Elisabet Clua - Academia.edu (original) (raw)

Papers by Elisabet Clua

Research paper thumbnail of Comparison of blastocyst euploidy rates following luteal versus follicular phase stimulation in a GnRH antagonist protocol: a prospective study with repeated ovarian stimulation cycles

Human Reproduction

STUDY QUESTION Is there any difference in the mean number of euploid embryos following luteal pha... more STUDY QUESTION Is there any difference in the mean number of euploid embryos following luteal phase start (LS) and follicular phase start (FS) of ovarian stimulation? SUMMARY ANSWER The mean number of euploid blastocysts is equivalent independent of whether the inseminated oocytes are derived from FS or LS. WHAT IS KNOWN ALREADY Starting ovarian stimulation at any time of the cycle (‘random-start’) is commonly used for emergency fertility preservation in cancer patients. A few retrospective studies have been published evaluating LS in women undergoing ovarian stimulation in the context of IVF, but there is a lack of robust data on the comparative efficacy of LS versus FS. Although ‘random start’ is commonly used in cancer survivors, few retrospective and uncontrolled studies have been published evaluating luteal phase stimulation in women undergoing ovarian stimulation in the context of IVF. Owing to this evident lack of robust data on the efficacy of LS, guidelines typically recomm...

Research paper thumbnail of Blastocyst versus cleavage embryo transfer improves cumulative live birth rates, time and cost in oocyte recipients: a randomized controlled trial

Reproductive BioMedicine Online, 2022

RESEARCH QUESTION Does embryo transfer day (day 5 versus day 3) affect cumulative live birth rate... more RESEARCH QUESTION Does embryo transfer day (day 5 versus day 3) affect cumulative live birth rates (CLBR), time to live birth (TLB) and cost per live birth (CPL) in recipients of donated oocytes? STUDY DESIGN A single-centre RCT conducted between April 2017 and August 2018. Recipients of donated oocytes were randomized to cleavage-stage (day 3) or to blastocyst-stage (day 5) embryo transfer. Eligible recipients were aged 18-50 years and in their first or second synchronous cycle. Primary outcome was CLBR (12 months from first embryo transfer), and fresh and subsequent cryopreserved transfers were considered; TLB and CPL were also analysed. RESULTS Recipients (n = 134) were randomized to the day-3 group (n = 69) or to the day-5 group (n = 65). Day-5 transfer resulted in a 15.9% relative increase in CLBR and a significant shorter TLB compared with day-3 transfer. To reach a 50% CLBR, the day-3 group required 6 months more than the day-5 group (15.3 versus 8.9 months, respectively). The average CPL in the day-3 strategy cost 24% more than the day-5 strategy (€14817.10 versus €10959.20). Clinical pregnancy rate was 25% less in the day-3 group. The trial was prematurely stopped after poor initial results in the day-3 arm led to unplanned interim analysis. CONCLUSIONS The transfer of blastocyst-stage embryos in recipients of donated oocytes is preferred as it leads to a higher clinical pregnancy rate, live birth rate, shorter time to pregnancy and lower costs to achieve live birth, compared with cleavage-stage embryo transfer.

Research paper thumbnail of Cross-Border Reproductive Care: Psychological Distress in A Sample of Women Undergoing In Vitro Fertilization Treatment with and without Oocyte Donation

International Journal of Fertility & Sterility, 2020

Background Cross-border reproductive care (CBRC) refers to the movement of patients to foreign co... more Background Cross-border reproductive care (CBRC) refers to the movement of patients to foreign countries for fertility treatment. Limited evidence indicates that this phenomenon is associated with a risk of psychologi- cal distress, but few studies on the psychological impact of CBRC are currently available. The aim of this study was to compare the anxiety and depression levels of a group of cross-border patients with a local Spanish patient group, both of which underwent in vitro fertilization (IVF) treatment. We also sought to explore the clinical, sociodemographic and personality profiles of the CBRC group and local women. Materials and Methods This present cross-sectional study was conducted on 161 infertile females (71 CBRC patients and 90 local women) who were undergoing IVF treatment. The following questionnaires were used to collect data: Spielberger State Anxiety Inventory (STAI-S), the Beck Depression Inventory-II (BDI-II) and the Zuckerman-Kuhlman Personality Questionnair...

Research paper thumbnail of Transferencia selectiva de un único embrión como prevención del embarazo múltiple

Prevention of prematurity by single embryo transfer. The development of Assisted Reproduction Tec... more Prevention of prematurity by single embryo transfer. The development of Assisted Reproduction Techniques represents an important advance in the treatment of human infertility. However, their great effectiveness has brought with it an excessive increase in multiple pregnancy rates with the serious medical, financial and social consequences that they entail. Now, the scientific societies, the health professionals, and the infertile couples themselves are aware of these risks and have worked together to implement various strategies to deal with this situation. The result that is being obtained from the strategy of selectively reducing the number of embryos transferred is obvious. The pandemic of multiple pregnancies is being brought under control and so we have effective prevention of the obstetric and neonatal complications arising from it. It is to be hoped that it will also contribute to significantly reducing the rates of prematurity and thus of severe neonatal complications.

Research paper thumbnail of Cribado ampliado de portadores en un programa de donación de ovocitos: Implementación de un nuevo test y resultados tras dos años de experiencia

Medicina Reproductiva y Embriología Clínica, 2017

Resumen El presente estudio describe la implementacion de un test de cribado de portadores de enf... more Resumen El presente estudio describe la implementacion de un test de cribado de portadores de enfermedades geneticas autosomicas recesivas y enfermedades ligadas al cromosoma X en un programa de donacion de ovocitos (donantes de ovocitos y parejas masculinas de las receptoras). El test empleado basado en tecnologia Next-Generation Sequencing (NGS), cubria 200 genes (68 mediante analisis completo de secuencia codificante y 132 por estrategia dirigida de analisis) asociados a 314 enfermedades (277 enfermedades autosomicas recesivas y 22 ligadas al cromosoma X). El resultado obtenido tras 2,5 anos mostro un alto grado de aceptacion (implementacion > 80%). Se identificaron un 56,4% de individuos (761/1.350) portadores de al menos una mutacion patogenica. Asimismo se identifico que el 1,9% de las candidatas a donantes eran portadoras de una enfermedad ligada al cromosoma X por lo que se excluyeron del programa de Donacion de Ovocitos. La carga mutacional media fue de 0,84 mutaciones p...

Research paper thumbnail of Desogestrel versus antagonist injections for LH suppression in oocyte donation cycles: a crossover study

Gynecological Endocrinology, 2019

To study whether ovarian response to corifollitropin among oocyte donors (OD) is different when o... more To study whether ovarian response to corifollitropin among oocyte donors (OD) is different when oral desogestrel (DSG) is used to block the luteinizing hormone (LH) surge when compared to GnRH-antagonist use. This is a retrospective, cohort study at a private, university-based, IVF center including 35 OD. Patients underwent two stimulation cycles under corifollitropin alfa (CFT), one under an antagonist and another under DSG, between February 2015 and May 2017. In antagonist cycles, daily ganirelix was administered since a leading follicle reached 14 mm. In the DSG cycles, daily oral DSG was prescribed. The main outcome measure was oocytes retrieved. Compared to antagonist cycles, cycles under DSG received fewer injections (10.3 ± 2.8 vs. 5.0 ± 2.1, p < .001), nominally lower total supplementary gonadotropin dose (497.4 ± 338.9I U vs. 442.9 ± 332.8 IU, p¼.45) with a lower total cost of medication (1018.6 ± 191.0e vs. 813.8 ± 145.9e, p<.001). There were no differences in the total number of retrieved oocytes between groups (17.4 ± 7.5 vs. 18.6 ± 8.9, p¼.34). In the corresponding oocyte recipients, clinical pregnancy rate was similar between groups: 52.0% vs. 58.6%, respectively (p¼.78). ODs' stimulation's response under DSG is similar when compared to (17.4 ± 7.5 vs. 18.6 ± 8.9, p¼.34) but associated with less injections and lower medication costs. The main advantage of this strategy is its simplicity, an aspect of utmost importance in the management of ODs.

Research paper thumbnail of Single or double embryo transfer? Decision-making process in patients participating in an oocyte donation program

Gynecological Endocrinology, 2019

Veiga (2019): Single or double embryo transfer? Decision-making process in patients participating... more Veiga (2019): Single or double embryo transfer? Decision-making process in patients participating in an oocyte donation program, Gynecological Endocrinology,

Research paper thumbnail of Ovarian response in oocyte donation cycles under LH suppression with GnRH antagonist or desogestrel progestin: retrospective and comparative study

Gynecological Endocrinology, 2019

Here are investigated the serum hormones in ovarian stimulation cycles of oocyte donors (OD), und... more Here are investigated the serum hormones in ovarian stimulation cycles of oocyte donors (OD), under endogenous luteinizing hormone (LH) suppression with GnRH antagonist (antGnRH) vs. desogestrel (DSG) (progesterone-primed [PP]). OD underwent ovarian stimulation with gonadotropins at a private, university-based, infertility center between January 2017 and March 2018. Endogenous LH peak was controlled with either daily injections of antGnRH or with daily oral 75 mcg DSG (PP) until triggering. LH and progesterone were measured at trigger and the following day. A total of 404 OD cycles were included. There were no differences in age (26.7 ± 4.9 vs. 27.1 ± 4.8 years), AMH (3.7 ± 2.1 vs. 4.1 ± 2.7 ng/ml), and body mass index (BMI) (22.4 ± 2.8 vs. 22.1 ± 3.0 kg/m 2) between PP and antGnRH groups, respectively. On the day of trigger, progesterone was lower in PP compared to antGnRH (0.9 ± 0.7, vs. 1.5 ± 1.2 ng/ml, p < .001), whereas no significant differences existed in estradiol or LH. On the day after trigger, lower progesterone in PP vs. antGnRH (10.8 ± 6.0 vs. 13.4 ± 7.9 ng/ml, p=.002) was observed. No differences were observed in the number of retrieved oocytes or the clinical pregnancies among recipients. Our study shows that endocrine response to DSG differs significantly as compared to antGnRH use for the control of endogenous LH without apparent impact on number of retrieved oocytes or the clinical pregnancies among recipients.

Research paper thumbnail of Reproductive outcomes in recipients are not associated with oocyte donor body mass index up to 28 kg/m 2 : a cohort study of 2722 cycles

Reproductive BioMedicine Online, 2017

since 1986. Her main interests are reproduction, infertility, contraception, oocyte donation, and... more since 1986. Her main interests are reproduction, infertility, contraception, oocyte donation, and fertility preservation. She has authored a number of papers in peer-reviewed journals, and is a member of several national and international scientist societies in the field. KEY MESSAGE Obesity has a well-known deleterious effect on reproductive outcomes. No negative effect was observed on the outcomes of oocyte donation cycles with increased donor body mass index (BMI) (up to donor BMI ≤28 kg/m 2). To minimize the negative effect of obesity on these outcomes, this BMI limit should be considered.

Research paper thumbnail of Acceptability and results of corifollitropin alfa (FSH-CFT) and desogestrel (DSG) for ovarian stimulation (COH) in oocyte donors (OD)

Fertility and Sterility, 2017

Research paper thumbnail of Evolución y resultados de la transferencia de un embrión en un programa de donación de ovocitos

Medicina Reproductiva y Embriología Clínica, 2016

Resumen Introduccion El embarazo multiple comporta un riesgo elevado de complicaciones obstetrica... more Resumen Introduccion El embarazo multiple comporta un riesgo elevado de complicaciones obstetricas y perinatales. La unica forma de evitar la gestacion multiple es transferir un embrion. El primer objetivo de este estudio es valorar la evolucion del porcentaje de transferencia de un embrion y la tasa de gestacion multiple en nuestro programa de donacion de ovocitos. Como segundo objetivo se comprobara la eficacia de la transferencia selectiva de un embrion (TES-1), tras implementar criterios embriologicos de numero y calidad para aconsejarla. Material y metodos Analisis retrospectivo de los resultados del periodo 2004-2014 y prospectivo analitico de las tasas acumuladas de embarazo, nacido vivo y gestacion multiple, tras aplicar TES-1 en pacientes con ≥ 5 embriones evolutivos y ≥ 2 optimos (diciembre 2012-octubre 2014). Resultados La transferencia de un embrion se incremento de 2,6% (ano 2004) a 43,1% (ano 2014), con una disminucion de la tasa de gestacion gemelar de 32,5% (ano 2004) a 22,5% (ano 2014). La aplicacion de criterios embriologicos supuso que se recomendara TES-1 en un 48,2% de los ciclos (500/1038) y se aplicara en un 59,4% (297/500). Las tasas de embarazo y nacido vivo en fresco fueron significativamente inferiores en el grupo de TES-1 que en TES-2. Sin embargo, las tasas acumuladas (transferencia en fresco + criotransferencia) de embarazo y nacido vivo fueron similares (TES-1: 73,1% y 55,9% vs TES-2: 70% y 50,2%; p > 0,05, respectivamente), con una tasa acumulada de gestacion multiple superior en TES-2 (TES-1: 8,8% vs TES-2: 34,5%; p Discusion El incremento progresivo del porcentaje de transferencia de un embrion se acentua al aplicar criterios para aconsejar TES-1 y conlleva una considerable, pero todavia insuficiente, disminucion en la tasa de gestacion multiple. Los resultados acumulados obtenidos colaboran en el progresivo grado de aceptacion y seguridad de la transferencia de un unico embrion y acreditan su practica en pacientes de buen pronostico.

Research paper thumbnail of Obstetric and perinatal complications in an oocyte donation programme. Is it time to limit the number of embryos to transfer?

Gynecological Endocrinology, 2015

The aim of this study is to describe obstetric and perinatal complications in pregnancies from oo... more The aim of this study is to describe obstetric and perinatal complications in pregnancies from oocyte donation (OD) cycles, delivering in our centre and to determine the impact of maternal age. Retrospective observational study of a 225 singleton pregnancies, 113 multiple pregnancies and 447 live birth. Pearson's 2 test or Fisher's exact test were used for the statistical analysis. A higher incidence of obstetric complications was observed in multiple compared to singleton pregnancies with regard to preeclampsia (24.8% versus 8%), premature rupture of membranes (9.7% versus 1.8%), preterm delivery at 537 weeks (54.9% versus 10.2%) and caesarean section (81.4% versus 64%) (p50.05). If the age factor is added, the caesarean sections are higher in the single pregnancy group aged 40 years than in the group of 540 years (73.5% versus 49.4%) (p50.05). A higher incidence is found in multiple versus singleton pregnancies for low birth weight (52500 g) (61.1% versus 8.2%), admissions to the intensive care unit (15.2% versus 4.7%) and perinatal mortality (13.5% versus 0%) (p50.05). It is necessary to consider preconception counselling prior to an OD cycle to inform patients about the incidence complications observed and recommend to transfer only a single embryo.

Research paper thumbnail of Conmemorando el Premio Nobel 2010 de Medicina. Transferencia selectiva de un embrión como prevención del embarazo múltiple

Anales de la Real Academia Nacional de Farmacia

The development of Assisted Reproduction Techniques represents an important advance in the treatm... more The development of Assisted Reproduction Techniques represents an important advance in the treatment of human infertility. However, their great effectiveness has brought with it an excessive increase in multiple pregnancy rates with the serious medical, financial and social consequences that they entail. Now, the scientific societies, the health professionals, and the infertile couples themselves are aware of these risks and have worked together to implement various strategies to deal with this situation. The result that is being obtained from the strategy of selectively reducing the number of embryos transferred is obvious. The pandemic of multiple pregnancies is being brought under control and so we have effective prevention of the obstetric and neonatal complications arising from it. It is to be hoped that it will also contribute to significantly reducing the rates of prematurity and thus of severe neonatal complications.

Research paper thumbnail of Is it justified to transfer two embryos in oocyte donation? A pilot randomized clinical trial

Reproductive BioMedicine Online, 2015

has been in charge of the oocyte and embryo donation program. She is a member of the European Soc... more has been in charge of the oocyte and embryo donation program. She is a member of the European Society of Human Reproduction and Embryology (ESHRE), the Association for the Study of Reproductive Biology (ASEBIR) and the Spanish Society of Fertility (SEF). Her main interests are related to oocyte and embryo donation, and multiple pregnancy, as well as ethics and psychological aspects of donation and cross-border reproductive care.

Research paper thumbnail of Comparison of starting ovarian stimulation on day 2 versus day 15 of the menstrual cycle in the same oocyte donor and pregnancy rates among the corresponding recipients of vitrified oocytes

Fertility and sterility, 2014

To assess the clinical pregnancy rate per transfer in recipients of embryos from donor oocytes ob... more To assess the clinical pregnancy rate per transfer in recipients of embryos from donor oocytes obtained after ovarian stimulation initiated on day 2 (D2) or day 15 (D15) of the menstrual cycle with a secondary end point of comparing the response to stimulation. Prospective observational comparative study. Private in vitro fertilization (IVF) program. Oocyte donors (OD) and recipients. Donors stimulated within 3 months, starting on day 2 or day 15 after bleeding, with recombinant follicle-stimulating hormone (FSH), gonadotropin-releasing hormone (GnRH) antagonist, and GnRH agonist trigger, and oocytes vitrified and later assigned to recipients, followed by routine IVF procedures one to two embryos transferred. Primary outcome pregnancy rate, and secondary outcome number of mature oocytes retrieved. Nine D2 and nine D15 cycles were performed in nine donors. There were no differences between D2 and D15 in the number of mature oocytes obtained (14.0±6.96 vs. 16.89±7.52). To date, 20 rec...

Research paper thumbnail of Using donor oocytes

The Subfertility Handbook

Research paper thumbnail of Analysis of factors associated with multiple pregnancy in an oocyte donation programme

Reproductive BioMedicine Online, 2010

in charge of the oocyte and embryo donation programme. She is a member of the European Society of... more in charge of the oocyte and embryo donation programme. She is a member of the European Society of Human Reproduction and Embryology, Association for the Study of the Reproductive Biology and Spanish Society of Fertility. Her main interests are related to oocyte and embryo donation, multiple pregnancy and ethics and psychological aspects of donation and cross-border reproductive care.

Research paper thumbnail of Elective single-embryo transfer in oocyte donation programmes: should it be the rule?

Reproductive BioMedicine Online, 2012

has been in charge of the oocyte and embryo donation programme. She is a member of the European S... more has been in charge of the oocyte and embryo donation programme. She is a member of the European Society of Human Reproduction and Embryology, Association for the Study of the Reproductive Biology and Spanish Society of Fertility. Her main interests are related to oocyte and embryo donation, multiple pregnancy and ethics and psychological aspects of donation and cross-border reproductive care.

Research paper thumbnail of Investigations into implantation failure in oocyte-donation recipients

Reproductive BioMedicine Online, 2014

In recent decades, the Western world has been experiencing a societal trend to prioritize the pro... more In recent decades, the Western world has been experiencing a societal trend to prioritize the professional careers of women who postpone motherhood to about 40 years of age, when, unfortunately, natural reproductive potential declines. This is the reason why these women increasingly find it necessary to resort to oocyte donation to have a child. Thanks to the young age of the donors, the efficacy of oocyte donation is the highest of all assisted reproduction treatments and pregnancy rates achieved with this technique exceed 50%. Moreover, the large registries from ESHRE and ASRM show live birth rates close to this figure. However, there are patients who experience repeated failures in several oocyte-donation cycles, and so far oocyte-donation repeated implantation failure has not been clearly defined. This study analysed the results obtained from 2531 oocyte-donation cycles carried out in 1990 patients and defines oocyte-donation repeated implantation failure as failure to implant with more than two embryo transfers and more than four high-grade embryos transferred. This study observed this condition in 140 oocyte recipients (7%). Also, oocyte cohort size, uterine factors and systemic thrombophilias as important aetiological factors were identified were to offer new therapeutic strategies to patients. RBMOnline

Research paper thumbnail of Identification and molecular cloning of two homologues of protein phosphatase X from Arabidopsis thaliana

Plant Molecular Biology, 1993

In a recent paper [Ariflo et al., Plant Mol Biol 21:475-485 (1993)] we reported the amplification... more In a recent paper [Ariflo et al., Plant Mol Biol 21:475-485 (1993)] we reported the amplification of a DNA fragment (AP-2) from the genome ofArabidopsis thaliana encoding an amino acid sequence corresponding to a Ser/Thr protein phosphatase distantly related to type 2A protein phosphatases. In this paper we report the use of the AP-2 fragment to isolate several cDNA clones from a leaf cDNA library. Two of these (EP124 and EP129) largely overlap and contain the AP-2 sequence, whereas a third clone (EP128) is different although very related in sequence (86~o of identity). Clones EP124/EP129 and EP128 were found to encode two highly related polypeptides (93 ~o identity) of 305 residues, showing a very high identity (83 ~o) to the catalytic subunit of protein phosphatase X (PPX) from rabbit. Therefore, they have been named PPX-1 (EP124/EP129) and PPX-2 (EP128). Southern blot analysis of genomic DNA indicates that only these two genes encoding phosphatases closely related to PPX are present in the genome ofA. thaliana. Both PPX-1 and PPX-2 are expressed at very low levels in A. thaliana flowers, leaves, stems and roots. The expression levels of four previously identified type 2A phosphatases are higher than those of PPX genes. PP2A-1 appears to be the major mRNA species detected in all the tissues analyzed.

Research paper thumbnail of Comparison of blastocyst euploidy rates following luteal versus follicular phase stimulation in a GnRH antagonist protocol: a prospective study with repeated ovarian stimulation cycles

Human Reproduction

STUDY QUESTION Is there any difference in the mean number of euploid embryos following luteal pha... more STUDY QUESTION Is there any difference in the mean number of euploid embryos following luteal phase start (LS) and follicular phase start (FS) of ovarian stimulation? SUMMARY ANSWER The mean number of euploid blastocysts is equivalent independent of whether the inseminated oocytes are derived from FS or LS. WHAT IS KNOWN ALREADY Starting ovarian stimulation at any time of the cycle (‘random-start’) is commonly used for emergency fertility preservation in cancer patients. A few retrospective studies have been published evaluating LS in women undergoing ovarian stimulation in the context of IVF, but there is a lack of robust data on the comparative efficacy of LS versus FS. Although ‘random start’ is commonly used in cancer survivors, few retrospective and uncontrolled studies have been published evaluating luteal phase stimulation in women undergoing ovarian stimulation in the context of IVF. Owing to this evident lack of robust data on the efficacy of LS, guidelines typically recomm...

Research paper thumbnail of Blastocyst versus cleavage embryo transfer improves cumulative live birth rates, time and cost in oocyte recipients: a randomized controlled trial

Reproductive BioMedicine Online, 2022

RESEARCH QUESTION Does embryo transfer day (day 5 versus day 3) affect cumulative live birth rate... more RESEARCH QUESTION Does embryo transfer day (day 5 versus day 3) affect cumulative live birth rates (CLBR), time to live birth (TLB) and cost per live birth (CPL) in recipients of donated oocytes? STUDY DESIGN A single-centre RCT conducted between April 2017 and August 2018. Recipients of donated oocytes were randomized to cleavage-stage (day 3) or to blastocyst-stage (day 5) embryo transfer. Eligible recipients were aged 18-50 years and in their first or second synchronous cycle. Primary outcome was CLBR (12 months from first embryo transfer), and fresh and subsequent cryopreserved transfers were considered; TLB and CPL were also analysed. RESULTS Recipients (n = 134) were randomized to the day-3 group (n = 69) or to the day-5 group (n = 65). Day-5 transfer resulted in a 15.9% relative increase in CLBR and a significant shorter TLB compared with day-3 transfer. To reach a 50% CLBR, the day-3 group required 6 months more than the day-5 group (15.3 versus 8.9 months, respectively). The average CPL in the day-3 strategy cost 24% more than the day-5 strategy (€14817.10 versus €10959.20). Clinical pregnancy rate was 25% less in the day-3 group. The trial was prematurely stopped after poor initial results in the day-3 arm led to unplanned interim analysis. CONCLUSIONS The transfer of blastocyst-stage embryos in recipients of donated oocytes is preferred as it leads to a higher clinical pregnancy rate, live birth rate, shorter time to pregnancy and lower costs to achieve live birth, compared with cleavage-stage embryo transfer.

Research paper thumbnail of Cross-Border Reproductive Care: Psychological Distress in A Sample of Women Undergoing In Vitro Fertilization Treatment with and without Oocyte Donation

International Journal of Fertility & Sterility, 2020

Background Cross-border reproductive care (CBRC) refers to the movement of patients to foreign co... more Background Cross-border reproductive care (CBRC) refers to the movement of patients to foreign countries for fertility treatment. Limited evidence indicates that this phenomenon is associated with a risk of psychologi- cal distress, but few studies on the psychological impact of CBRC are currently available. The aim of this study was to compare the anxiety and depression levels of a group of cross-border patients with a local Spanish patient group, both of which underwent in vitro fertilization (IVF) treatment. We also sought to explore the clinical, sociodemographic and personality profiles of the CBRC group and local women. Materials and Methods This present cross-sectional study was conducted on 161 infertile females (71 CBRC patients and 90 local women) who were undergoing IVF treatment. The following questionnaires were used to collect data: Spielberger State Anxiety Inventory (STAI-S), the Beck Depression Inventory-II (BDI-II) and the Zuckerman-Kuhlman Personality Questionnair...

Research paper thumbnail of Transferencia selectiva de un único embrión como prevención del embarazo múltiple

Prevention of prematurity by single embryo transfer. The development of Assisted Reproduction Tec... more Prevention of prematurity by single embryo transfer. The development of Assisted Reproduction Techniques represents an important advance in the treatment of human infertility. However, their great effectiveness has brought with it an excessive increase in multiple pregnancy rates with the serious medical, financial and social consequences that they entail. Now, the scientific societies, the health professionals, and the infertile couples themselves are aware of these risks and have worked together to implement various strategies to deal with this situation. The result that is being obtained from the strategy of selectively reducing the number of embryos transferred is obvious. The pandemic of multiple pregnancies is being brought under control and so we have effective prevention of the obstetric and neonatal complications arising from it. It is to be hoped that it will also contribute to significantly reducing the rates of prematurity and thus of severe neonatal complications.

Research paper thumbnail of Cribado ampliado de portadores en un programa de donación de ovocitos: Implementación de un nuevo test y resultados tras dos años de experiencia

Medicina Reproductiva y Embriología Clínica, 2017

Resumen El presente estudio describe la implementacion de un test de cribado de portadores de enf... more Resumen El presente estudio describe la implementacion de un test de cribado de portadores de enfermedades geneticas autosomicas recesivas y enfermedades ligadas al cromosoma X en un programa de donacion de ovocitos (donantes de ovocitos y parejas masculinas de las receptoras). El test empleado basado en tecnologia Next-Generation Sequencing (NGS), cubria 200 genes (68 mediante analisis completo de secuencia codificante y 132 por estrategia dirigida de analisis) asociados a 314 enfermedades (277 enfermedades autosomicas recesivas y 22 ligadas al cromosoma X). El resultado obtenido tras 2,5 anos mostro un alto grado de aceptacion (implementacion > 80%). Se identificaron un 56,4% de individuos (761/1.350) portadores de al menos una mutacion patogenica. Asimismo se identifico que el 1,9% de las candidatas a donantes eran portadoras de una enfermedad ligada al cromosoma X por lo que se excluyeron del programa de Donacion de Ovocitos. La carga mutacional media fue de 0,84 mutaciones p...

Research paper thumbnail of Desogestrel versus antagonist injections for LH suppression in oocyte donation cycles: a crossover study

Gynecological Endocrinology, 2019

To study whether ovarian response to corifollitropin among oocyte donors (OD) is different when o... more To study whether ovarian response to corifollitropin among oocyte donors (OD) is different when oral desogestrel (DSG) is used to block the luteinizing hormone (LH) surge when compared to GnRH-antagonist use. This is a retrospective, cohort study at a private, university-based, IVF center including 35 OD. Patients underwent two stimulation cycles under corifollitropin alfa (CFT), one under an antagonist and another under DSG, between February 2015 and May 2017. In antagonist cycles, daily ganirelix was administered since a leading follicle reached 14 mm. In the DSG cycles, daily oral DSG was prescribed. The main outcome measure was oocytes retrieved. Compared to antagonist cycles, cycles under DSG received fewer injections (10.3 ± 2.8 vs. 5.0 ± 2.1, p < .001), nominally lower total supplementary gonadotropin dose (497.4 ± 338.9I U vs. 442.9 ± 332.8 IU, p¼.45) with a lower total cost of medication (1018.6 ± 191.0e vs. 813.8 ± 145.9e, p<.001). There were no differences in the total number of retrieved oocytes between groups (17.4 ± 7.5 vs. 18.6 ± 8.9, p¼.34). In the corresponding oocyte recipients, clinical pregnancy rate was similar between groups: 52.0% vs. 58.6%, respectively (p¼.78). ODs' stimulation's response under DSG is similar when compared to (17.4 ± 7.5 vs. 18.6 ± 8.9, p¼.34) but associated with less injections and lower medication costs. The main advantage of this strategy is its simplicity, an aspect of utmost importance in the management of ODs.

Research paper thumbnail of Single or double embryo transfer? Decision-making process in patients participating in an oocyte donation program

Gynecological Endocrinology, 2019

Veiga (2019): Single or double embryo transfer? Decision-making process in patients participating... more Veiga (2019): Single or double embryo transfer? Decision-making process in patients participating in an oocyte donation program, Gynecological Endocrinology,

Research paper thumbnail of Ovarian response in oocyte donation cycles under LH suppression with GnRH antagonist or desogestrel progestin: retrospective and comparative study

Gynecological Endocrinology, 2019

Here are investigated the serum hormones in ovarian stimulation cycles of oocyte donors (OD), und... more Here are investigated the serum hormones in ovarian stimulation cycles of oocyte donors (OD), under endogenous luteinizing hormone (LH) suppression with GnRH antagonist (antGnRH) vs. desogestrel (DSG) (progesterone-primed [PP]). OD underwent ovarian stimulation with gonadotropins at a private, university-based, infertility center between January 2017 and March 2018. Endogenous LH peak was controlled with either daily injections of antGnRH or with daily oral 75 mcg DSG (PP) until triggering. LH and progesterone were measured at trigger and the following day. A total of 404 OD cycles were included. There were no differences in age (26.7 ± 4.9 vs. 27.1 ± 4.8 years), AMH (3.7 ± 2.1 vs. 4.1 ± 2.7 ng/ml), and body mass index (BMI) (22.4 ± 2.8 vs. 22.1 ± 3.0 kg/m 2) between PP and antGnRH groups, respectively. On the day of trigger, progesterone was lower in PP compared to antGnRH (0.9 ± 0.7, vs. 1.5 ± 1.2 ng/ml, p < .001), whereas no significant differences existed in estradiol or LH. On the day after trigger, lower progesterone in PP vs. antGnRH (10.8 ± 6.0 vs. 13.4 ± 7.9 ng/ml, p=.002) was observed. No differences were observed in the number of retrieved oocytes or the clinical pregnancies among recipients. Our study shows that endocrine response to DSG differs significantly as compared to antGnRH use for the control of endogenous LH without apparent impact on number of retrieved oocytes or the clinical pregnancies among recipients.

Research paper thumbnail of Reproductive outcomes in recipients are not associated with oocyte donor body mass index up to 28 kg/m 2 : a cohort study of 2722 cycles

Reproductive BioMedicine Online, 2017

since 1986. Her main interests are reproduction, infertility, contraception, oocyte donation, and... more since 1986. Her main interests are reproduction, infertility, contraception, oocyte donation, and fertility preservation. She has authored a number of papers in peer-reviewed journals, and is a member of several national and international scientist societies in the field. KEY MESSAGE Obesity has a well-known deleterious effect on reproductive outcomes. No negative effect was observed on the outcomes of oocyte donation cycles with increased donor body mass index (BMI) (up to donor BMI ≤28 kg/m 2). To minimize the negative effect of obesity on these outcomes, this BMI limit should be considered.

Research paper thumbnail of Acceptability and results of corifollitropin alfa (FSH-CFT) and desogestrel (DSG) for ovarian stimulation (COH) in oocyte donors (OD)

Fertility and Sterility, 2017

Research paper thumbnail of Evolución y resultados de la transferencia de un embrión en un programa de donación de ovocitos

Medicina Reproductiva y Embriología Clínica, 2016

Resumen Introduccion El embarazo multiple comporta un riesgo elevado de complicaciones obstetrica... more Resumen Introduccion El embarazo multiple comporta un riesgo elevado de complicaciones obstetricas y perinatales. La unica forma de evitar la gestacion multiple es transferir un embrion. El primer objetivo de este estudio es valorar la evolucion del porcentaje de transferencia de un embrion y la tasa de gestacion multiple en nuestro programa de donacion de ovocitos. Como segundo objetivo se comprobara la eficacia de la transferencia selectiva de un embrion (TES-1), tras implementar criterios embriologicos de numero y calidad para aconsejarla. Material y metodos Analisis retrospectivo de los resultados del periodo 2004-2014 y prospectivo analitico de las tasas acumuladas de embarazo, nacido vivo y gestacion multiple, tras aplicar TES-1 en pacientes con ≥ 5 embriones evolutivos y ≥ 2 optimos (diciembre 2012-octubre 2014). Resultados La transferencia de un embrion se incremento de 2,6% (ano 2004) a 43,1% (ano 2014), con una disminucion de la tasa de gestacion gemelar de 32,5% (ano 2004) a 22,5% (ano 2014). La aplicacion de criterios embriologicos supuso que se recomendara TES-1 en un 48,2% de los ciclos (500/1038) y se aplicara en un 59,4% (297/500). Las tasas de embarazo y nacido vivo en fresco fueron significativamente inferiores en el grupo de TES-1 que en TES-2. Sin embargo, las tasas acumuladas (transferencia en fresco + criotransferencia) de embarazo y nacido vivo fueron similares (TES-1: 73,1% y 55,9% vs TES-2: 70% y 50,2%; p > 0,05, respectivamente), con una tasa acumulada de gestacion multiple superior en TES-2 (TES-1: 8,8% vs TES-2: 34,5%; p Discusion El incremento progresivo del porcentaje de transferencia de un embrion se acentua al aplicar criterios para aconsejar TES-1 y conlleva una considerable, pero todavia insuficiente, disminucion en la tasa de gestacion multiple. Los resultados acumulados obtenidos colaboran en el progresivo grado de aceptacion y seguridad de la transferencia de un unico embrion y acreditan su practica en pacientes de buen pronostico.

Research paper thumbnail of Obstetric and perinatal complications in an oocyte donation programme. Is it time to limit the number of embryos to transfer?

Gynecological Endocrinology, 2015

The aim of this study is to describe obstetric and perinatal complications in pregnancies from oo... more The aim of this study is to describe obstetric and perinatal complications in pregnancies from oocyte donation (OD) cycles, delivering in our centre and to determine the impact of maternal age. Retrospective observational study of a 225 singleton pregnancies, 113 multiple pregnancies and 447 live birth. Pearson's 2 test or Fisher's exact test were used for the statistical analysis. A higher incidence of obstetric complications was observed in multiple compared to singleton pregnancies with regard to preeclampsia (24.8% versus 8%), premature rupture of membranes (9.7% versus 1.8%), preterm delivery at 537 weeks (54.9% versus 10.2%) and caesarean section (81.4% versus 64%) (p50.05). If the age factor is added, the caesarean sections are higher in the single pregnancy group aged 40 years than in the group of 540 years (73.5% versus 49.4%) (p50.05). A higher incidence is found in multiple versus singleton pregnancies for low birth weight (52500 g) (61.1% versus 8.2%), admissions to the intensive care unit (15.2% versus 4.7%) and perinatal mortality (13.5% versus 0%) (p50.05). It is necessary to consider preconception counselling prior to an OD cycle to inform patients about the incidence complications observed and recommend to transfer only a single embryo.

Research paper thumbnail of Conmemorando el Premio Nobel 2010 de Medicina. Transferencia selectiva de un embrión como prevención del embarazo múltiple

Anales de la Real Academia Nacional de Farmacia

The development of Assisted Reproduction Techniques represents an important advance in the treatm... more The development of Assisted Reproduction Techniques represents an important advance in the treatment of human infertility. However, their great effectiveness has brought with it an excessive increase in multiple pregnancy rates with the serious medical, financial and social consequences that they entail. Now, the scientific societies, the health professionals, and the infertile couples themselves are aware of these risks and have worked together to implement various strategies to deal with this situation. The result that is being obtained from the strategy of selectively reducing the number of embryos transferred is obvious. The pandemic of multiple pregnancies is being brought under control and so we have effective prevention of the obstetric and neonatal complications arising from it. It is to be hoped that it will also contribute to significantly reducing the rates of prematurity and thus of severe neonatal complications.

Research paper thumbnail of Is it justified to transfer two embryos in oocyte donation? A pilot randomized clinical trial

Reproductive BioMedicine Online, 2015

has been in charge of the oocyte and embryo donation program. She is a member of the European Soc... more has been in charge of the oocyte and embryo donation program. She is a member of the European Society of Human Reproduction and Embryology (ESHRE), the Association for the Study of Reproductive Biology (ASEBIR) and the Spanish Society of Fertility (SEF). Her main interests are related to oocyte and embryo donation, and multiple pregnancy, as well as ethics and psychological aspects of donation and cross-border reproductive care.

Research paper thumbnail of Comparison of starting ovarian stimulation on day 2 versus day 15 of the menstrual cycle in the same oocyte donor and pregnancy rates among the corresponding recipients of vitrified oocytes

Fertility and sterility, 2014

To assess the clinical pregnancy rate per transfer in recipients of embryos from donor oocytes ob... more To assess the clinical pregnancy rate per transfer in recipients of embryos from donor oocytes obtained after ovarian stimulation initiated on day 2 (D2) or day 15 (D15) of the menstrual cycle with a secondary end point of comparing the response to stimulation. Prospective observational comparative study. Private in vitro fertilization (IVF) program. Oocyte donors (OD) and recipients. Donors stimulated within 3 months, starting on day 2 or day 15 after bleeding, with recombinant follicle-stimulating hormone (FSH), gonadotropin-releasing hormone (GnRH) antagonist, and GnRH agonist trigger, and oocytes vitrified and later assigned to recipients, followed by routine IVF procedures one to two embryos transferred. Primary outcome pregnancy rate, and secondary outcome number of mature oocytes retrieved. Nine D2 and nine D15 cycles were performed in nine donors. There were no differences between D2 and D15 in the number of mature oocytes obtained (14.0±6.96 vs. 16.89±7.52). To date, 20 rec...

Research paper thumbnail of Using donor oocytes

The Subfertility Handbook

Research paper thumbnail of Analysis of factors associated with multiple pregnancy in an oocyte donation programme

Reproductive BioMedicine Online, 2010

in charge of the oocyte and embryo donation programme. She is a member of the European Society of... more in charge of the oocyte and embryo donation programme. She is a member of the European Society of Human Reproduction and Embryology, Association for the Study of the Reproductive Biology and Spanish Society of Fertility. Her main interests are related to oocyte and embryo donation, multiple pregnancy and ethics and psychological aspects of donation and cross-border reproductive care.

Research paper thumbnail of Elective single-embryo transfer in oocyte donation programmes: should it be the rule?

Reproductive BioMedicine Online, 2012

has been in charge of the oocyte and embryo donation programme. She is a member of the European S... more has been in charge of the oocyte and embryo donation programme. She is a member of the European Society of Human Reproduction and Embryology, Association for the Study of the Reproductive Biology and Spanish Society of Fertility. Her main interests are related to oocyte and embryo donation, multiple pregnancy and ethics and psychological aspects of donation and cross-border reproductive care.

Research paper thumbnail of Investigations into implantation failure in oocyte-donation recipients

Reproductive BioMedicine Online, 2014

In recent decades, the Western world has been experiencing a societal trend to prioritize the pro... more In recent decades, the Western world has been experiencing a societal trend to prioritize the professional careers of women who postpone motherhood to about 40 years of age, when, unfortunately, natural reproductive potential declines. This is the reason why these women increasingly find it necessary to resort to oocyte donation to have a child. Thanks to the young age of the donors, the efficacy of oocyte donation is the highest of all assisted reproduction treatments and pregnancy rates achieved with this technique exceed 50%. Moreover, the large registries from ESHRE and ASRM show live birth rates close to this figure. However, there are patients who experience repeated failures in several oocyte-donation cycles, and so far oocyte-donation repeated implantation failure has not been clearly defined. This study analysed the results obtained from 2531 oocyte-donation cycles carried out in 1990 patients and defines oocyte-donation repeated implantation failure as failure to implant with more than two embryo transfers and more than four high-grade embryos transferred. This study observed this condition in 140 oocyte recipients (7%). Also, oocyte cohort size, uterine factors and systemic thrombophilias as important aetiological factors were identified were to offer new therapeutic strategies to patients. RBMOnline

Research paper thumbnail of Identification and molecular cloning of two homologues of protein phosphatase X from Arabidopsis thaliana

Plant Molecular Biology, 1993

In a recent paper [Ariflo et al., Plant Mol Biol 21:475-485 (1993)] we reported the amplification... more In a recent paper [Ariflo et al., Plant Mol Biol 21:475-485 (1993)] we reported the amplification of a DNA fragment (AP-2) from the genome ofArabidopsis thaliana encoding an amino acid sequence corresponding to a Ser/Thr protein phosphatase distantly related to type 2A protein phosphatases. In this paper we report the use of the AP-2 fragment to isolate several cDNA clones from a leaf cDNA library. Two of these (EP124 and EP129) largely overlap and contain the AP-2 sequence, whereas a third clone (EP128) is different although very related in sequence (86~o of identity). Clones EP124/EP129 and EP128 were found to encode two highly related polypeptides (93 ~o identity) of 305 residues, showing a very high identity (83 ~o) to the catalytic subunit of protein phosphatase X (PPX) from rabbit. Therefore, they have been named PPX-1 (EP124/EP129) and PPX-2 (EP128). Southern blot analysis of genomic DNA indicates that only these two genes encoding phosphatases closely related to PPX are present in the genome ofA. thaliana. Both PPX-1 and PPX-2 are expressed at very low levels in A. thaliana flowers, leaves, stems and roots. The expression levels of four previously identified type 2A phosphatases are higher than those of PPX genes. PP2A-1 appears to be the major mRNA species detected in all the tissues analyzed.