Large-scale retrospective analysis of methodological factors affecting pregnancy rates after embryo transfer for in vitro fertilization.

This study aimed to investigate the impact of methodological factors on pregnancy rates after embryo transfer (ET) for in vitro fertilization. This retrospective cross-sectional study was conducted between September 2020 and April 2022. A total of 2048 patients who underwent ultrasonography-guided first frozen embryo transfer (FET) or a fresh ET cycle due to infertility were included in the study. The effects of age, ET protocol (frozen or fresh), preimplantation genetic testing, number of embryos transferred (NET), and embryo fundus distance on pregnancy rate were investigated. The mean age of pregnant patients (31.51 ±â€…5.28) was significantly lower than that of non-pregnant patients (35.34 ±â€…6.39) (P < .001). Multiple regression analysis showed that women with lower age (P < .001), higher NET (P < .001), higher embryo fundus distance (P < .001), FET (P < .001), and preimplantation genetic testing (P = .012) had a significantly higher likelihood of pregnancy. Appropriate transfer depth, younger age, euploid embryo transfer, FET, and a higher NET can increase the likelihood of pregnancy. However, multiple factors must be considered when deciding the best protocol for a particular patient, including patient preference, costs and timing.

Euploidy rates of embryos in young patients with good and low prognosis according to the POSEIDON criteria.

RESEARCH QUESTION: Does an association exist between ovarian reserve, ovarian response and embryonic euploidy in female patients under age 35 years? DESIGN: This was a retrospective analysis of intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidies cycles among patients enrolled at Bahceci Fulya IVF Center between January 2016 and August 2019. A total of 133 patients in POSEIDON group 1 (suboptimal responder; female age <35 years, antral follicle count [AFC] ≥5, number of oocytes retrieved <10) (group A), 133 patients in POSEIDON group 3 (expected low responder; female age <35 years, AFC <5) (group B) and 323 in the non-low-prognosis group (female age <35 years, AFC ≥5 and number of oocytes retrieved >9) (group C) were included. RESULTS: There was no significant difference in euploidy rate per embryo among the three groups (61.7% [145/235] for group A versus 53.5% [68/127] for group B versus 62% [625/1008] for group C; P = 0.13). The cancellation rate in cycles without a euploid blastocyst was significantly lower in group C than groups A and B (8.4% versus 12.8% and 16.5%; P = 0.034). Multivariate regression analysis indicated that the ovarian response group did not significantly affect the probability of obtaining a euploid embryo. Trophectoderm score 'C' (odds ratio 0.520, P = 0.007) and inner cell mass score 'C' (odds ratio 0.480, P < 0.001) were associated with a decreased probability of obtaining a euploid embryo. CONCLUSIONS: These results confirm that POSEIDON group 1 and group 3 and non-low-prognosis patients have different probabilities of euploid embryos being obtained per cycle. However, euploidy rates per embryo are not affected by the patient's ovarian reserve and response.

Prediction of gestational diabetes mellitus at first trimester in low-risk pregnancies.

OBJECTIVE: We aimed to assess the relationship among the sex hormone-binding globulin (SHBG), homeostasis model assessment (HOMA), glycosylated hemoglobin (HbA1c), and cholesterol panel values to predict subsequent gestational diabetes mellitus (GDM) in low-risk pregnancies. MATERIALS AND METHODS: Thirty-eight pregnant women with GDM and 295 low-risk pregnant women without GDM were included in this study. Maternal blood samples were obtained during the first trimester examination to determine the SHBG, HbA1c, fasting blood glucose, insulin, thyroid stimulating hormone (TSH), free thyroxine, total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) levels. The variables that exhibited statistically significant differences between the groups and independent predictors for GDM were examined using logistic regression analysis. The risk of developing GDM, according to cutoff values, was determined using receiver operating characteristic (ROC) curve analysis. RESULTS: The SHBG, HOMA, LDL, and TG levels were found to be the significant independent markers for GDM [adjusted odds ratio (OR) = 0.991; 95% confidence interval (CI), 0.986-995; OR = 1.56; 95% CI, 1.24-1.98; OR = 1.02; 95% CI, 1.01-1.04; and OR = 1.01; 95% CI, 1.00-1.02, respectively]. The HbA1c, body mass index, and mean arterial pressure values were nonindependent predictors of GDM. The areas under the ROC curve used to determine the predictive accuracy of SHBG, HOMA, TG, and LDL-C for development of GDM were 0.73, 0.75, 0.70, and 0.72, respectively. For a false positive rate of 5% for the prediction of GDM, the values of the sensitivities were 21.1, 26.3, 21.1, and 18.4%, respectively. CONCLUSION: The HOMA, SHBG, TG, and LDL-C levels are independent predictors for subsequent development of GDM in low-risk pregnancies, but they exhibit low sensitivity.

Comparison of two doses of recombinant hcg for oocyte maturation in obese women (BMI > or = 30) undergoing assisted reproductive techniques.

OBJECTIVE: To compare the efficacy of two doses (250 microg vs. 500 microg) of r-hCG for oocyte maturation in obese women with a body mass index (BMI) > or = 30 and undergoing assisted reproduction techniques. MATERIALS AND METHODS: A Prospective, randomized, clinical study of seventy two patients undergoing IVF/ intracytoplasmic sperm injection cycles with BMI > or = 30 kg/m2. Patients with high BMI were randomized to receive either 250 microg or 500 microg rhCG. Blood and follicular fluid (FF) samples were collected on the day of oocyte pick-up (OPU). The outcome measures were serum and FF hCG levels on the day of OPU, number of oocytes retrieved per patient, number of mature oocytes retrieved, clinical pregnancy rates (PR). RESULTS: Serum hCG levels were significantly lower in patients receiving 250 microg of r-hCG than in patients receiving 500 microg of r-hCG. However FF hCG levels, implantation rates, abortion rates, clinical PRs were not significantly different. CONCLUSIONS: 250 microg of r-hCG is sufficient and safe to trigger ovulation in women with BMI > or = 30.

Serum homocysteine and asymmetric dimethylarginine levels in patients with premature ovarian failure: a prospective controlled study.

OBJECTIVE: To investigate serum homocysteine and asymmetric dimethylarginine (ADMA) levels in patients with premature ovarian failure (POF). STUDY DESIGN: A total of 69 women, 32 with POF and 37 apparently healthy women were included in the study. Fasting blood samples were drawn to measure serum homocysteine and ADMA levels using ELISA method. RESULTS: The study and control group had a mean age of 37.3 + 2.6, 37.5 + 2.5 years; a mean homocysteine level of 13.54 + 5.19, 12.71 + 3.99 mmol/l and a mean ADMA level of 1.32 + 0.27, 1.26 + 0.36 mmol/l, respectively. There were no statistically significant differences between the two groups in terms of homocysteine and ADMA levels (with p values of 0.465 and 0.423, respectively). A negative significant correlation was found between estradiol and ADMA (p <0.05). CONCLUSION: Homocysteine and ADMA levels did not change in comparison with the control group, which suggests that estrogen deficiency in patients with POF does not have any effect on homocysteine and asymmetric dimethylarginine levels.

A prospective, randomized, controlled study to compare two doses of recombinant human chorionic gonadotropin in serum and follicular fluid in woman with high body mass index.

This prospective, randomized, controlled study compares the efficiency of 250 microg or 500 microg of recombinant hCG in serum and follicular fluid (FF) levels and pregnancy rates (PR) in women with high body mass index (BMI) (>or=26 kg/m(2)) undergoing assisted reproduction treatment (ART). Treatment outcomes are similar between the two groups.