“Delayed start” gonadotropin-releasing hormone antagonist protocol in Bologna poor-responders: A systematic review and meta-analysis of randomized controlled trials

Publication date: Available online 23 November 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Mauro Cozzolino, Jason Franasiak, Alessandra Andrisani, Guido Ambrosini, Amerigo VitaglianoAbstractTo evaluate the effectiveness of delay start protocol in improving the success of in vitro fertilization (IVF) in poor responders according to Bologna’s criteria. Only randomized controlled trial (RCT) of infertile women undergoing a single IVF/ICSI cycle with ovarian stimulation protocol based on daily injections with delay start protocol or a conventional antagonist protocol were included in this systematic review and meta-analysis. The review protocol was registered in PROSPERO before starting the data extraction (CRD42019128284). Primary outcomes was clinical pregnancy rate. Ongoing pregnancy rate, miscarriage rate, number of oocytes, number of MII oocytes, stimulation length, gonadotropin amount and cancellation rate were considered as secondary outcomes. Four randomized controlled trials were included with a total number of 380 participants. 189 patients were included in the delayed start protocol and 191 were allocated to the comparison group. The results showed a significant higher clinical pregnancy rate (CPR) in patients allocated to the intervention. Data from all studies failed to detect a statistical difference between groups in terms of ongoing pregnancy rate (OPR), miscarriage rate (MR), Total-Oocyte, MII-Oocyte and Tot...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research

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CONCLUSIONS: While avoiding unnecessary embryo transfers and miscarriages are important goals, patients and doctors need to be aware of the high cost implications of applying PGT-A using aCGH on polar bodies. FUNDING: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The ESTEEM study was funded by the European Society for Human Reproduction and Embryology. Illumina provided microarrays and other consumables necessary for aCGH testing of polar bodies. PMID: 31930663 [PubMed - as supplied by publisher]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
ConclusionsAOA was able to “rescue” the poor reproductive outcomes in certain types of infertile couples with history of failure pregnancy.
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
Authors: Yang DN, Wu JH, Geng L, Cao LJ, Zhang QJ, Luo JQ, Kallen A, Hou ZH, Qian WP, Shi Y, Xia X Abstract This meta-analysis was intended to evaluate the effects of intrauterine perfusion of peripheral blood mononuclear cells (PBMC) on the pregnancy outcomes including clinical pregnancy rates, embryo implantation rates, live birth rates and miscarriage rates of infertile women who were undergoing in vitro fertilisation (IVF) treatment. By searching Pubmed, Embase database, five articles meeting the inclusion criteria were included, and 1173 women were enrolled (intrauterine PBMC group: n = 514; NO-P...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
CONCLUSIONS: This review evaluated different temperatures for embryo culture during IVF. There is a lack of evidence for the majority of outcomes in this review. Based on very low-quality evidence, we are uncertain if incubating at a lower temperature than 37°C improves pregnancy outcomes. More RCTs are needed for comparing different temperatures of embryo culture which require reporting of clinical outcomes as live birth, miscarriage, clinical pregnancy and adverse events. PMID: 31529804 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
ConclusionArtificial oocyte activation with ionomycin does not adversely affect pregnancy and neonatal outcomes in patients undergoing frozen –thawed embryo transfer, which is beneficial to clinicians counseling patients on the risks of artificial oocyte activation.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
ConclusionsA trend towards consistently better results was achieved by removing spermatozoa with fragmented DNA. The fragmentation of the DNA in sperm is the end stage of apoptosis. Sorting of spermatozoa may be improved by selecting parameters of processes active more upstream of apoptosis, such as chromatin decondensation.Trial registrationNCT02166567. June 14, 2014.
Source: Journal of Assisted Reproduction and Genetics - Category: Reproduction Medicine Source Type: research
Male factor infertility is responsible for approximately half of all causes of infertility. In the last decade, more attention has been given to sperm DNA fragmentation (SDF) as a potential cause of unexplained infertility. The increased DNA damage in spermatozoa from men with oligozoospermia seems to be associated with both a reduced chance of natural conception and an increased risk of early pregnancy loss (1). Nevertheless, the role of SDF during in  vitro fertilization cycles where intracytoplasmic sperm injection (ICSI) is adopted is still unclear.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research
Male factor infertility is responsible for approximately half of all causes of infertility. In the last decade, more attention has been given to sperm DNA fragmentation (SDF) as a potential cause of unexplained infertility. The increased DNA damage in spermatozoa from men with oligozoospermia seems to be associated with both a reduced chance of natural conception and an increased risk of early pregnancy loss (1). Nevertheless, the role of SDF during in  vitro fertilization cycles where intracytoplasmic sperm injection (ICSI) is adopted is still unclear.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research
ConclusionOur long-term follow-up data demonstrate that the hysteroscopic correction of dysmorphic uteri may result in a high live birth rate in women suffering from unexplained infertility or repeated miscarriages.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
SummaryPolycystic ovary syndrome (PCOS) is one of the most common causes of infertility in women. Progestin-primed ovarian stimulation (PPOS) protocol, which used oral progestin to prevent premature luteinizing hormone (LH) surges in ovarian stimulation, has been proved to be effective and safe in patients with PCOS. The aim of the present study was to compare the efficacy of PPOS protocol with that of the traditional gonadotropin-releasing hormone (GnRH) antagonist protocol in patients with PCOS. A total of 157 patients undergoingin-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) were recruited into t...
Source: Journal of Huazhong University of Science and Technology -- Medical Sciences -- - Category: Research Source Type: research
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