Showing posts with label prospective. Show all posts
Showing posts with label prospective. Show all posts

Monday, March 28, 2011

Fibroids not encroaching the endometrial cavity and IVF success rate: a prospective study

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Edgardo Somigliana1,*, Silvia De Benedictis1,2, Paolo Vercellini1,2, Anna Elisa Nicolosi1, Laura Benaglia1,2, Claudia Scarduelli1, Guido Ragni1 and Luigi Fedele1,2
1Department of Obset/Gynecol-Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milano, Italy
2Università degli Studi di Milano, Milan, Italy *Correspondence address. Tel: +39-349-2267868; E-mail: dadosomigliana{at}yahoo.itReceived August 17, 2010. Revision received December 28, 2010. Accepted January 13, 2011. BACKGROUND The impact of fibroids, not encroaching the endometrial cavity, have on the rate of success of IVF is still controversial. Recent meta-analyses suggest a detrimental effect of intramural lesions but not subserosal lesions. However, they also emphasize the need for further evidence. In order to elucidate this, we designed a prospective cohort study to compare the rate of success of IVF in women with and without fibroids.

METHODS Exposed women were those with asymptomatic intramural or subserosal fibroids with a diameter below 50 mm and who were selected for IVF. Unexposed women were those free of fibroids, who were matched to cases by age and number of previous IVF cycles. All recruited patients underwent hystero-sonography to rule out intra-cavitary lesions.

RESULTS There were 119 cases and 119 controls recruited. The number of clinical pregnancies in women with and without fibroids was 28 (24%) and 22 (19%), respectively (P= 0.43). The adjusted odds ratio (OR) for pregnancy in affected women was 1.38 [95% confidence interval (CI): 0.73–2.60]. The number of deliveries was 22 (18%) and 16 (13%), respectively (P= 0.38). The adjusted OR was 1.45 (95% CI: 0.71–2.94). Similar results emerged when focusing exclusively on women carrying intramural lesions (n= 80 couples). There was no significant relationship between clinical outcome and either the number or size of the fibroids.

CONCLUSIONS In asymptomatic patients selected for IVF, small fibroids not encroaching the endometrial cavity did not impact on the rate of success of the procedure.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (4): 834-839. doi: 10.1093/humrep/der015 First published online: February 11, 2011

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.



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Saturday, March 26, 2011

Treating women under 36 years old without top-quality embryos on day 2: a prospective study comparing double embryo transfer with single blastocyst transfer

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F. Guerif1,2,3,4,*, C. Frapsauce1,2,3,4, C. Chavez1, V. Cadoret1,2,3,4 and D. Royere1,2,3,4
1Service de Médecine et Biologie de la Reproduction, CHRU de Tours, F-37044 Tours, France
2Université François Rabelais de Tours, F-37041 Tours, France
3INRA, UMR85 PRC, F-37380 Nouzilly, France
4CNRS, UMR6175 PRC, F-37380 Nouzilly, France *Correspondence address. Service de Medecine et Biologie de la Reproduction, 2 boulevard Tonnelle, 37000 Tours, France. E-mail: guerif{at}med.univ-tours.frReceived November 17, 2010. Revision received January 4, 2011. Accepted January 11, 2011. BACKGROUND Embryologists currently face a challenge when counselling patients regarding the stage and the number of embryos to transfer when no top-quality embryos (TQE) are available.

METHODS The aim of this study was to evaluate the efficacy of single blastocyst transfer (SBT) in comparison with the transfer of two cleavage-stage embryos in women under 36 years old. A total of 450 women under 36 years undergoing their first or second IVF treatment who had no TQE on Day 2 were included in this prospective study. Couples were assigned to either a SBT or a double cleavage-stage embryo transfer (DET). The clinical end-points monitored were rates of implantation, delivery and multiple deliveries.

RESULTS The rate of transfer was significantly lower for couples assigned to the SBT group compared with the DET group (88 versus 100%, respectively, P < 0.001) while the delivery rate per oocyte retrieval was similar in both groups (26.7%). By contrast, the rate of multiple deliveries was significantly lower in the SBT group compared with the DET group (3.3 versus 23.3%, respectively, P < 0.01). Blastocyst cryopreservation was twice as high in the SBT group compared with the DET group (39 versus 18%, respectively, P < 0.001).

CONCLUSIONS These findings show the value of extended embryo culture for couples without TQE. In such situations, delaying embryo transfer in order to select a single blastocyst with the highest potential for implantation can reduce the number of multiple pregnancies. Furthermore, our results demonstrate that extended culture allows blastocyst cryopreservation from embryos not available for Day 2 cryopreservation.

© The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com This ArticleHum. Reprod. (2011) 26 (4): 775-781. doi: 10.1093/humrep/der020 First published online: February 9, 2011

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.



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Peliculas Online

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