Minimal ovarian stimulation combined with elective single embryo transfer policy: age-specific results of a large, single-centre, Japanese cohort

Kato, Keiichi; Takehara, Y.; Segawa, Tomoya; Kawachiya, Satoshi; Okuno, Takashi; Kobayashi, Tamotsu; Bodri, Daniel; Kato, Osamu

doi:10.1186/1477-7827-10-35

Cited by 106 publications

(91 citation statements)

References 17 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cycles resulting in monozygotic twin pregnancies and ectopic pregnancies were excluded. At our centre the blastocyst transfer strategy was routinely indicated in case of tubal factor infertility (tubal obstruction, hydrosalpinx, or a history of extrauterine pregnancy) and following previous failed cycles with single cleavage-stage embryo transfers and constituted a large part of treatments preformed in our center (Kato et al, 2012).…”

Section: Patients and Study Designmentioning

confidence: 99%

See 1 more Smart Citation

Women's age and embryo developmental speed accurately predict clinical pregnancy after single vitrified-warmed blastocyst transfer

Kato

Ueno²,

Yabuuchi³

et al. 2014

Reproductive BioMedicine Online

Self Cite

View full text Add to dashboard Cite

The aim of this study is to establish a simple, objective blastocyst grading system using women's age and embryo developmental speed to predict clinical pregnancy following single vitrified-warmed blastocyst transfer (SVBT) by 6-year retrospective cohort study in a private infertility center.A total of 7,341 SVBT cycles divided into 2006-2011 (6,046 cycles) and 2012 cohort (1,295 cycles) were included. Clinical (CPR), ongoing pregnancy (OPR) and delivery rates (DR) were stratified by women's age (<35, 35-37, 38-39, 40-41, 42-45 years) and time to blastocyst expansion (<120, 120-129, 130-139, 140-149, >149 hours) as embryo developmental speed. In all the age groups, CPR, OPR, and DR decreased as the embryo developmental speed decreased (P < 0.0001). A simple 5-grade score based on women's age and embryo developmental speed was determined by actual clinical pregnancy rates observed in the 2006-2011 cohort. Subsequently the novel grading score was validated in the 2012 cohort (1295 cycles) finding an excellent association. In conclusion, in the present study we established a novel blastocyst grading system using women's age and embryo developmental speed as objective parameters.

show abstract

Section: Patients and Study Designmentioning

confidence: 99%

“…All patients underwent a clomiphene-based minimal ovarian stimulation protocol or drug-free natural cycle IVF treatment (Teramoto et al, 2007;Kato et al, 2012). Oocyte retrieval was performed without any anesthesia, using a fine 21-22 G needle (Kitazato, Japan).…”

Section: Minimal Ovarian Stimulation Oocyte Retrieval and Fertilizatmentioning

confidence: 99%

Women's age and embryo developmental speed accurately predict clinical pregnancy after single vitrified-warmed blastocyst transfer

Kato

Ueno²,

Yabuuchi³

et al. 2014

Reproductive BioMedicine Online

Self Cite

View full text Add to dashboard Cite

show abstract

“…High fertilization and cleavage rates were obtained regardless of age, whereas blastocyst formation and LBR showed an age-dependent decrease. An elective single-ET program based on a minimal ovarian stimulation protocol yielded acceptable LBR per ET in infertile patients up until their mid-40s [14]. However, in very advanced age patients (equal to or higher than 45 years old) success rates fall below 1 %.…”

Section: Discussionmentioning

confidence: 95%

“…A retrospective, cohort study was performed in private infertility center to evaluate the embryological and clinical results of a large exclusive SET program according to patient age (lower or equal 29, 30-34, 35-39, 40-44 and equal to or higher than 45 years) [14]. A total of 7,244 infertile patients underwent 20,244 cycles with a clomiphene-based minimal stimulation or natural-cycle IVF protocol during 2008.…”

Section: Discussionmentioning

confidence: 99%

Getting Older Women Pregnant: Contemporary Thoughts

Allahbadia

2015

J Obstet Gynecol India

View full text Add to dashboard Cite

For women of advanced age with abnormally increased FSH levels, standardized hormonal stimulation often represents a cost-intensive procedure with a low success rate. It is well established now that with mild ovarian stimulation, there is a greater percentage of goodquality eggs (although a smaller number) than with higherdose conventional stimulation. Mild stimulation protocols reduce the mean number of days of stimulation, the total amount of gonadotropins used and the mean number of oocytes retrieved. The proportion of high-quality and euploid embryos seems to be higher compared with conventional stimulation protocols, and the pregnancy rate per embryo transfer is comparable. Moreover, the reduced costs, the better tolerability for patients and the less time needed to complete an IVF cycle make mild approaches clinically and cost-effective over a given period of time. The low number of embryos available for transfer poses a great challenge in the management of older women going in for IVF. A potential management of these older women is to create a sufficient pool of embryos by accumulating 123 vitrified good-grade embryos over several minimal stimulation and natural cycles. At the end of the accumulation process, these embryos can be subjected to a preimplantation genetic screening using next-generation sequencing and then the pool would have only chromosomal normal embryos with maximal chances of implantation. This would potentially make the chances of success for older women similar to normal responders. This management, however, is unthinkable without an outstanding vitrification program. The option of accumulating embryos has become a promising reality with the advent of vitrification technologies.

show abstract

“…There are limited data regarding the use of mild stimulation for women over age 38. In one large case series reporting on the use of clomiphene-based mild ovarian stimulation, a mature oocyte was retrieved in 68 % of cycles for women aged 40-44 compared with 71 % of women aged 30-34 [19].…”

Section: Reasons To Consider Mild Stimulationmentioning

confidence: 99%

Mild ovarian stimulation for in vitro fertilization: one perspective from the USA

Baker

2013

J Assist Reprod Genet

View full text Add to dashboard Cite

Purpose To provide a perspective regarding mild ovarian stimulation, taking into account particular issues relevant in the United States Methods Literature review and editorial commentary Results Mild ovarian stimulation for IVF has some proven and some theoretical advantages over conventional stimulation, such as lower risk of ovarian hyperstimulation syndrome and lower cost per fresh IVF cycle. However, cumulative live birth rate, including transfers from fresh and frozen embryos, is likely to be lower with mild stimulation. The cost-effectiveness of mild stimulation IVF in the United States has not been established. Conclusions Mild ovarian stimulation is an appropriate option to consider for certain patient groups or based on patient preference. However, significant potential disadvantages limit its widespread acceptability for patients in the United States at this time.

show abstract

Minimal ovarian stimulation combined with elective single embryo transfer policy: age-specific results of a large, single-centre, Japanese cohort

Cited by 106 publications

References 17 publications

Women's age and embryo developmental speed accurately predict clinical pregnancy after single vitrified-warmed blastocyst transfer

Women's age and embryo developmental speed accurately predict clinical pregnancy after single vitrified-warmed blastocyst transfer

Getting Older Women Pregnant: Contemporary Thoughts

Mild ovarian stimulation for in vitro fertilization: one perspective from the USA

Contact Info

Product

Resources

About