Total number of oocytes and zygotes are predictive of live birth pregnancy in fresh donor oocyte in vitro fertilization cycles

This retrospective cohort study of donor oocyte in vitro fertilization cycles suggests that the number of total and mature oocytes, zygotes, and cleaved embryos is associated with increased probability of live birth.

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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.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

6 Comments

Go to the profile of Alexander Quaas
Alexander Quaas over 3 years ago

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?

Go to the profile of Eduardo Hariton
Eduardo Hariton over 3 years ago

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.

Go to the profile of Eduardo Hariton
Eduardo Hariton over 3 years ago

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.

Go to the profile of Alexander Quaas
Alexander Quaas over 3 years ago

Thank you for your quick and informative reply Dr Hariton.

Go to the profile of Hans-Peter
Hans-Peter over 3 years ago

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

Go to the profile of Micah J Hill
Micah J Hill over 3 years ago

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?