Volume 108, Issue 2, Pages 262–268
Authors:
Eduardo Hariton, M.D., M.B.A., Keewan Kim, Ph.D., M.P.H., Sunni L. Mumford, Ph.D., M.S., Marissa Palmor, B.S., M.B.E., Pietro Bortoletto, M.D., Eden R. Cardozo, M.D., Anatte E. Karmon, M.D., Mary E. Sabatini, M.D., Ph.D., Aaron K. Styer, M.D.
Abstract:
Objective
To evaluate the association of oocyte donor–recipient characteristics, oocyte donor response, and live birth pregnancy rate following fresh donor oocyte IVF-ET.
Design
Retrospective cohort study.
Setting
Academic reproductive medicine practice.
Patient(s)
Two hundred thirty-seven consecutive fresh donor oocyte IVF-ET cycles from January 1, 2007 to December 31, 2013 at the Massachusetts General Hospital Fertility Center.
Intervention(s)
None.
Main Outcome Measure(s)
Live birth rate per cycle initiated.
Result(s)
The mean (±SD) age of oocyte donors and recipients was 27.0 ± 3.7 and 41.4 ± 4.6 years, respectively. Oocyte donor demographic/reproductive characteristics, ovarian reserve testing, and peak serum E2 during ovarian stimulation were similar among cycles which did and did not result in live birth, respectively. Overall implantation, clinical pregnancy, and live birth pregnancy rates per cycle initiated were 40.5%, 60.8%, and 54.9%, respectively. The greatest probability of live birth was observed in cycles with >10 oocytes retrieved, mature oocytes, oocytes with normal fertilization (zygote–two pronuclear stage), and cleaved embryos.
Conclusion(s)
The number of oocytes (total and mature), zygotes, and cleaved embryos are associated with live birth following donor oocyte IVF cycles. These findings suggest that specific peri-fertilization factors may be predictive of pregnancy outcomes following donor oocyte IVF cycles.
Comments
Thank you for this well conducted insightful study on predictors of live birth in donor egg IVF cycles. What changes in clinical practice / counseling of patients do the authors suggest or anticipate based on their findings?
Thank you for your thoughtful question Dr. Quaas. Our study suggests that certain perifertilization factors (number of oocytes (total and mature), zygotes, and cleaved embryos) are associated with live birth. In the scenario where an oocyte donor candidate has undergone prior treatment and ovarian response data are available, we anticipate that the findings of this study will provide guidance for the donor selection process and starting gonadotropin dosing. Furthermore, these findings may also help clinicians to set real-time expectations with patients for pregnancy outcomes based upon results at the time of oocyte retrieval, fertilization check, and early embryo development.
Thank you for your thoughtful question Dr. Quaas. Our study suggests that certain perifertilization factors (number of oocytes (total and mature), zygotes, and cleaved embryos) are associated with live birth. In the scenario where an oocyte donor candidate has undergone prior treatment and ovarian response data are available, we anticipate that the findings of this study will provide guidance for the donor selection process and starting gonadotropin dosing. Furthermore, these findings may also help clinicians to set real-time expectations with patients for pregnancy outcomes based upon results at the time of oocyte retrieval, fertilization check, and early embryo development.
Thank you for your quick and informative reply Dr Hariton.
Congrats to this interesting paper.
Please can you describe your OPU technique.
SL or DL Needle, flushing or not flushing etc.
My aim was to invent a technique to achieve an optimal percentage of eggs/ follicle. www.ivfetflex.com
Thin needle 19gauge for flushing. Option to flush follicles selectively.
There is no place to believe or not believe in flushing follicles, if you use a properNeedle for flushing.
I would be happy to offer you a clinical trial with my needle or discussion via
office@ivfetflex.com
Hans, thank you for your post. Do you have any solid data to back up your statement that there is no place not to believe in flushing with a proper needle? The published data that does support flushing is retrospective. However, the RCTs and meta-analyses of RCTs show no benefit with follicle flushing. The RCT data further demonstrates an increase in surgical time and cost with flushing. So what level 1 data is there to support flushing?