Variations in vascular endothelial growth factor levels during ovarian superovulation and reduction of ovarian hyperstimulation incidence in young women: A prospective study

Variations in Vascular Endothelial Growth Factor (VEGF) levels were prospectively evaluated in 18 young women undergoing in vitro fertilization treatments according to the “Long Protocol” and a typical pattern of VEGF levels was recorded. A significant increase in VEGF concentrations was observed only when the follicles reached a mean diameter of 15.3 mm in concurrence with mature oocyte retrieval. Since an increase in VEGF levels is related to follicular vascularity and oocyte developpment, our study supports the approach that oocyte retrieval may be performed when follicles > 15 mm in diameter appear. Anticipating egg retrieval in young patients with an optimal ovarian reserve may decrease the incidence of severe ovarian hyperstimulation, without compromising the treatment results.

First Trimester Pregnancy Loss May Temporary Reduce the Ovarian Response during the Subsequent IVF Cycle

The aim of this study was to compare the in vitro fertilization (IVF) cycles ended by miscarriage with subsequent IVF cycles in relation to various IVF cycle parameters and pregnancy termination modalities. Comparison of pre-miscarriage to post-miscarriage IVF cycles parameters demonstrated that lower peak E2 levels (1087 ± 593 versus 1237 ± 676 pg/ml, respectively;p p p p p p < 0.05), and an increase in the conception rate (34.7% versus 42.2%, respectively) at the second post-miscarriage IVF cycle.

Synchronous and Asynchronous Blastomere Cleavage at Cryopreservation: Effect on Subsequent Embryo Survival, Pregnancy and Live Birth Rates

Capsule: Although embryos with synchronous blastomere cleavage showed higher post-thaw survival rates, pregnancy rates did not differ. Thus, embryos with all cleavage patterns may be safely cryopreserved. Objective: To compare post-thaw embryo survival, pregnancy and live birth rates of embryos with synchronous vs asynchronous blastomere cleavage in frozen embryo transfer (FET) cycles. Design: Retrospective study. Setting: University-affiliated IVF unit. Patients: One thousand and sixty FET cycles performed from 2004-2006. Interventions: Cycles were divided into 3 groups: 1: cycles in which only embryos with synchronous blastomere cleavage were frozen;2: cycles in which only embryos with asynchronous blastomere cleavage were frozen;3: cycles in which both embryos with synchronous and asynchronous blastomere cleavage were frozen. Clinical and laboratory data were recorded and analyzed. Main Outcome Measures: Post-thaw embryo survival, morphologic grading, pregnancy and live birth rates. Results: A total of 1863 embryos were analyzed. Synchronous embryos had higher blastomere survival rates and morphological grading at thawing. Pregnancy and birth rates did not differ among groups. In a multivariant logistic regression analysis, a number of transferred embryos and embryo morphological grading at thawing were the only parameters that affected pregnancy and live birth rates. Conclusions: Embryos with both synchronous and asynchronous blastomere cleavage can be selected by classical embryo grading and safely cryopreserved.

Is It Possible to Predict the Outcome of IVF Treatment in Poor Response Patients?

Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to women’s age (years) during the treatment cycle: 1) 20 - 34 (n = 133), 2) 35 - 39 (n = 133), 3) 40 - 42 (n = 78), 4) 43 - 47 y (n = 42), and correlated with the characteristics of the population. The clinical pregnancy rates for groups 1, 2, 3, and 4 were: 23.3%, 12%, 2.6%, 4.8%, respectively. It was found to be significantly higher (p < 0.001) comparing group 1 with group 3 patients. The “take home baby” rate was much lower (p < 0.001) in group 3;there were no deliveries in group 4. Delivery rates for groups 1, 2, 3, and 4 were: 19.5%, 10.5%, 1.3% and 0%, respectively. Intraabdominal adhesions were more common (p = 0.005) as the cause of infertility in group 3 women compared to groups 2 and 1: 24.4% compared with 9% and 9.8%, respectively. According to multivariate regression analysis, the parameters that negatively reflect on the pregnancy rate in POR women are intraabdominal adhesions, POR in the past, and increased age. We suggest encouraging young POR patients to pursue IVF treatments since the “take home baby” rates are reasonably good.

年长男子的生育年龄对生育质量的影响

最近几十年来，妇女生第一胎的年龄越来越大。同样的趋势在男性群体也逐渐表现出来了。母亲年龄对生育、染色体异常、孕期并发症、先天缺陷以及对后代的整体健康的影响已经得到全面的研究，而且这些研究结果已经应用于临床受孕咨询和产前咨询中。但男性的年龄及其对生育结果的影响相对来说得到的关注度较低。本综述的目的是对最近相关文献中父亲年龄对生育结果的影响做一个综合评述。

胚胎移植过程中的催眠术对于体外受精结局的影响:一项病例对照研究

Objective: To investigate whether hypnosis during ET contributes to successful IVF/ET outcome. Design: Case-control clinical study. Setting: Academic Fertility and IVF Unit, Soroka Medical Center, Beer-Sheva, Israel. Patient(s): Infertile couples undergoing IVF. Intervention(s): Ninety-eight IVF/ET cycles with hypnosis during the ET procedure were matched with 96 regular IVF/ET cycles. Main Outcome Measures: Comparison of clinical pregnancy and implantation rates between the two groups. Result(s): We obtained 52 clinical pregnancies out of 98 cycles (53.1% ) with an implantation rate of 28% among hypnosis IVF/ET cycles, and 29 out of 96 (30.2% ) clinical pregnancies and an implantation rate of 14.4% in the control cycles. Our overall IVF program pregnancy rate for the same period was 32.1% . Logistic regression analysis was performed emphasizing the positive contribution of hypnosis to the IVF/ET conception rates. Conclusion(s): This study suggests that the use of hypnosis during ET may significantly improve the IVF/ET cycle outcome in terms of increased implantation and clinical pregnancy rates. Furthermore, it seems that the patients’ attitude to the treatment was more favorable.

Effect of varicocele on semen characteristics according to the new 2010 World Health Organization criteria： a systematic review and meta-analysis

This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （volume, sperm count, motility, and morphology） were the primary outcomes. An electronic search to collect the data was conducted using the Medline/PubMed, SJU discover, and Google Scholar databases. We searched articles published from 2010 to August 2015, i.e., after the publication of the 2010 WHO manual. We included only those studies that reported the actual semen parameters of adult infertile men diagnosed with clinical varicocele and contained a control group of either fertile men or normozoospermic men who were not diagnosed with varicocele. Ten studies were included in the meta-analysis, involving 1232 men. Varicocele was associated with reduced sperm count （mean difference： -44.48 x 106 ml-1; 95% Ch -61.45, -27.51 x 106 ml-1; P〈 0.001）, motility （mean difference： -26.67%; 95% Ch -34.27, -19.08; P 〈 0.001）, and morphology （mean difference： -19.68%; 95% Ch -29.28, -10.07; P 〈 0.001） but not semen volume （mean difference： -0.23 ml; 95% CI： -0.64, 0.17）. Subgroup analyses indicated that the magnitude of effect was influenced by control subtype but not WHO laboratory manual edition used for semen assessment. We conclude that varicocele is a significant risk factor that negatively affects semen quality, but the observed pooled effect size on semen parameters does not seem to be affected by the WHO laboratory manual edition. Given most of the studies published after 2010 still utilized the 1999 manual for semen analysis, further research is required to fully understand the clinical implication of the 2010 WHO laboratory manual on the association between varicocele and semen parameters.