Progesterone elevation on the day of oocyte retrieval and live birth rate after in vitro fertilisation treatment.

The objective of this study was to evaluate if progesterone elevation (PE) on the day of oocyte retrieval is associated with IVF outcome. A prospective cohort study of 400 IVF-ICSI cycles, with fresh embryo transfer on day 2-3 was performed. We proposed a serum progesterone (P) level on percentile (p) 90 as a threshold.Pregnancy rates were not affected, however there were more miscarriages (25.7% vs 43.8%) and lower live birth rate (LBR) (28% vs 23.1%) in the PE group (not statistically significant). We also found a positive correlation between P levels and retrieved and mature oocytes, total embryos, and good quality embryos. This is the first study to analyse LBR based on P levels on the day of oocyte retrieval. PE is not associated with the IVF outcome, but there is a trend to lower ongoing pregnancy rate and LBR and more miscarriages. Our results also show that P levels have no negative effects on oocyte and embryo quality.Impact statementWhat is already known on this subject? The influence of PE during IVF cycle on pregnancy rates remains controversial.What do the results of this study add? This is the first study to analyse LBR based on P levels on the day of oocyte retrieval.What are the implications of these findings for clinical practice and/or further research? We demonstrated that pregnancy rates were not affected by PE at oocyte retrieval, but there is a trend to lower ongoing pregnancy rate and LBR and more miscarriages. Randomised controlled trials are needed to offer more evidence of these relationships.

Estudio de la integridad del ADN espermático en relación con la calidad seminal y los resultados del ciclo de fecundación in vitro / Sperm DNA fragmentation in relation to seminal parameters and outcome of in vitro fertilization/intracytoplasmic sperm injection

Objetivo. Analizar la relación existente entre el grado de fragmentación del ADN espermático y los parámetros seminales, la edad del varón y los resultados del ciclo de FIV-ICSI. Sujetos y métodos. Cuarenta y tres pacientes sometidos a tratamientos de FIV-ICSI. La edad media de los varones fue 35,62±4,87 años. En este estudio prospectivo analizamos la fragmentación del ADN espermático mediante la técnica de SCSA (sperm chromatin structure assay) y los parámetros seminales clásicos (concentración, movilidad y morfología espermática). Los parámetros del ciclo de FIV-ICSI analizados fueron: tasa de fecundación, calidad embrionaria, tasa de embarazo, tasa de gestación y tasa de aborto. Resultados. La fragmentación del ADN está relacionada con un descenso en la movilidad progresiva de la muestra en fresco (p=0,000) y capacitada (p=0,041). También observamos un descenso en la movilidad progresiva de la muestra en fresco (p=0,034) y en la calidad del ADN espermático (p=0,043) en pacientes de mayor edad. No observamos relación entre la fragmentación y la tasa de fecundación, calidad embrionaria, tasa de embarazo y tasa de aborto. Conclusiones. El grado de fragmentación del ADN está inversamente correlacionado con la movilidad progresiva de la muestra seminal en fresco. La fragmentación del ADN no es útil como predictor del resultado del ciclo de FIV-ICSI, pero sí podría ser útil como herramienta diagnóstica ya que añade información al análisis seminal básico. Su valoración podría resultar de utilidad en determinados pacientes, como aquellos que presentan esterilidad idiopática. La calidad espermática del varón se ve afectada por el aumento en la edad(AU)

Objective. To establish the relationship between the degree of sperm DNA fragmentation and seminal parameters, male age and outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Subjects and methods. The sample consisted of 43 couples undergoing IVF/ICSI. The mean age of men was 35.62±4.87 years and that of women was 33.88±3.95 years. We prospectively analyzed sperm DNA fragmentation from each patient by the Sperm Chromatin Structure Assay (SCSA) and correlated the findings with seminal parameters (volume, concentration, progressive motility and morphology), IVF/ICSI outcomes and male age. IVF/ICSI outcome was evaluated by measuring the fertilization rate, embryo quality and the pregnancy and miscarriage rates. Results. DNA fragmentation was negatively correlated with progressive motility (p=0.000) of fresh and capacitated (p=0.041) semen. Older patients had a significantly lower percentage of progressive motility in fresh seminal samples (p=0.034) and worse sperm DNA quality (p=0.043). There were no significant differences between the fragmentation rate and fertilization rate, embryo quality, and the pregnancy and miscarriage rates. Conclusions. DNA fragmentation is inversely correlated with progressive motility in fresh seminal samples. DNA fragmentation does not predict the IVF/ICSI outcome but screening for sperm DNA damage may provide useful information in the diagnosis of idiopathic male infertility. Seminal quality is affected by increasing male age(AU)