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Effect of double cleavage stage versus sequential cleavage and blastocyst stage embryo transfer on clinical pregnancy rates

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Asian pacific Journal of Reproduction 2020年第3期9卷 124-128页

作者： Gozde Kaya Begüm Alyürük ozge senem yucel cicek Sule Yildirim Kopük Ahmet Yigit Cakiroglu Emek Doger Serdar Filiz IVF Center Faculty of MedicineKocaeli University41380IzmitKocaeliTurkey IVF Center Acibadem Maslak Hospital34457SariyerIstanbulTurkey Medical Faculty Acibadem Mehmet Ali Aydinlar UniversityIstanbulTurkey

Objective:To compare clinical pregnancy rates following sequential day-3 and day-5 embryo transfer with double or sequential cleavage-stage ***:This study enrolled 242 patients undergoing gonadotropin-releasing hormone antagonist protocol and fresh embryo *** follicle stimulating hormone,luteinizing hormone,serum estradiol and anti-Müllerian hormone levels and controlled ovarian stimulation outcomes were *** 242 women,135 underwent double embryo transfer on day 2 or day 3(the double group),54 women underwent sequential embryo transfer on day 2 and day 3(the D2/D3 group),and 53 underwent sequential embryo transfer on day 3 and day 5(the D3/D5 group).Clinical pregnancy rates were compared among the ***:Female age,body mass index,basal follicle stimulating hormone,luteinizing hormone and estradiol levels were similar among the groups(P>0.05).The D3/D5 group had a significantly higher number of metaphaseⅡoocytes,fertilized oocytes and good quality embryos on day 3 compared with the double group and the D2/D3 group(P<0.001).Clinical pregnancy rates in the double,D2/D3 and D3/D5 groups were 26.6%(36/135),16.6%(9/54)and 37.7%(20/53),*** was no significant difference in clinical pregnancy rates between the double group and the D2/D3 group(P=0.204)or the D3/D5 group(P=0.188).The D3/D5 group had significantly higher clinical pregnancy rates compared with the D2/D3 group(P=0.025).Conclusions:Sequential cleavage-stage transfer(D2/D3)or cleavage stage and blastocyst transfer(D3/D5)does not improve clinical pregnancy rates compared with double cleavage-stage embryo *** sequential transfer seems to be an effective option in certain patient populations,routine application of this technique might not be a suitable approach in an unselected population to improve assisted reproductive technology outcomes.

关键词： Sequential transfer Blastocyst Cleavage stage embryo In vitro fertilization

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The Effect of Recombinant LH Addition to Recombinant FSH on Assisted Reproductive Technologies Outcomes in Overweight and Obese Patients without Polycystic Ovary Syndrome

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 433-444页

作者： Merve Demir Emre Sertel ozge senem yucel cicek Leylim Yalcınkaya Sare Dogan Osman Onur Daloglu Emek Doger Birol Vural Department of Obstetrics and Gynecology Kocaeli University Faculty of MedicineKocaeliTurkey Department of Obstetrics and Gynecology Kiziltepe State HospitalMardinTurkey Department of Internal Medicine Kocaeli State HospitalKocaeliTurkey Department of Obstetrics and Gynecology Kolan International HospitalIstanbulTurkey

Background: Obesity and overweight negatively affect fertility. Protocols need?to be developed in ART treatments for obese and overweight women. Objectives: To investigate the effect of recombinant luteinizing hormone (rLH) addition to recombinant follicle stimulating hormone (rFSH) on treatment outcomes?in assisted reproductive technologies (ART) cycles in obese and overweight women without polycystic ovary syndrome. Methods: This retrospective cohort study was carried out in Kocaeli University Faculty of Medicine, Assisted Reproductive Techniques Clinic between January 2016 and March 2019. To analyze the impact of rLH addition to rFSH in GnRH antagonist cycles in overweight and obese, the patients were divided into four groups according to body mass index (BMI) and gonadotropin type;Group 1: patients with BMI ≥ 25 stimulated with rFSH alone (n: 37), Group 2: patients with BMI ≥ 25 stimulated with rFSH + rLH (n: 37), Group 3: patients with BMI between 18.5 - 24.99 stimulated with rFSH alone (n: 33), Group 4: patients with BMI between 18.5 and 24.99 stimulated with rFSH + rLH (n: 30). Patients with polycystic ovary syndrome were excluded. Results: Basal LH levels were found to be significantly lower in obese and overweight patients compared to normoweight patients (p = 0.01). Grade 1 embryo ratio in obese and overweight patients was higher in rLH added obese group than in group LH not included (64.9%, p = 0.005). Ongoing pregnancy rates (OPR) in obese and overweight patients were significantly higher in rLH added group compared to rFSH only group (43.2% vs 18.9% respectively, p = 0.044). However, OPR did not differ significantly in rLH added and rFSH only groups in normoweight patients (p = 0.588). Conclusion: This study has shown that obese and overweight non-PCOS patients have lower endogenous LH levels. It has also shown that rLH supplementation in GnRH antagonist cycles in obese and overweight women improves embryo quality and ongoing pregnancy rates. However rL

关键词： Recombinant LH In Vitro Fertilization Obesity GnRH Antagonist Protocol

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