implantation and pregnancy rates using thawed embryos, irrespective of women's age or ZP thickness.

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Section: Discussionsupporting

confidence: 90%

Thinning and drilling laser-assisted hatching in thawed embryo transfer: A randomized controlled trial

Lê

Nguyen

et al. 2018

Clin Exp Reprod Med

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“…It is well established that abnormalities in the bidirectional embryo-endometrial dialog are one of the major cause of infertility resulting in implantation failure [2,3]. Noteworthy, advancing maternal age represents one of the major causes of the altered embryo-endometrial communication [4]. As expected, several large studies have reported age-specific outcomes of IVF, and maternal age has clearly been associated with a decline in cumulative live birth rates in patients older than 37 [5,6].…”

Section: Introductionmentioning

confidence: 76%

Proteomic profile of maternal-aged blastocoel fluid suggests a novel role for ubiquitin system in blastocyst quality

Tedeschi

Albani

Borroni

et al. 2016

J Assist Reprod Genet

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Purpose The etiology of maternal aging, a common cause of female factor infertility and a rate-limiting step in vitro fertilization (IVF) success, remains still unclear. Proteomic changes responsible for the impaired successful pregnancy outcome after IVF with aged blastocysts have not been yet evaluated. The objective of this prospective study was to employ proteomic techniques and bioinformatic tools to enlight differences at the protein level in blastocoel fluid of aged and younger woman. Methods Protein composition of human blastocoel fluid isolated by micromanipulation from 46 blastocysts of women aged <37 years (group A) and 29 of women aged ≥37 years (group B) have been identified by a shotgun proteomic approach based on high-resolution nano-liquid chromatography electrospray-ionization-tandem mass spectrometry (nLC-ESI-MS/MS) using label free for the relative quantification of their expression levels. Results The proteomic analysis leads to the identification and quantification of 148 proteins; 132 and 116 proteins were identified in groups A and B, respectively. Interestingly, the identified proteins are mainly involved in processes aimed at fine tuning embryo implantation and development. Among the 100 proteins commonly expressed in both groups, 17 proteins are upregulated and 44 downregulated in group B compared to group A. Overall, the analysis identified 33 proteins, which were increased or present only in B while 76 were decreased in B or present only in A. Conclusions Data revealed that maternal aging mainly affects blastocyst survival and implantation through unbalancing the equilibrium of the ubiquitin system known to play a crucial role in fine-tuning several aspects required to ensure successful pregnancy outcome.

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“…The likelihood of live birth among women age <30 who undergo IVF is excellent. Previous work from this center has shown that after six cycles, 58 % of patients age <25 and 69 % of patients age 25-<30 will achieve a live birth [14]. Why then do women with such positive prognoses for pregnancy discontinue treatment at the same rate as women who have lower chances for success?…”

Section: Discussionmentioning

confidence: 99%

The impact of younger age on treatment discontinuation in insured IVF patients

Dodge

Sakkas

Hacker

et al. 2016

J Assist Reprod Genet

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Purpose This retrospective cohort study aimed to determine whether age influences treatment discontinuation among insured patients undergoing in vitro fertilization (IVF). We hypothesized that the youngest patients would be the least likely to discontinue treatment. Methods All women age 18-42 who underwent their first fresh, non-donor IVF cycle from 2002 to 2013 were followed until a live birth was achieved, until they discontinued treatment at our center (not presenting for treatment for a one-year period), or until they completed six fresh or frozen embryo transfer cycles, whichever occurred first. Results Of 11,361 women included, 4336 (38.2 %) discontinued treatment at our center before achieving a live birth or undergoing six IVF cycles. Discontinuation differed by age for cycles 2-4 (all P ≤ 0.004), with the proportion among women age 40-42 averaging 6-7 % higher than the other groups; discontinuation per cycle was similar among women <30 compared to women age 30-<35 and 35-<40. This continued in cycles 5 and 6, and in the sixth, 35.2, 32.0, 32.3, and 40.2 % of women among the four age groups discontinued treatment, respectively (P = 0.17). In cycles 2-5, women in the oldest two age groups with secondary infertility consistently discontinued treatment more frequently than those with primary infertility. Conclusions We found that women in the oldest age group were more likely to discontinue IVF treatment than younger women. Surprisingly, we found that the youngest women discontinued treatment in a similar fashion to women age 30-<40.

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In vitro fertilization in women under 35: counseling should differ by age

Cited by 10 publications

References 14 publications

Thinning and drilling laser-assisted hatching in thawed embryo transfer: A randomized controlled trial

Thinning and drilling laser-assisted hatching in thawed embryo transfer: A randomized controlled trial

Proteomic profile of maternal-aged blastocoel fluid suggests a novel role for ubiquitin system in blastocyst quality

The impact of younger age on treatment discontinuation in insured IVF patients

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