Pregnancy results after fresh embryo transfer and selective frozen-thawed embryo transfer: Single-center experience.

OBJECTIVE: To compare the clinical pregnancy and live birth results of fresh embryo transfer (ET) and selective frozen embryo transfer (sFET) in cohort of infertile patients aged between 18-42 years of age in single IVF center. MATERIALS AND METHODS: In this retrospective cross-sectional study, the clinical and live birth results of 620 fresh embryo transfer cycles and 580 frozen embryo transfer cycles were investigated in Sisli Kolan International Hospital Fertility Unit between 2015-2018. RESULTS: Age, BMI, causes of infertility, duration of infertility, ovulation induction protocols, the number of oocytes collected and the thickness of endometrium on the day of transfer were similar in the ET and sFET groups. More good quality embryos were obtained in sFET group. The clinical pregnancy and live birth rates were 71.04 % and 59.31 % in the sFET groups, and 56.77 % and 44.52 % in the ET group, respectively (p < 0.05). CONCLUSION: Pregnancy, clinical pregnancy and live birth rates were higher in frozen embryo transfer cycles than in fresh embryo cycles. However, appropriate in vitro fertilization and embryo transfer methods suitable for each patient should be determined before choosing fresh ET or sFET treatment modalities.

Does feticide shorten termination duration in second trimester pregnancy terminations?

BACKROUND: A retrospective (case-controlled) study was conducted with the aim of identifying the effect of the use of misoprostol on termination time in patients who did and did not undergo feticide procedures in second trimester pregnancy terminations. METHODS: The sampling of the study consisted of 144 pregnant women who were diagnosed as having major fetal anomalies incompatible with life, and were recommended for termination of pregnancy. The investigation showed that feticide procedures were performed for 99 women, and feticide procedures were not performed for 45 women. Misoprostol protocol was administered for 48 hours in the termination period; whether the feticide procedure directly affected the termination duration in patients who did and did not undergo feticide was evaluated. RESULTS: Abortion/birth was achieved in 103 (71.5%) women during the first 48 hours. There was no significant difference between the termination duration of the misoprostol protocol among the women who did and did not undergo feticide. There was no significant difference between the termination durations and fetal biometric measurements (BPD, HC) except head diameters (p=0.020 and p=0.015). CONCLUSIONS: The misoprostol protocol is shown to be effective and safe for the termination of pregnancies during the second trimester. Feticide has no affect on the duration of termination.

Evaluation of the effect of indomethacin and piroxicam administration before embryo transfer on pregnancy rate.

AIM: The aim of this study was to evaluate the effect of non-steroidal anti-inflammatory drug (NSAID) administration before embryo transfer (ET) on pregnancy rates in women undergoing in vitro fertilization/intracytoplasmic sperm injection ET. METHODS: Our study included 255 patients diagnosed with primary or secondary infertility caused by a male or tubal-related factor, endometriosis or unexplained factors. The patients were divided randomly into three groups. Two groups were administered oral piroxicam (10 mg capsules) or 100 mg indomethacin (rectal suppository), respectively, 1-2 h before ET. As a control, the third group did not receive any form of treatment before ET. Basal levels of follicle-stimulating hormone, luteinizing hormone, and level 17ß-estradiol on the day of human chorionic gonadotropin administration, the collected and transferred number of embryos, and the number of grade A embryos obtained were determined in all patients. RESULTS: The implantation, clinical pregnancy, and miscarriage rates of the groups were compared. The clinical pregnancy rate per ET and the implantation rate were 35.2% and 12.15% in the piroxicam group, 31.7% and 10.9% in the indomethacin group, and 32.9% and 12.5% in the control, respectively. The miscarriage rates of groups 1, 2 and 3 were 12%, 11.7% and 11.7%, respectively (P = 0.964). The differences in clinical pregnancy rates among the groups were not statistically significant (P = 0.887). There were also no significant differences in the implantation rates (P = 0.842). CONCLUSION: These results suggest that NSAID administration before ET has no additional effect on pregnancy outcome in patients undergoing in vitro fertilization.

Bishop score versus ultrasound of the cervix before induction of labor for prolonged pregnancy: which one is better for prediction of cesarean delivery.

OBJECTIVES: To find an effective way to predict Cesarean section (CS) before induction of labor. METHODS: Nulliparous women at ≥ 41 weeks of pregnancy were enrolled in the study. Bishop score (BS), cervical length (CL), posterior cervical angle (PCA), quantification of the cervical stromal echogenicity by tissue histograms and opening of the internal cervical os (funnelling) were recorded. The vaginal delivery and CS groups were then compared in terms of the clinical and ultrasonographic cervical findings. RESULTS: BS, CL, PCA and funnelling were the significant predictors of CS, whereas no such relationship existed for the quantitative echogenicity of the cervical stroma. Although the difference was not statistically significant, the area under the curve was higher for the BS than that for sonographic CL and PCA in the prediction of all CSs. The best cut-off values to predict CS for BS, CL and PCA were <5, >27 mm and <98°, respectively. Combination of all three parameters had a sensitivity of 83.3%, specificity of 100%, positive predictive value of 100% and a negative predictive value of 82% for the prediction of CS. CONCLUSIONS: In nulliparous women with prolonged pregnancy, the BS predicts the need for CS better than the ultrasonographic assessment of the cervix.