The influence of age, body mass index, waist-to-hip ratio and anti-Mullerian hormone level on clinical pregnancy rates in ART.

The aim of this study was to estimate the influence of age, body mass index, waist-to-hip ratio and anti-Mullerian hormone levels on clinical pregnancies in assisted reproduction technologies (ART). We used the database of the fertility clinic both the in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) units. A total of 1134 treatment cycles from 2013 through 2015 were analyzed. We evaluated clinical pregnancy rate in terms of age, body mass index, waist-to-hip ratio, anti-Mullerian hormone level. The clinical pregnancy rate was 39.9%. The live birth rate was 25.5%. Women who conceived where statistically significantly younger and had lower body mass index. No statistical differences across pregnancy groups were found for waist-to-hip ratio, and anti-Mullerian hormone levels. Low AMH levels do not influence pregnancy rates in younger patients (<36 years).

Immune factors in human embryo culture and their significance.

There is increasing evidence that human development before implantation is regulated by embryonically and maternally derived growth factors. The "regulators" of embryonic origin such as soluble human leukocyte antigen G, platelet-activating factor, Th1/Th2 cytokines, insulin-like growth factor, epidermal growth factor, transforming growth factor alpha, colony-stimulating factor, platelet-derived growth factor may be used as indicators of embryo viability and implantation potential. The data prove the influence of growth factors on the development and growth of preimplantation embryos. Though there is a lot of research in the field of biomarkers during folliculogenesis and maternal-fetal interface, only few of them deal with regulators derived from embryonic cells to the cultivation medium. The aim of our study was to summarize the research dealing with immune markers produced by embryos in vitro and to estimate their impact on the cell growth, viability and implantation potential.

An observational study of assisted reproductive technology outcomes in new European Union member states: an overview of protocols used for ovarian stimulation.

BACKGROUND: The development of new fertility treatment options has facilitated individualized assisted reproductive technology (ART) protocols to improve outcomes. Manufacturing improvements to recombinant human follitropin alfa have allowed precise dosing based on mass (filled-by-mass; FbM) rather than bioactivity (filled-by-bioassay; FbIU). Continued monitoring and reporting of follitropin alfa treatment outcomes in routine clinical practice is essential. OBJECTIVE: To provide an overview of the frequency of different controlled ovarian-stimulation protocols used in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles in new European Union member states, and to provide post-registration efficacy and safety data on follitropin alfa. RESEARCH DESIGN AND METHODS: A 2-year, prospective, observational, multicentre, Phase IV study conducted at ART clinics in the Czech Republic, Estonia, Latvia, Lithuania, Poland, Slovakia and Slovenia. Women aged 18-47 years undergoing ovarian stimulation with follitropin alfa for conventional IVF or ICSI were eligible for inclusion. The main treatment outcome was cumulative clinical pregnancy rate. Data were analysed descriptively. RESULTS: Clinical pregnancy outcomes were available for 4055 of 4085 (99.3%) patients. In total, 1897 (46.8%) patients used follitropin alfa FbIU; 2133 (52.6%) used follitropin alfa FbM. Clinical pregnancy was achieved by 39.5% (1603/4055) of patients. A greater proportion of patients with polycystic ovary syndrome achieved a clinical pregnancy than those with endometriosis (41.8% vs 37.8%, respectively). A higher cumulative pregnancy rate was observed with the use of follitropin alfa FbM than follitropin alfa FbIU (41.3% vs 37.8%, respectively; p = 0.02). CONCLUSIONS: This study represents the most comprehensive audit of individualized ART in clinical practice in Central and Eastern Europe. Overall, clinical pregnancy was achieved by 39.5% of patients after stimulation with follitropin alfa. The use of follitropin alfa FbM resulted in a higher cumulative pregnancy rate than did the FbIU formulation. However, limitations of the study include the observational and non-comparative study design, and descriptive nature of statistical analyses; furthermore, the study was not designed to make direct comparisons between the success rates of different ovarian-stimulation protocols.

Follicular fluid levels of interleukin-10 and interferon-gamma do not predict outcome of assisted reproductive technologies.

PROBLEM: Follicular fluid (FF) and surrounding tissue contains various lymphocytes that synthesize different cytokines. The other sources of cytokines are ovarian somatic cells. FF provides microenvironment for the oocyte and contains immunological factors for the regulation of its development. Changes in expression and concentrations of certain cytokines can influence oocyte and embryo quality, resulting in a reduced ability to implant. Some data shows that follicular environment depends on infertility indication. The purpose of our study was to investigate whether cytokines interleukin-10 (IL-10) and interferon-gamma (IFN-gamma) are released in the human FF and also to evaluate impact of those cytokines on fertilization rate, cleavage rate, embryo quality, and pregnancy rate. METHODS OF STUDY: Couples treated by assisted reproductive technologies were selected for this study. A total of 121 patients participated in the study. Until cytokine detection samples of FF were stored at -20 degrees C. In vitro fertilization or intracytoplasmic sperm injection procedure was used depending on the indication. After 72 hr, on the day of transfer, embryo morphology was evaluated. Embryo transfer based on embryo morphology was performed. Commercial enzyme-linked immunosorbent assay kit from Diaclone, France was used for the quantitative determination of human IL-10 and IFN-gamma concentrations in FF. Analysis of the results was performed using spss 12.0. RESULTS: One hundred and twenty-one FF samples were tested for IL-10 and IFN-gamma. IFN-gamma and IL-10 were detected in 14 (11.6%) and 108 (89.3%) FF samples, respectively (range 0.9-31.1 pg/mL for IFN-gamma and 0.7-10.8 pg/mL for IL-10). There was no significant correlation between infertility indication, fertilization rate, cleavage rate, and concentrations of the follicular cytokines. Similarly, IL-10 concentrations did not differ significantly in different age groups and did not alter pregnancy rate. CONCLUSION: Our study showed that IFN-gamma and IL-10 are not suitable markers in predicting outcome of assisted reproductive technologies.