What is a difficult transfer? Analysis of 7,714 embryo transfers: the impact of maneuvers during embryo transfers on pregnancy rate and a proposal of objective assessment

Kava-Braverman, Alejandro; Martínez, Francisca; Rodríguez, Ignacio; Alvarez, María; Barri, Pedro N.; Coroleu, Buenaventura

doi:10.1016/j.fertnstert.2016.11.020

Cited by 41 publications

(36 citation statements)

References 41 publications

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“…As for the quality of the transfer, it seems to be for some authors, the most important factor influencing the occurrence of pregnancy in the course of medically assisted procreation. Our results are similar to those described by several authors who find a statistically significant association between easy transfer and favorable outcome [11,13].…”

Section: Discussionsupporting

confidence: 93%

Predictive Factors of Pregnancy in Women Admitted for Ovarian Stimulation during Medically Assisted Procreation at the Yaounde Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital (YGESHRTH)

Kasia¹,

Belinga²,

Ndoua³

et al. 2019

SIJOG

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Introduction: Medically Assisted procreation (MAP) does not guarantee the outcome of an attempt to conceive. Our goal was to study the factors that can predict the occurrence of pregnancy in stimulated women in our center. Methodology: This was a cross-sectional and retrospective study carried out from August 1, 2016 to January 31, 2018 at the YGESHRTH, comparing two groups of women under the age of 40 years, who had undergone ovarian stimulation during MAP. The first group (group I) consisted of women who had conceived following stimulation during MAP, and group II consisted of those who never conceived. Sampling was consecutive and exhaustive. Discontinuous variables were compared using the Khi-2 test and continuous variables using Student's t-test. A P-value of <0.05 was considered statistically significant. Results: Of the 263 women recruited for the study, 69 (26.2%) had a positive pregnancy test confirmed both by blood samples and ultrasound. The average age of the patients was 33 ± 4.4 years. A significant association was found between the age group of 25-30 years (p = 0.043), a height range of 1.70-1.80m (p = 0.001), the transfer of 03 embryos (p = 0.027), the ease of transfer of the embryos (p = 0.030) and the occurrence of pregnancy. Conclusion: The predictive factors of pregnancy in women stimulated during the MAP found in our study were; the age group of 25-30 years, a height range of 1.7-1.8m, the transfer of 03 embryos and the ease transfer.

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Section: Discussionsupporting

confidence: 93%

Predictive Factors of Pregnancy in Women Admitted for Ovarian Stimulation during Medically Assisted Procreation at the Yaounde Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital (YGESHRTH)

Kasia¹,

Belinga²,

Ndoua³

et al. 2019

SIJOG

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“…Patient BMI is also a modifier of CC gene expression in both polycystic ovarian syndrome (PCOS) [ 44 ] and non-PCOS women [ 54 ]. CC gene expression from different patients were studied, and it is known that factors such as different stimulation protocols, patient characteristics and transfer techniques may impact either CC gene expression or implantation [ 44 , 50 – 56 ].…”

Section: Discussionmentioning

confidence: 99%

Is there a correlation between follicle size and gene expression in cumulus cells and is gene expression an indicator of embryo development?

Kahraman

Çetinkaya

et al. 2018

Reprod Biol Endocrinol

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BackgroundIn an article published in 2017, we discussed the results of the first part of our study into the morphokinetic development of embryos in relation to follicle diameter and homogeneity of follicular development. Our findings showed that embryos coming from small follicles in heterogeneous cycles had significantly higher rates of arrest or failure to reach blastocyst than embryos coming from large follicles in homogenous cycles. The aim of this further study was to investigate the relationship between follicular size and gene expression of cumulus cells (CCs) and evaluate whether gene expression could be an indicator of embryo development.MethodsThis study was based on 2495 COCs from 184 patients. CC expressions of five genes (TNFAIP6, PTGS2, HAS2, PTX3 and GDF9) were studied by generalized linear mixed models (GLMMs) regarding follicular size. CC expressions were then separately analysed regarding patient-specific variables (age, BMI, AMH and follicular size) in relation to embryos reaching blastocyst (eRB) or top or good quality blastocysts (TQ + GQ) using GLMMs with logit link.ResultsFollicular size significantly correlated with the potential of an oocyte to develop into a blastocyst: oocytes developing from large follicles were more than twice as likely to develop into an eRB than oocytes from small follicles (p < 0.001). Gene expression of HAS2 and GDF9 correlated with blastocyst quality when separately evaluated with follicular size and the patient specific variables of age, BMI and AMH. However, no such correlation was found in other gene expressions studied.ConclusionsOur findings suggest that differences in the expression of genes studied could be related to follicular size rather than to embryo quality. Although gene expression of HAS2 and GDF9 correlated with blastocyst quality, the only variable correlating with eRB and TQ and GQ blastocysts for each of these five models was follicular size.Trial registrationThis prospective cohort study was registered at clinicaltrials.gov (NCT02230449).Electronic supplementary materialThe online version of this article (10.1186/s12958-018-0388-0) contains supplementary material, which is available to authorized users.

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“…Traditionally, a longer transfer time was thought to be a marker of a difficult embryo transfer and conferred a lower pregnancy rate, but recent studies have focused on identifying other factors to characterize the transfer as ''difficult,'' such as the use of additional maneuvers, such as a Stylette or a tenaculum (10). Interestingly, recent guidelines on embryo transfer from the Practice Committee of the American Society for Reproductive Medicine did not clarify any specific cutoffs for transfer time, because there are insufficient data on which to base evidence-backed guidelines (3).…”

Section: Discussionmentioning

confidence: 99%

Impact of transfer time on pregnancy outcomes in frozen-embryo transfer cycles

Lee

Cardozo

Karmon

et al. 2018

Fertility and Sterility

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What is a difficult transfer? Analysis of 7,714 embryo transfers: the impact of maneuvers during embryo transfers on pregnancy rate and a proposal of objective assessment

Abstract: The CPR decreases progressively with the use of additional maneuvers during ET. An objective classification of the instrumentation applied during ET is proposed.

Cited by 41 publications

References 41 publications

Predictive Factors of Pregnancy in Women Admitted for Ovarian Stimulation during Medically Assisted Procreation at the Yaounde Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital (YGESHRTH)

Predictive Factors of Pregnancy in Women Admitted for Ovarian Stimulation during Medically Assisted Procreation at the Yaounde Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital (YGESHRTH)

Is there a correlation between follicle size and gene expression in cumulus cells and is gene expression an indicator of embryo development?

Impact of transfer time on pregnancy outcomes in frozen-embryo transfer cycles

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