Preimplantation genetic testing for aneuploidy and chromosomal structural rearrangement: A summary of a nationwide study by the Japan Society of Obstetrics and Gynecology

BackgroundFollitropin δ may be an alternative to conventional follitropin α/β for controlled ovarian stimulation (COS) within assisted reproductive treatment (ART), but its efficacy and safety remain unknown. We performed a random‐effects meta‐analysis to compare the efficacy and safety of follitropin δ and follitropin α/β.MethodsWe searched randomized controlled trials comparing follitropin δ and follitropin α/β using MEDLINE, Embase, CENTRAL, ClinicalTrials.gov, and WHO‐ITCRP on December 14, 2022. The primary outcomes were the live birth rate and the incidence of moderate or severe ovarian hyperstimulation syndrome (OHSS). The certainty of the evidence was assessed using the grading of recommendations assessment, development, and evaluation approach. The protocol was registered on the Open Science Framework.ResultsThree studies involving 2682 participants were included in our meta‐analysis. The results indicated that follitropin δ may result in little to no difference in live birth rates (risk ratio [RR], 1.12; 95% confidence interval [CI], 0.91–1.38; low certainty) and the incidence of moderate or severe OHSS (RR, 0.78; 95% CI, 0.48–1.26; low certainty) compared with follitropin α/β.ConclusionFollitropin δ may result in little to no difference in COS compared with follitropin α/β, especially in terms of live births and safety.

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of follitropin delta versus follitropin alpha/beta in infertility treatment: A systematic review and meta‐analysis

Komiya,

Watanabe,

Terayama

et al. 2024

Beyond appearance: Can morphologically low‐grade euploid blastocysts yield successful pregnancies?

Suzuki,

Ishida,

Yoshioka

et al. 2024

PurposeThe primary objective of this investigation is to evaluate how morphological quality affects the pregnancy outcomes in euploid embryos determined by preimplantation genetic testing for aneuploidies (PGT‐A). Concurrently, as a secondary objective, we aim to identify which specific aspects of morphological evaluation exert the most significant impact on these outcomes.MethodsA retrospective analysis of 451 single euploid embryo transfer cycles at our clinic was conducted. Embryos were evaluated based on the degree of blastocyst expansion, inner cell mass (ICM), trophectoderm (TE) morphology, and the day of blastocyst vitrification. Outcomes between morphologically low‐grade and high‐grade embryos were compared. Additionally, the study analyzed which morphological factors most influenced pregnancy outcomes.ResultsPregnancy outcomes were significantly lower in morphologically low‐grade blastocysts compared to high‐grade ones. Among the morphological evaluations, the ICM assessment was significantly associated with the live birth rate.ConclusionOur study indicates that the morphological quality of euploid embryos, particularly the evaluation of the ICM, plays a crucial role in IVF‐ET success.

The number of previous implantation failures is a critical determinant of intrauterine autologous platelet‐rich plasma infusion success in women with recurrent implantation failure

Fujii,

Oguchi

2024

PurposeWe aimed to identify factors influencing the reproductive outcomes of frozen–thawed embryo transfer (FET) with intrauterine autologous platelet‐rich plasma (PRP) infusion in patients with either a thin endometrium or recurrent implantation failure (RIF) despite a normal endometrial appearance.MethodsIn this retrospective study of women who underwent PRP‐FET, factors influencing PRP‐FET outcomes were identified using multivariate logistic regression analysis.ResultsWe enrolled 111 patients (70 with refractory thin endometrium and 41 with RIF but no thin endometrium). For 99 completed FET cycles, the β‐hCG positivity rate was 46.7%, clinical pregnancy rate (CPR) was 41.0%, and live birth rate (LBR) was 36.2%. PRP treatment was associated with significant improvements over previous cycles, and participants with thin endometria demonstrated thickening. Multivariate logistic regression analysis showed that the number of previous implantation failures in women with RIF was a significant factor affecting the PRP‐FET outcomes. The CPR and LBR of women with RIF were lower when there had been ≥3 previous implantation failures occurred.ConclusionsIntrauterine PRP infusion improves the pregnancy outcomes of patients with RIF or a thin endometrium. The number of previous implantation failures is a critical determinant of successful intrauterine PRP infusions in women with RIF.