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A randomized, non-inferiority trial on the DuoStim strategy in PGT-A cycles
Is the DuoStim strategy an effective alternative to two conventional ovarian stimulation cycles in poor-prognosis patients undergoing preimplantation genetic testing for aneuploidies (PGT-A) to improve euploidy rates and obtain the first euploid embryo in less time?Preimplantation genetic testing for human blastocysts with potential parental contamination using a quantitative parental contamination test (qPCT): an evidence-based study
Is it possible to develop a quantitative method for detecting parental DNA contamination in conventional IVF using preimplantation genetic testing for aneuploidy (PGT-A)?Does the HCG trigger dose used for IVF impact luteal progesterone concentrations? a randomized controlled trial
Is there an association between the ovulation trigger dose of human chorionic gonadotrophin (HCG) and endogenous progesterone production during the luteal phase?Comparison of predictive models for cumulative live birth rate after treatment with ART
Can a machine learning model better predict the cumulative live birth rate for a couple after intrauterine insemination or embryo transfer than Cox regression based on their personal characteristics?IVF impact on the risk of recurrence of endometrial adenocarcinoma after fertility-sparing management
Do IVF treatments after conservative management of endometrial atypical hyperplasia or grade 1 endometrial adenocarcinoma (AH/EC) increase the risk of disease recurrence?The prevalence, promotion and pricing of three IVF add-ons on fertility clinic websites
How are IVF clinic websites advertising three common IVF add-ons: assisted hatching, time-lapse embryo imaging and preimplantation genetic testing for aneuploidies (PGT-A)?‘There is only one thing that is truly important in an IVF laboratory: everything’ Cairo Consensus Guidelines on IVF Culture Conditions
This proceedings report presents the outcomes from an international expert meeting to establish consensus guidelines on IVF culture conditions. Topics reviewed and discussed were: embryo culture – basic principles and interactions; temperature in the IVF laboratory; humidity in culture; carbon dioxide control and medium pH; oxygen tension for embryo culture; workstations – design and engineering; incubators – maintaining the culture environment; micromanipulation – maintaining a steady physcochemical environment; handling practices; assessment practices; culture media – buffering and pH, general composition and protein supplementation, sequential or single-step media for human embryo culture; use and management – cold chain and storage; test equipment – calibration and certification; and laboratory equipment and real-time monitoring.Human growth hormone for poor responders: a randomized placebo-controlled trial provides no evidence for improved live birth rate
Does the addition of human growth hormone (HGH) to an IVF cycle improve the live birth rate in previously documented poor responders to FSH?Autologous endometrial cell co-culture improves human embryo development to high-quality blastocysts: a randomized controlled trial
Does autologous endometrial cell co-culture (AECC) improve the number of good-quality blastocysts obtained by IVF/intracytoplasmic sperm injection (ICSI), compared with conventional embryo culture medium in a broad group of patients referred to assisted reproductive technology (ART)?Insights from clinical experience in treating IVF poor responders
‘Poor responders’ is a term used to describe a subpopulation of IVF patients who do not respond well to ovarian stimulation with gonadotrophins. While there is no standard definition of a poor responder, these patients tend to be of advanced maternal age (≥40 years), have a history of poor ovarian response with conventional stimulation protocols, and/or have low ovarian reserve. Despite the heterogeneity of this patient group, there are characteristics and needs common to many poor responders that can be addressed through a holistic approach.Bio-equivalent doses of recombinant HCG and recombinant LH during ovarian stimulation result in similar oestradiol output: a randomized controlled study
In nature, HCG is secreted by the implanting embryo from peri-implantation and onwards. In contrast, LH is mandatory for steroidogenesis and follicular development during the follicular phase, working in synergy with FSH. Moreover, LH is mandatory for the function of the corpus luteum. Although LH and HCG bind to the same receptor, significant molecular, structural and functional differences exist, inducing differences in bioactivity. This randomized controlled study compared the effect of recombinant FSH stimulation combined with daily either micro-dose recombinant HCG or recombinant LH supplementation in a 1:1 bioactivity ratio from day 1 of stimulation in a long gonadotrophin releasing hormone agonist down regulation protocol.‘Model’ versus ‘everyday’ patients: can randomized controlled trial data really be applied to the clinic?
New drug approval requires a new drug to undergo rigorous clinical trials to determine its efficacy and safety. A drug is approved only for the population on which it was tested, i.e. those who meet the inclusion criteria of the trial. The aim of this study was to determine what percentage of ‘real life’ patients in our clinic meet the inclusion and exclusion criteria used in large-scale clinical trials required for drug registration in the field of assisted reproduction. All 265 consecutive patients with pertinent data treated in a tertiary centre IVF Unit during 2015 were surveyed.GnRH agonist trigger for the induction of oocyte maturation in GnRH antagonist IVF cycles: a SWOT analysis
Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of ovarian hyperstimulation syndrome during IVF treatment. This trigger concept, however, results in early corpora lutea demise and consequently luteal phase dysfunction and impaired endometrial receptivity. The aim of this strenghths, weaknesses, opportunities and threats analysis was to summarize the progress made over the past 15 years to optimize ongoing pregnancy rates after GnRHa trigger.Factors associated with willingness to donate embryos for research among couples undergoing IVF
Most couples enrolled in IVF and intracytoplasmic sperm injection (ICSI) cycles need to make decisions about embryo disposition (Provoost et al., 2010; Wånggren et al., 2013). It has been consistently shown that this is a complex decision-making process, involving different sequential stages that can change over time (de Lacey, 2005; Provoost et al., 2009, 2012a). Patients undergoing IVF usually reveal multifaceted views about embryo status (Haimes and Taylor, 2009; Provoost et al., 2009), disagreements between partners (Provoost et al., 2012b) and emotional distress (de Lacey, 2005; Fuscaldo et al., 2007).A pilot study to evaluate a device for the intravaginal culture of embryos
The aim of this comparative randomized embryology trial was to determine if an intravaginal culture device (IVC) can provide acceptable embryo development compared with conventional IVF. Ten women between the ages of 27 and 37 years with an indication for IVF treatment were included in this study. After ovarian stimulation, oocytes were randomized to fertilization in the IVC device or using conventional IVF. Fertilization rates were higher in the IVF group compared with the IVC device (68.7% ± 36 % versus 40.7% ± 27%), respectively, whereas cleavage rates were similar (93% ± 1.5% versus 97% ± 6%) for both groups.What's in a name? Variations in terminology of third-party reproduction
The terminology used to discuss third-party reproduction, as with other new biomedical processes, can ease or impede communication and even influence behaviour. In an effort to sensitize analysts and stakeholders to variations in terminology and to facilitate communication on issues arising from international surrogacy arrangements, this paper examines variations in terms used. We introduce some of the issues previously raised by scholars concerned with analysis of discourse related to third-party reproduction.Freeze-all can be a superior therapy to another fresh cycle in patients with prior fresh blastocyst implantation failure
Despite numerous advances in assisted reproduction, implantation failure remained the most common outcome following embryo transfer in 2011 (Society for Assisted Reproductive Technology, 2011). Most fresh autologous embryo transfers in 2011 failed to result in live birth, and national average implantation rates ranged from 4–36%, depending on maternal age. Therefore, a large proportion of patients undergoing IVF experience at least one fresh embryo transfer cycle resulting in implantation failure.Outcomes of blastocysts biopsied and vitrified once versus those cryopreserved twice for euploid blastocyst transfer
Trophectoderm biopsy with comprehensive chromosome screening (CCS) has been shown to increase implantation and pregnancy rates. Some patients desire CCS on previously cryopreserved blastocysts, resulting in blastocysts that are thawed/warmed, biopsied, vitrified and then warmed again. The effect of two cryopreservation procedures and two thawing/warming procedures on outcomes has not been effectively studied. Cycles were divided into two groups: group 1 patients underwent a cryopreserved embryo transfer with euploid blastocysts that were vitrified and warmed once; group 2 patients had a cryopreserved embryo transfer of a euploid blastocyst that was cryopreserved, thawed/warmed, biopsied, vitrified and warmed.Effectiveness of indometacin to prevent ovulation in modified natural-cycle IVF: A randomized controlled trial
Modified natural-cycle IVF has a lower pregnancy rate per started cycle as compared with IVF with ovarian stimulation due to, for example, premature ovulation. Indometacin administered before ovulation prevents follicle rupture. Therefore, addition of indometacin may improve the effectiveness of modified natural-cycle IVF. This double-blind, randomized, placebo-controlled trial with indometacin or placebo in 120 women aged 27–36 years compared the number of patients without premature ovulation as compared with the number of patients with one or more ovulations in a maximum of six cycles.IVF versus ICSI for the fertilization of in-vitro matured human oocytes
Traditional dogma suggests that intracytoplasmic sperm injection (ICSI) should be performed to ensure successful oocyte fertilization in an in-vitro maturation (IVM) cycle. This study postulated that there would be no difference in the fertilization rate when ICSI was compared with IVF. This hypothesis was tested in a randomized trial of IVF versus ICSI in IVM. A total of 150 immature oocytes were collected in eight cycles of IVM for patients diagnosed with polycystic ovarian syndrome (PCOS). Patients were primed with minimal FSH before transvaginal oocyte aspiration.Serum HCG measured in the peri-implantation period predicts IVF cycle outcomes
The current study assessed the relationship between serum concentrations of human chorionic gonadotrophin (HCG) measured in the peri-implantation period and various outcome measures following blastocyst transfer in IVF cycles. The study group included 767 autologous IVF cycles, each with the transfer of two fresh blastocysts in a 6-year study period, ending 31 December 2009. Outcome measures were ectopic pregnancy, biochemical pregnancy loss, ongoing pregnancy, spontaneous abortion and multiple pregnancy.Optimization of cryocycles by using pinopode detection in patients with multiple implantation failure: preliminary report
The aim of this study was to investigate pinopode formation patterns in patients with a history of multiple IVF failures and to evaluate if their detection with subsequent modification of protocols using frozen–thawed embryos could help to increase the pregnancy and live-birth rates in these patients. The study included 55 women with at least three implantation failures. On-time pinopodes were present in only 12.7% of cases, the rest showed acceleration, delay, arrest or asynchronization of pinopode formation.
