Effect of steroid and antibiotic treatment during assisted hatching on IVF outcomes.

There are limited data on the use of steroids and antibiotics in assisted reproductive technology (ART). Our aim was to evaluate the impact of these treatments on the outcome of IVF cycles in which Assisted Hatching (AH) was performed. We studied a retrospective cohort in a large university-affiliated infertility centre. Data from 1126 AH cycles performed between 2007 and 2009 were reviewed. Cycles were categorized as "treatment" (n = 640) and "no treatment" (n = 486), depending on whether they received steroids and antibiotics. The primary outcome was live birth. Secondary outcomes included implantation, spontaneous abortion, biochemical, clinical and ectopic pregnancy. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). OR were adjusted (AOR) for age, BMI, baseline FSH, peak estradiol, cycle number, number of oocytes retrieved, number of embryos that underwent AH, number of high-implantation potential embryos, number of embryos transferred and physician in charge. The AOR (95% CI) of live birth was 1.91 (1.08-3.38), of clinical pregnancy, 1.75 (1.08-2.83) and of biochemical pregnancy, 0.24 (0.07-0.85). Our study suggests that treatment with steroids and antibiotics during AH cycles significantly increases the odds of live birth.

Prognosis for clinical pregnancy and delivery after total fertilization failure during conventional in vitro fertilization or intracytoplasmic sperm injection.

OBJECTIVE: To determine the prognosis for clinical pregnancy and delivery after total fertilization failure. DESIGN: Retrospective analysis of patient treatment cycles. SETTING: Private fertility clinic. PATIENT(S): 555 couples who had total fertilization failure during a cycle of conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Delivery rates, peak estradiol level, number of mature follicles, number of oocytes retrieved, number of mature oocytes, sperm concentration, and sperm motility. RESULT(S): Delivery rates for IVF patients who elected to continue treatment after fertilization failure were 44% per patient, 25% per embryo transfer (ET), and 22% per cycle. Delivery rates for ICSI patients were 36% per patient, 23% per ET, and 18% per cycle. The number of mature oocytes was always statistically significantly lower in the total fertilization failure cycle when compared with fertilization cycles that occurred either before or after, whether ICSI or conventional IVF was involved. CONCLUSION(S): The prognosis for pregnancy is encouraging in subsequent cycles after total fertilization failure. Fertilization failure was a result of suboptimal response to ovarian stimulation.