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NEWS: Oral contraceptives with high androgenic progestins reported to suppress oocyte yields

A recent retrospective study demonstrates that use of oral contraceptives with high androgenic progestin suppresses functional ovarian reserve and oocyte yields in young oocyte donors. Accordingly, researchers highlight the need for reevaluating the routine practice of using oral contraceptives prior to in vitro fertilization (IVF) cycles.
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New evidence linking lower donor age and better IVF outcomes in oocyte recipient cycles

The link between donor or recipient age and treatment outcomes in oocyte recipient cycles is not clearly understood, despite evidence indicating that advancing maternal age is an independent risk factor for unfavorable pregnancy and perinatal outcomes in autologous cycles. Highlighting the negative impact of advancing donor age, a recent population study has suggested that the probability of pregnancy and live delivery is higher in older recipients when an oocyte donor <35 years of age is selected. Continue Reading

Posted in ART, Donors, Ethics, Female Infertility, Fertility, Fertility Preservation, IVF Outcome, Infertility, PregnancyComments Off

NEWS: Semen Washing Does Not Eliminate Risk of HPV Infection

Conventional sperm recovery procedures are hypothesized to depend on the migration of motile sperms away from washed epithelial cells and immotile sperms, thus leading to the elimination of infected epithelial cells and enabling virus-free sperm preparations. Although this seems biologically plausible, a recent cross-sectional clinical study highlights that conventional sperm selection techniques may not entirely remove the risk of HPV infection. Continue Reading

Posted in ART, Diagnostics, Donors, Ethics, Fertility, Guidelines, IVF, IVF Outcome, Infertility, Laboratory, Male Infertility, News, Pregnancy, TechnologyComments Off

Study Reports Effective Blastocyst Cyropreservation Using Closed Blastocyst Vitrification System

A recent study has reported the effectiveness of a closed blastocyst vitrification (CBS-VIT) high security (HS) device for the cryopreservation of blastocyts from early cavitating to expanded blastocyst stage. Continue Reading

Posted in ART, Cryopreservation, Donors, Embryology, Ethics, ICSI, IVF, IVF Outcome, InfertilityComments Off

Higher Risk of Gestational Hypertensive Disorders with Donor Oocyte-derived Pregnancies

Oocyte donation (OD) is being increasingly advised, especially in couples or individuals with inheritable diseases, repeated IVF failures, and advanced maternal age. However, IVF cycles using donor oocytes have been associated with a high risk for obstetric complications, such as preterm labor, postpartum hemorrhage, and pregnancy induced hypertension (PIH). A new retrospective matched cohort study validates the increased risk of developing gestational hypertension and preeclampsia in pregnancies conceived using donor oocytes and donor cryopreserved-thawed embryos.

Peter C Klatsky from the Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, and coworkers, compared the risk of gestational hypertension and preeclampsia in women who underwent IVF cycles using autologous and donor oocytes. Donor oocyte recipients (n=77) with live births were matched with those undergoing autologous IVF (n=81) for age and plurality (singleton or twin).

The groups did not differ with respect to parity, age, and gestational type. In comparison to women undergoing autologous IVF, the ovum-donor recipients had
• substantially higher occurrence of preeclampsia (16.9% vs. 4.9%; P=0.02) and gestational hypertension (24.7% vs. 7.4%; P<0.01)
• greater probability for premature delivery (34% vs.19%) even after controlling for multiple gestation (OR=2.6; 95% CI=1.04-6.3)

It was also observed that pregnancies derived from cryopreserved embryos (n=16) were more vulnerable for hypertensive disorders (OR=5.0; 95% CI=1.2-20.5).

Earlier, Keegan et al (Fertility Sterility, 2007) conducted a retrospective anonymous questionnaire study to analyze and compare the rates of obstetric outcomes between OD recipients and IVF patients in the age group of either <35 or ≥40 years. They found that PIH rates were significantly higher in women using donated oocytes (<35 years, 42%; ≥40 years, 26%), when compared to those undergoing IVF (<35 years, 12%; ≥40 years, 14%). It was also seen that PIH rates among the twin pregnancies was higher in OD recipients than the IVF group.

In contrast, a more recent retrospective cohort study by Krieg et al (Fertility Sterility, 2008) found that rates of obstetric complications, such as gestational diabetes, hypertensive disorders in pregnancy, prematurity, and placental abnormalities, were comparable between women who conceived using donated and autologous oocytes in IVF. It was also demonstrated that the two groups did not show any significant difference with respect to infant birth weight and gestational age at the time of delivery.

Although the exact etiology of preeclampsia in oocyte donor cycles is yet to be established, altered or insufficient immunoprotective capability of the fetoplacental unit due to the brief exposure to non-maternal antigens is hypothesized as one of the reasons for its development.

A 2008 report by The Society of Obstetricians and Gynaecologists of Canada suggested the use of donated gametes in ART to be one of the first trimester risk markers for preeclampsia. With the current study results reaffirming the higher chances of hypertensive disorders in donor oocyte pregnancies, it is important to counsel such patients on the potential risks prior to treatment initiation.

References

1. Klatsky PC, Delaney SS, Caughey AB, et al. The Role of Embryonic Origin in Preeclampsia: A Comparison of Autologous In Vitro Fertilization and Ovum Donor Pregnancies. Obstet Gynecol. 2010 Dec;116(6):1387-1392.

2. Keegan DA, Krey LC, Chang HC, Noyes N. Increased risk of pregnancy-induced hypertension in young recipients of donated oocytes. Fertil Steril. 2007 Apr;87(4):776-781.

3. Krieg SA, Henne MB, Westphal LM. Obstetric outcomes in donor oocyte pregnancies compared with advanced maternal age in in vitro fertilization pregnancies. Fertil Steril. 2008 Jul;90(1):65-70.

4. Magee LA, Helewa M, Moutquin JM, et al. SOGC clinical practice guideline: diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. JOGC. 2008 Mar;30(suppl 1):S1-S48.

Posted in ART, Cryopreservation, Donors, Embryology, Genetics, IVF, IVF Outcome0 Comments

Scientists Develop Breakthrough Technique to Prevent Mitochondrial Diseases

A team of researchers from the Newcastle University have developed a pioneering ‘three-person IVF’ technique, in which the fertilization procedure uses the nuclear DNA of the biological parents, and the mitochondrial DNA (mtDNA) from an oocyte donor. The technique, which facilitates exchange of DNA between two oocytes, could serve in preventing the transmission of mitochondrial diseases to offspring. The findings of the groundbreaking study have been published in the online edition of the journal, Nature. Continue Reading

Posted in ART, Donors, Embryology, Ethics, Genetics, Infertility, Laboratory, News, Stem Cells, Technology0 Comments

Study Observes Fertility Decline with Increasing Age in Males

There is substantial evidence to support the progressive decline in fertility in women with advancing age; however, this association has not been well established in men. Now, a recent study reports that semen volume, sperm motility, and the rate of fertilization reduces with age in men. The findings of the study are published in the recent issue of the journal, Reproductive BioMedicine Online. Continue Reading

Posted in ART, Donors, Ethics, Fertility, Genetics, IVF, IVF Outcome, Infertility, Male Infertility, PregnancyComments Off

Importance of Screening Prospective Oocyte Donors for Optimal Reproductive Outcomes

Introduction
Over the past quarter century, there has been a dramatic rise in the number of people seeking infertility treatment. According to the 2002 National Survey of Family Growth, around 11.8% of women in the US, aged between 15 to 44 years, had impaired fecundity. The importance given to reproduction and the generation of progeny has led to the development of various assisted conception techniques and methods to overcome infertility. One such method is “third party reproduction”, which uses sperms, oocytes, or embryos donated by a donor to help infertile couples achieve parenthood. Continue Reading

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ALERT: AMH Testing Effective for Individualizing Stimulation Protocols in Oocyte Donors

Although the efficacy of anti-Müllerian hormone (AMH) as a marker in IVF cycles has been established in various studies, there is insufficient evidence about its usefulness in oocyte donors. Now, a study has reported that AMH assessment in oocyte donors has the potential to ascertain the gonadotropin sensitivity and reduce/prevent the occurrence of ovarian hyperstimulation syndrome (OHSS). The findings, indicating the benefits of testing AMH for individualizing stimulation protocols, have been published in the online issue of the journal, Reproductive BioMedicine Online. Continue Reading

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Study Reports Key Recipient Determinants Influencing IVF Outcome in Donor Oocyte Cycles

The success of any IVF cycle is known to be multifactorial, although there is no consensus about the factors that influence the outcome. Now, a new retrospective study elucidates the negative effect of certain key recipient-related parameters, such as increased body mass index (BMI >30 kg/m2), endometrial thickness (<8 mm), and pituitary down-regulation, on IVF outcome in donor oocyte cycles, independent of the age of the recipient. The study results have been published in the current issue of Human Reproduction. Continue Reading

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