P01.28: Analysis of nuchal translucency measurements in pregnancies achieved by assisted reproduction techniques

The significance of premature luteinization in an oocyte-donation programme

BACKGROUND: Several evidences indicate that premature luteinization (PL) may affect IVF outcome. The primary end-point of the present study was to verify the effect of PL on the pregnancy rate (PR) of our oocytedonation programme. METHODS: PL was defined as serum progesterone ³1.2 ng/ml on the day of HCG. We analysed retrospectively 240 oocyte-donation cycles in which 120 women donated twice, with PL in the first donation cycle and no PL in the following one, acting as its own control. Recipients (n = 240) were divided in two groups according to the presence of PL (n = 120) or not (n = 120). Both groups were compared regarding donor cycle parameters and recipient cycle outcome. RESULTS: The…

Antral follicle count (AFC) can be used in the prediction of ovarian response but cannot predict the oocyte/embryo quality or the in vitro fertilization outcome in an egg donation program

To verify whether the antral follicle count (AFC) could predict ovarian response, oocyte/embryo quality, and IVF outcome.Prospective study.Instituto Universitario-Instituto Valenciano de Infertilidad, Valencia, Spain.One thousand seventy-four donors and 975 oocyte recipient cycles.Controlled ovarian hyperstimulation (COH), endometrial preparation, IVF/intracytoplasmic sperm injection, ET.COH and oocyte/embryo quality parameters and IVF outcome.We observed lower E(2) levels and fewer mature retrieved oocyte numbers among donors who showed an AFC that was10. These donors also showed significantly higher cancellation and no-donation rates; poor and/or insufficient response was the principal ca…

The impact of cigarette smoking on the health of descendants

This paper presents a review of the literature on the effects of cigarette smoking on the health of descendants and the possible mechanisms that lead to them. The evidence of the effects of prenatal cigarette smoke exposure on neonatal morbidity is clear. A number of birth defects have their incidence raised by maternal cigarette smoking during pregnancy. Prenatal smoke exposure also increases the risk of infant irritability, inattention, decreased response to inanimate auditory stimuli and hypertonia. In addition, the prevalence of obesity in preschool children is higher if the mother smoked during pregnancy, as well as the presence of male or female subfertility/infertility in adult life.…

GnRH agonist administration at the time of implantation does not improve pregnancy outcome in intrauterine insemination cycles: a randomized controlled trial.

Objective To assess whether GnRH agonist administration in the luteal phase improves pregnancy outcome in intrauterine insemination (IUI) cycles. Design Single-center, randomized, single-blind, placebo-controlled trial. Setting University-affiliated infertility clinic, between February 2005 and December 2007. Patient(s) Three hundred forty-four women undergoing IUI owing to mild to moderate male factor or donor sperm indication. Intervention(s) Random administration to either a single subcutaneous injection of 0.1 mg triptorelin (group A; n = 172) 8 days after hCG administration, or solvent only (group B; n=172) at the same time. Main Outcome Measure(s) Pregnancy rate was the primary outcom…

Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome

Objective To determine whether luteal phase endometrial transcriptome is altered in obese women during the window of implantation (WOI), considering the presence of infertility, fat distribution and association with polycystic ovary syndrome (PCOS). Design Prospective study. Setting University-affiliated infertility clinic, between May 2007 and March 2009. Patient(s) One control group of women with normal weight (n = 4), and four study groups of obese women (n = 6 each one) according to the association with infertility, PCOS, and ovarian stimulation. Intervention(s) The endometrium was biopsied 7 days after LH surge or hCG administration in 28 women. Main Outcome Measure(s) Endometrial gene…

GnRH agonist versus recombinant HCG in an oocyte donation programme: a randomized, prospective, controlled, assessor-blind study.

The use of gonadotrophin-releasing hormone (GnRH) agonists for triggering ovulation remains controversial. The primary objective of this study was to evaluate the incidence of ovarian hyperstimulation syndrome (OHSS) following GnRH agonist versus recombinant human chorionic gonadotrophin (HCG) as methods for triggering ovulation. A second aim was to compare the clinical outcome and embryo quality according to the two procedures. The cycle characteristics of 100 oocyte donors undergoing ovarian stimulation and IVF outcomes of their 100 oocyte recipients were analysed. Donors were prospectively randomized into two groups on the last day of ovarian stimulation: Group I received a single bolus …

Obesity and poor reproductive outcome: the potential role of the endometrium

Objective To analyze the potential role of extraovarian factors such as endometrium in the reproductive outcome of obese patients. Design Retrospective study. Setting University-affiliated infertility clinic, between January 2001 and July 2005. Patient(s) Women undergoing a total of 2656 first ovum donation (OD) cycles with good quality embryos. Intervention(s) The oocyte donors underwent controlled ovarian hyperstimulation, and recipients received a well-established hormonal replacement therapy for endometrial preparation. In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) was performed according to semen characteristics. All first cycles (n = 2656) of ovum donation us…

A prospective, randomized, controlled trial comparing three different gonadotropin regimens in oocyte donors: ovarian response, in vitro fertilization outcome, and analysis of cost minimization

Objective To compare the efficacy of three different gonadotropin regimens in an oocyte donation program. The analysis of cost minimization also was evaluated. Design Prospective, randomized, controlled study. Setting Instituto Universitario–IVI, Valencia, Spain. Patient(s) One thousand twenty-eight donors undergoing a GnRH agonist protocol were assigned randomly to one of three groups: group 1 (n = 346), only recombinant FSH (rFSH); group 2 (n = 333), only highly purified menotropin (HP-hMG); and group 3 (n = 349), rFSH plus HP-hMG. One thousand seventy-nine oocyte recipients. Intervention(s) Controlled ovarian stimulation. Main Outcome Measure(s) Controlled ovarian stimulation parameters,…

Improvements achieved in an oocyte donation program over a 10-year period: sequential increase in implantation and pregnancy rates and decrease in high-order multiple pregnancies

Objective To compare outcome parameters and cumulative pregnancy rates (PRs) in oocyte donation cycles over a period of 10 years. Design Retrospective study. Setting University-affiliated assisted reproductive technology program. Patient(s) Women undergoing oocyte donation (10,537 cycles) between 1995 and 2005. Intervention(s) Ovarian stimulation and oocyte retrieval in donors. Embryo transfer performed in recipients after endometrial preparation. Main Outcome Measure(s) Outcome parameters and cumulative PRs were calculated and compared in relation to indication, age, and origin of sperm used. Result(s) Overall PR, implantation rate, clinical PR, and miscarriage rate per embryo transfer per…

Female obesity impairs in vitro fertilization outcome without affecting embryo quality.

Objective To compare embryo quality and reproductive outcome in our IVF program according to the women's body mass index (BMI). Design Retrospective study. Setting University-affiliated infertility clinic, between January 2001 and April 2007. Patient(s) Women undergoing a total of 6,500 IVF–intracytoplasmic sperm injection (ICSI) cycles. Intervention(s) Six thousand five hundred IVF-ICSI cycles were included and divided into four groups: lean ( 2 ; n=1,070; 16.5%); normal (20–24.9 kg/m 2 ; n=3,930; 60.5%); overweight (25–29.9 kg/m 2 ; n=1,081; 16.6%); and obese (≥30 kg/m 2 ; n=419; 6.4%). Main Outcome Measure(s) Comparison of embryo quality and reproductive outcome (implantation, pregnancy,…