Archive | Embryology

Vitrified-warmed Blastocyst Transfers Found to have Similar Clinical Outcomes as Fresh Transfers

A vital component of any cryopreservation protocol used in ART is the minimal effect of the method on the preserved embryos. With its inherent benefits when compared to slow freezing, vitrification has been widely accepted worldwide and considering its widespread usage, numerous studies have evaluated the neonatal outcomes with encouraging results. Adding further credence to this technique, a recent retrospective study highlights that vitrified-warmed blastocyst transfers have equal live birth rates and enhanced neonatal outcomes in comparison to fresh transfers. The study findings are published in the journal, Fertility and Sterility.
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Posted in ART, Cryopreservation, Embryo Transfer, Embryology, Female Infertility, IVF, IVF Outcome, Infertility, PregnancyComments Off

Systematic Review and Meta-analysis Finds Little Evidence on Benefits of Cervical Mucus Removal Prior to Embryo Transfer in ART Cycles

Pregnancy rates during IVF/ICSI cycles may be adversely impacted even by small variations in embryo transfer methods. Although some studies have evaluated the impact of removal of cervical discharge on ART outcomes, there is a lack of consensus on the embryo transfer outcomes. A recent systematic review and meta-analysis, published in Fertility and Sterility, did not find any significant proof regarding the beneficial effects of cervical mucus removal before embryo transfer in improving the IVF/ICSI cycle outcomes.
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Influence of Economics on ART Access and Embryo Transfer Practices – Data from 30 High and Upper-middle Income Countries

Although it is well-known that the psycho-physical burden of the ART treatment is one of the most important factors that influence the withdrawal from the treatment, certain studies have also found that cost is a vital factor responsible for the decrease in ART access. A recent international study which analyzed the ART treatment, healthcare system, and socio-demographic data collected from 30 different upper and upper-middle income countries, further substantiated the impact of consumer cost on ART utilization and numbers of embryos transferred. The results of the study are published in the Fertility and Sterility journal.
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Retrospective Study Reports Embryo Quality and Progesterone Levels as Most Significant Predictors of Live Birth Rates in Fresh Embryo Transfer

A recent retrospective cohort study conducted on 2,525 infertile women has reaffirmed that embryo quality and progesterone levels on the day of hCG administration are important predictors of live birth rates and pregnancy, respectively, in fresh IVF cycles. The study findings are published in Journal of Assisted Reproduction and Genetics.

Qian Fang Cai from the Reproductive Medicine Center, Women and Children’s Hospital of Guangdong Province, China, and coworkers conducted the study to determine the independent predictors of live birth in fresh IVF cycles by assessing the effect of cohort-specific parameters such as the number of retrieved oocytes, antral follicle count (AFC), and number and quality of embryos. Bootstrap algorithm was used to identify independent predictors, and multivariable logistic regression was employed along with measurement of proportion of explained variation for comparing the value of transfer-specific and cohort-specific predictors.
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Literature Search Highlights Role of microRNAs associated with Endometrial Receptivity as Biomarkers in IVF

Endometrial receptivity plays a crucial role in embryo implantation and successful pregnancy; however, the key molecules or mechanisms associated with it are still unclear. A recent review, published in Current Drug Targets, highlighted the importance of better understanding the molecular mechanisms that affect endometrial receptivity and embryo implantation to improve the ART outcomes. Novel molecular targets such as microRNAs (miRNA) could serve as a biomarker for endometrial receptivity, thereby increasing the chances of implantation in both natural and artificial conception. Another recent study, published in Reproductive Sciences, identified the potential miRNA target genes that may be vital for endometrial receptivity like CAST, CFTR, FGFR2, and LIF. The findings emphasized the importance of miRNA and their target genes in endometrial receptivity.
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NEWS: Uterine length affects fertility outcomes in IVF therapy

Embryo transfer, despite being the final critical step in IVF therapy, has till recently not received due attention from researchers. Previous studies have reported that knowledge of the position and size of the uterus during embryo transfer may aid in improving pregnancy outcomes. Now, a recent retrospective cohort study, published in the journal Human Reproduction, has shown an association between uterine length and IVF outcomes.
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NEWS: Luteal phase progesterone support may improve pregnancy rates

Luteal phase progesterone secretion is vital for endometrial adaptation for pregnancy. The low levels of progesterone or hCG in assisted reproductive technology (ART) cycles necessitate support with progesterone, hCG, or GnRH agonists in the luteal phase. Now, a recent study has confirmed the benefits of progesterone support in patients undergoing ovulation induction.
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NEWS: Bed rest following embryo transfer speculated to adversely impact IVF outcomes

Embryo implantation in in vitro fertilization (IVF) therapy is a complicated process influenced by several factors such as endometrial receptivity and embryo quality. Numerous interventions have been tested towards improving implantation, and although implantation failure is not usually associated with increased activity, bed rest is commonly prescribed. However, a recent study has proved that bed rest following embryo transfer (ET) may have a negative influence on IVF outcomes.
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NEWS: Time-lapse imaging and morphokinetic analysis help identify embryo risk for aneuploid chromosomes

Time-lapse imaging of preimplantation embryos is increasingly being employed in assisted reproduction treatment. This technique has facilitated the use of objective algorithms based on embryo morphokinetic variables for embryo selection. A recent study has detailed the use of time-lapse imaging using defined morphokinetic data for detecting embryos at risk of having aneuploid chromosome structure, without the need to perform preimplantation genetic screening.
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NEWS: Conversion of high-response gonadotropin IUI cycles to rescue IVF cycles yields better outcomes than regular IVF

Intrauterine insemination (IUI) is usually the first line of treatment in unexplained and mild male factor subfertility. Although IUI may improve pregnancy rates, supernumerary follicles in high responding women increase their risk for multiple pregnancy and ovarian hyperstimulation syndrome (OHSS), particularly in gonadotropin cycles. A recent study reports the benefits of conversion of high-response gonadotropin IUI cycles to rescue IVF cycles when compared with hyper-responder IVF controls.
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