History of spontaneous abortion increases the risk of oocyte donation pregnancy loss (original) (raw)
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Journal of Experimental and Clinical Medicine
This research aimed to show the role of the number of transferred embryos on pregnancy outcomes of the oocyte donation cycles (ODC). This retrospective cohort study included 122 ODCs performed at a private in vitro fertilization (IVF) center between 2020 June - 2021 January. Cases with severe male infertility, tuboperitoneal, and endometrial factors were not included in the study. The median (interquartile range) recipient age was 43 (30–54) years. ODC results revealed that 10.7% of the cases were negative, 4.9% were biochemical pregnancies, and 84.4% were clinical pregnancies. Pregnancy outcomes were checked; miscarriage, preterm, and term delivery rates were 5.7%, 3.9%, and 90.4%, respectively. The rate of recipients for the younger than 40 years was 32%, between the 40–44 years was 27%, and between 45–54 years was 41% respectively. Statistically significant difference was not observed between age groups in terms of endometrial thickness (p = 0.059), number of transferred embryos ...
Early pregnancy losses in in vitro fertilization and oocyte donation
Fertility and Sterility, 1999
Objective: To evaluate prospectively the incidence of early pregnancy losses (before menstruation occurs) in IVF and ovum donation cycles. Design: Prospective case-control study. Setting: Tertiary care, university-associated center. Patient(s): One hundred forty-five patients undergoing IVF and 92 undergoing oocyte donation were recruited. The control group for IVF consisted of 15 ovum donors who had no ET and were instructed to avoid intercourse. The control group for oocyte donation included 10 women undergoing a mock cycle of steroid replacement. Intervention(s): Starting on day 6 after ET, the women were instructed to collect the first urine sample of the day every 2 days. Each patient collected six different specimens of urine (days 6, 8, 10, 12, 14, and 16 after ET for cases or the same days without ET for controls. Main Outcome Measure(s): -HCG was measured with a standardized microparticle enzyme immunoassay, and IVF reproductive outcome was assessed. Result(s): For IVF, positive implantation was registered in 88 of 145 cycles of embryo replacement (60.7%). Only 30 (20.7%) resulted in viable pregnancies, whereas the remaining 58 miscarried. Forty-two of these miscarriages (72.4%) were early pregnancy losses and 13 (22.4%) were classified as clinical abortions. In ovum donation, positive implantation was recorded in 64 of 92 cycles of ET (69.6%). A total of 30 (32.6%) ended in viable pregnancies, whereas the remaining 34 (37.0%) were miscarriages. Early pregnancy loss accounted for 70.6% of pregnancy losses, whereas biochemical pregnancies and clinical abortions accounted for 11.8% and 17.6%, respectively. Conclusion(s): Our results demonstrate that patients undergoing assisted reproductive technology have an increased rate of early pregnancy loss compared with fertile patients. In addition, these data indicate that implantation is more frequently impaired in IVF than in oocyte donation cycles, resulting in a high incidence of early pregnancy loss. This suggests that implantation may be subjected to abnormal conditions in assisted reproduction.
JBRA Assisted Reproduction, 2019
Objective: Multiple embryos have been transferred to compensate for low implantation rates, which in turn, increase the likelihood of multiple pregnancies. Despite the publication of clinical guidelines and a reduction in the number of embryos transferred, double embryo transfer still is the most common practice. There is no clear evidence of who should receive the single embryo transfer (SET), and it is more commonly indicated for patients of good prognosis. However, it is not clear how much the presence of other infertility factors can affect the SET prognosis. The aim of this study was to evaluate differences in clinical pregnancy rates (CPR) of frozen-thawed SET cycles for women presenting with different infertility factors. Methods: Retrospective cohort study evaluating 305 frozen-thawed SET cycles performed in the last 10 years in a private IVF center. We included patients undergoing ovarian stimulation cycles, using ejaculated sperm and a frozen-thawed ET. Embryos were routinely vitrified and warmed up, and the blastocysts were transferred after endometrium preparation. The cycles were categorized according to the infertility factor classified by the Society for Assisted Reproductive Technologies (SART) as anatomic female factor (n=55), endocrine female factor (n=26), endometriosis (n=37), male factor (n=60), ovarian insufficiency (n=26), unexplained (n=24), multiple factors (n=45) and other (n=32). CPR were compared between the groups and the multivariate analysis was performed to evaluate the association of each infertility factor and the CPR, adjusted for confounders. Results: The women varied in age from 18 to 44 years (35.9±3.8), presented Body Mass Index of 22.4±3.1kg/ m 2 , baseline serum FSH of 7.4±8.3 IU/ml, and had a mean of 11.0±8.4 MII oocytes recovered and 6.4±5.3 embryos cryopreserved. The CPR, according to infertility factors were: anatomic female factor (25.9%), endocrine female factor (30.8%), endometriosis (27.8%), male factor (20.7%), ovarian insufficiency (21.7%), unexplained (9.5%), multiple factors (17.1%) and other (20.7%). Multivariate analysis did not show significant association of infertility factors and CPR adjusted for confounders. Conclusions: Patients presenting different infertility factors seem to have a satisfactory CPR for a SET cycle, except those with unexplained infertility. This is a preliminary outcome and the number of patients by category is small; in addition, the retrospective characteristics of the study are its limitations. Overall, our findings suggest that patients presenting any infertility factor, except unexplained infertility, are suitable to receive a SET with satisfactory outcomes.
Human …, 2011
A history of IA did not put women at higher risk of preterm birth in comparison with a previous miscarriage [Adj. OR 0.94, 95% CI 0.81-1.10]. In comparison with women who had an initial miscarriage, women with an IA in their first pregnancy were less likely to have a subsequent miscarriage [Adj. OR 0.28, 95% CI 0.24-0.32] or ectopic pregnancy [Adj. OR 0.57, 95% CI 0.46-0.71] but more likely to have a second induced abortion [Adj. OR 2.26, 95% CI 1.86-2.75]. They were also more prone to develop pre-eclampsia [Adj. OR 1.43, 95% CI 1.18-1.74] in their next ongoing pregnancy. Surgical abortion was associated with a higher chance of spontaneous preterm birth in the next ongoing pregnancy than medical abortion [Adj. OR 1.27, 95% CI 1.11-1.45]. In comparison with a single IA, the adjusted odds ratios (95% CI) for spontaneous preterm birth in the next ongoing pregnancy following two, three and four consecutive IAs were 1.11 (0.99-1.24), 1.43 (1.15-1.77) and 1.87 (1.41-2.89) respectively. Conclusions: Induced abortion in a first pregnancy is associated with a higher risk of spontaneous preterm birth in a subsequent pregnancy than that in primigravidae or women with a previous livebirth, but is not significantly higher than that observed in women with an initial miscarriage. This risk is increased in women who undergo more than two consecutive induced abortions. Surgical abortion appears to be associated with an increased risk of spontaneous preterm birth in comparison with medical termination of pregnancy SELECTED ORAL COMMUNICATION SESSION
Analysis of factors associated with multiple pregnancy in an oocyte donation programme
Reproductive BioMedicine Online, 2010
The aim of this study is to identify the factors associated with multiple pregnancy in an oocyte donation programme. A retrospective study (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) of 945 synchronous cycles was performed. Two embryos were transferred in all cycles on day 2 after oocyte retrieval. All variables (egg donor and recipient age, number of inseminated oocytes, fertilized oocytes, cleaved embryos, good-quality embryos available, good-quality embryos transferred and frozen embryos) were analysed in relation to the clinical pregnancy rate per transfer (PR) and the multiple pregnancy rate (MPR). The donor age was 26.8 ± 4.5 years and recipient age was 41.0 ± 5.4. The number of good-quality embryos per recipient was 3.1 ± 2.5. The PR was 55.1% and the MPR 36.5%. The number of good-quality embryos transferred (2 versus 0) was significantly associated (P < 0.05) with the PR (60.6% versus 43.5%). The relationship between the MPR and the number of good-quality embryos transferred was adjusted by donor and recipient's age. For those patients who received 2 versus 0 good-quality embryos, the odds ratio of a multiple pregnancy was 2.1 (95% CI 1.121-3.876). The only predictive factor for multiple pregnancies in an oocyte donation programme is the quality of the transferred embryos. RBMOnline Reproductive BioMedicine Online (2010) 21, 694-699 w w w . s c i e n c e d i r e c t . c o m w w w . r b m o n l i n e . c o m
Reproductive Sciences, 2018
Two of the many milestone developments in the field of assisted reproduction have been oocyte donation and preimplantation genetic testing for aneuploidy (PGT-A). Because it has been demonstrated that even young women produce a meaningful proportion of aneuploid embryos, screening out such abnormalities could potentially increase the efficacy of donor egg (DE) cycles. In this retrospective cohort study, we investigated the effect of PGT-A on DE cycle outcomes, including implantation rate (IR), spontaneous abortion rate (SABR), and ongoing pregnancy/live birth rate. We used fresh and frozen donor cycles not using PGT-A as comparison groups; all cases involved single embryo transfer. Data analysis revealed that PGT-A did not improve pregnancy outcome metrics in DE cycles, although there was a trend toward decreasing the SABR. There was a significant increase in IR with fresh cycles outperforming all frozen cycles. Overall, these results suggest that the benefits of performing PGT-A on...
Reproductive biomedicine online, 2016
Outcome measures of IVF success, which account for effectiveness of IVF and perinatal outcome risks, have recently been described. The association between number of embryos transferred in average and poor-prognosis IVF patients, and the chances of having good or poor IVF and perinatal outcomes, was investigated. Good IVF and perinatal outcome was defined as the birth of a live, term, normal-weight infant (≥2500 g). Poor IVF and perinatal outcome was defined as no live birth or birth of a very low weight neonate (<1500 g) or severe prematurity (birth at <32 weeks gestation). Each neonate was analysed as a separate outcome. A total of 713 IVF cycles in 504 average and poor-prognosis patients from January 2010 to December 2013 were identified. The odds of having good IVF and perinatal outcomes increased by 28% for each additional embryo transferred. The odds of poor IVF and perinatal outcome decreased by 32% with an additional embryo transferred. The likelihood of live birth with...
Gynecological Endocrinology, 2015
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.