OBJECTIVETo compare anesthesia and assisted reproductive technology (ART) outcomes in patients with a body mass index (BMI) of 40-44.9kg/m2 to those with a BMI ≥45kg/m2 as these patients are often excluded from care.DESIGNRetrospective cohort study SUBJECTS: All patients with a BMI ≥40kg/m2 undergoing oocyte retrieval for ART from January 2018-2023 from one academic fertility clinic and one private fertility clinic.EXPOSUREBMI ≥45kg/m2 compared to a BMI of 40-44.9kg/m2.MAIN OUTCOME MEASURESThe primary outcome was anesthesia complications at the time of retrieval. Demographic data, cycle specific information, medical comorbidities, BMI at retrieval, length of oocyte retrieval, ART and anesthesia complications, laboratory data, and pregnancy rates were recorded.RESULTSA total of 98 patients with a BMI ≥40kg/m2 undergoing oocyte retrieval were identified for the study, 56 patients with a BMI from 40-44.9kg/m2 and 42 patients with a BMI ≥45kg/m2. Demographics were not statistically different between both groups, except more patients with a BMI 40-44.9 kg/m2 identified as White (73% vs 60%) or Black (9% vs 0%), p=0.03. All patients were successfully managed with intravenous sedation and did not require higher level of sedation or care. Mean surgical duration was longer for patients with a BMI ≥45 kg/m2 than in those with a with a BMI 40-44.9 kg/m2 (26.8min, SD 13min vs. 22.3min, SD 8.4min, p=0.04). Most patients (93%) did not experience any anesthesia complication. The only adverse anesthesia complication in both groups was oxygen desaturation <90%, which did not differ by cohort even when adjusting for age. There was no difference in the number of mature oocytes retrieved, day 5/6 blastocysts, the number of euploid embryos, clinical pregnancy, miscarriage or live birth rates.CONCLUSIONBMI is commonly used as a threshold for access to ART. When using intravenous sedation, patients with BMI ≥45 kg/m2 have similar ART outcomes with few anesthesia or ART complications in comparison to patients with a BMI of 40-44.9 kg/m2. With appropriate counseling and preoperative preparation, patients with a BMI ≥45 kg/m2 can safely undergo oocyte retrieval.
{"title":"Patients with a body mass index ≥45 kg/m2 can safely undergo oocyte retrievals and anticipate similar assisted reproductive technology outcomes.","authors":"Marissa Luck,Elizabeth Rubin,Bharti Garg,Stephanie Powell,Thomas O'Leary,Paula Amato,Diana Wu,David Lee,Lynn Bentley Davis,Sacha Krieg","doi":"10.1016/j.fertnstert.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.014","url":null,"abstract":"OBJECTIVETo compare anesthesia and assisted reproductive technology (ART) outcomes in patients with a body mass index (BMI) of 40-44.9kg/m2 to those with a BMI ≥45kg/m2 as these patients are often excluded from care.DESIGNRetrospective cohort study SUBJECTS: All patients with a BMI ≥40kg/m2 undergoing oocyte retrieval for ART from January 2018-2023 from one academic fertility clinic and one private fertility clinic.EXPOSUREBMI ≥45kg/m2 compared to a BMI of 40-44.9kg/m2.MAIN OUTCOME MEASURESThe primary outcome was anesthesia complications at the time of retrieval. Demographic data, cycle specific information, medical comorbidities, BMI at retrieval, length of oocyte retrieval, ART and anesthesia complications, laboratory data, and pregnancy rates were recorded.RESULTSA total of 98 patients with a BMI ≥40kg/m2 undergoing oocyte retrieval were identified for the study, 56 patients with a BMI from 40-44.9kg/m2 and 42 patients with a BMI ≥45kg/m2. Demographics were not statistically different between both groups, except more patients with a BMI 40-44.9 kg/m2 identified as White (73% vs 60%) or Black (9% vs 0%), p=0.03. All patients were successfully managed with intravenous sedation and did not require higher level of sedation or care. Mean surgical duration was longer for patients with a BMI ≥45 kg/m2 than in those with a with a BMI 40-44.9 kg/m2 (26.8min, SD 13min vs. 22.3min, SD 8.4min, p=0.04). Most patients (93%) did not experience any anesthesia complication. The only adverse anesthesia complication in both groups was oxygen desaturation <90%, which did not differ by cohort even when adjusting for age. There was no difference in the number of mature oocytes retrieved, day 5/6 blastocysts, the number of euploid embryos, clinical pregnancy, miscarriage or live birth rates.CONCLUSIONBMI is commonly used as a threshold for access to ART. When using intravenous sedation, patients with BMI ≥45 kg/m2 have similar ART outcomes with few anesthesia or ART complications in comparison to patients with a BMI of 40-44.9 kg/m2. With appropriate counseling and preoperative preparation, patients with a BMI ≥45 kg/m2 can safely undergo oocyte retrieval.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"31 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-20DOI: 10.1016/j.fertnstert.2025.04.018
Zachary Walker
{"title":"DO YOU REQUIRE ANY ASSISTANCE? - ASSISTED HATCHING MAY HAVE NEGATIVE IMPACT ON CYCLES USING VITRIFIED/WARMED DONOR OOCYTES.","authors":"Zachary Walker","doi":"10.1016/j.fertnstert.2025.04.018","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.018","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"21 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-20DOI: 10.1016/j.fertnstert.2025.04.011
Yigit Cakiroglu,Tansu Gudelci,Bulent Tiras
Azoospermia is the most severe form of male infertility presenting around 1% of the male population and 5%-10% of infertile men. Azoospermia is classified into two categories: obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). Currently, micro Testicular Sperm Extraction (mTESE) is still the primary approach especially for cases with NOA. However, there are still some NOA patients in whom sperm can not be yielded even after repeated mTESE attempts. Besides, no definitive alternative treatments exist, prompting ongoing research into new approaches for restoring spermatogenesis in NOA patients. This review focuses on the current literature regarding the possible role of intratesticular autologous platelet rich plasma injection in couples with non-obstructive azoospermia. First, we give an overview of the pathophysiology of azoospermia and the sperm retrieval techniques in azoospermia. Subsequently, we give information about platelet rich plasma (PRP), and briefly discuss the role of PRP on ovaries and endometrium in the light of literature. Finally, we review the current literature on the testicular administration of PRP on animal models and on human. As a conclusion, the findings of the present review suggests that autologous PRP therapy shows promise as a novel approach in male infertility, especially for NOA patients. Nevertheless, additional investigation through randomized controlled trials is necessary to refine the technique and determine its effectiveness to answer the question of whether PRP could significantly improve the second attempt retrieval rate after a failed previous mTESE procedure.
{"title":"INTRATESTICULAR AUTOLOGOUS PLATELET RICH PLASMA INJECTION IN COUPLES WITH NON-OBSTRUCTIVE AZOOSPERMIA: A NARRATIVE REVIEW.","authors":"Yigit Cakiroglu,Tansu Gudelci,Bulent Tiras","doi":"10.1016/j.fertnstert.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.011","url":null,"abstract":"Azoospermia is the most severe form of male infertility presenting around 1% of the male population and 5%-10% of infertile men. Azoospermia is classified into two categories: obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). Currently, micro Testicular Sperm Extraction (mTESE) is still the primary approach especially for cases with NOA. However, there are still some NOA patients in whom sperm can not be yielded even after repeated mTESE attempts. Besides, no definitive alternative treatments exist, prompting ongoing research into new approaches for restoring spermatogenesis in NOA patients. This review focuses on the current literature regarding the possible role of intratesticular autologous platelet rich plasma injection in couples with non-obstructive azoospermia. First, we give an overview of the pathophysiology of azoospermia and the sperm retrieval techniques in azoospermia. Subsequently, we give information about platelet rich plasma (PRP), and briefly discuss the role of PRP on ovaries and endometrium in the light of literature. Finally, we review the current literature on the testicular administration of PRP on animal models and on human. As a conclusion, the findings of the present review suggests that autologous PRP therapy shows promise as a novel approach in male infertility, especially for NOA patients. Nevertheless, additional investigation through randomized controlled trials is necessary to refine the technique and determine its effectiveness to answer the question of whether PRP could significantly improve the second attempt retrieval rate after a failed previous mTESE procedure.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"52 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.fertnstert.2025.04.012
Alessandro Conforti,Sandro C Esteves,Carlo Alviggi
{"title":"Strengthening Systematic Review Methods: Reflections on GRADE, Risk of Bias, and Clinical Relevance.","authors":"Alessandro Conforti,Sandro C Esteves,Carlo Alviggi","doi":"10.1016/j.fertnstert.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.012","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.fertnstert.2025.04.010
Thomas A Molinaro,Maria Costantini-Ferrando
{"title":"\"The Birds, The Bees and The Blastocysts\".","authors":"Thomas A Molinaro,Maria Costantini-Ferrando","doi":"10.1016/j.fertnstert.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.010","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"47 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVETo report a rare case of unicornuate uterus, whose rudimentary horn has finally developed into a diffuse adenomyosis foci, and to demonstrate a fertile preserved approach for the treatment of such a condition.DESIGNstep by step video of a rare case report SUBJECTS: A 29-year-old nulliparous patient presented with severe dysmenorrhea, menorrhagia and an infertility history for nearly 10 years. Her dysmenorrhea has been worsening in recent two years, and she has a strong desire of giving birth. The study was approved by the local ethics committee of Shanghai Jiao Tong University School of Medicine Affiliated International Peace Maternal and Child Health Hospital. The patient included in this video gave consent for publication of the video and posting of the video online including social media, the journal website, scientific literature websites (such as PubMed, ScienceDirect, Scopus, etc.) and other applicable sites.EXPOSURETransvaginal ultrasonography, magnetic resonance imaging, and laparoscopic resection of rudimentary horn with adenomyosis, endometrioma and superficial endometriosis. Chromopertubation was also performed to assess tubal competency. Laparoscopic resection was performed to relief pain and preserve fertility.MAIN OUTCOME MEASURE(S)Symptomatic relief, restoration of normal anatomy, and fertile reservation.RESULT(S)During the follow up, her dysmenorrhea resolved. Her ovarian reserve remained at 2.04 after the surgery. She was considering embryo transfer.CONCLUSION(S)We reported a rare case of unicornuate uterus with adenomyosis in the rudimentary horn, with superficial endometriosis lesions and ovarian endometrioma. While endometriosis is commonly seen in patients with uterine malformation, the development of adenomyosis is rare. The long term periodic bleeding inside the obstructive rudimentary horn with functional endometrium may help the development of adenomyosis, indicating an advanced stage of this uterine malformation. Early diagnosis of such a uterine malformation is quite necessary to prevent such severe complications. The existence of adenomyosis should be considered in infertile women with uterine malformations. The laparoscopic resection of the pathological rudimentary horn is possible after careful adhesiolysis without cutting the uterine artery to relief clinical symptoms, restore normal pelvic anatomy, and preserve future fertility.
{"title":"A rare case of unicornuate uterus with pathological rudimentary horn: settling the associated adenomyosis with fertility preservation.","authors":"Chenxuan Wei,Jing Ouyang,Ruoer Yu,Siqin Yang,Hong Xu","doi":"10.1016/j.fertnstert.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.004","url":null,"abstract":"OBJECTIVETo report a rare case of unicornuate uterus, whose rudimentary horn has finally developed into a diffuse adenomyosis foci, and to demonstrate a fertile preserved approach for the treatment of such a condition.DESIGNstep by step video of a rare case report SUBJECTS: A 29-year-old nulliparous patient presented with severe dysmenorrhea, menorrhagia and an infertility history for nearly 10 years. Her dysmenorrhea has been worsening in recent two years, and she has a strong desire of giving birth. The study was approved by the local ethics committee of Shanghai Jiao Tong University School of Medicine Affiliated International Peace Maternal and Child Health Hospital. The patient included in this video gave consent for publication of the video and posting of the video online including social media, the journal website, scientific literature websites (such as PubMed, ScienceDirect, Scopus, etc.) and other applicable sites.EXPOSURETransvaginal ultrasonography, magnetic resonance imaging, and laparoscopic resection of rudimentary horn with adenomyosis, endometrioma and superficial endometriosis. Chromopertubation was also performed to assess tubal competency. Laparoscopic resection was performed to relief pain and preserve fertility.MAIN OUTCOME MEASURE(S)Symptomatic relief, restoration of normal anatomy, and fertile reservation.RESULT(S)During the follow up, her dysmenorrhea resolved. Her ovarian reserve remained at 2.04 after the surgery. She was considering embryo transfer.CONCLUSION(S)We reported a rare case of unicornuate uterus with adenomyosis in the rudimentary horn, with superficial endometriosis lesions and ovarian endometrioma. While endometriosis is commonly seen in patients with uterine malformation, the development of adenomyosis is rare. The long term periodic bleeding inside the obstructive rudimentary horn with functional endometrium may help the development of adenomyosis, indicating an advanced stage of this uterine malformation. Early diagnosis of such a uterine malformation is quite necessary to prevent such severe complications. The existence of adenomyosis should be considered in infertile women with uterine malformations. The laparoscopic resection of the pathological rudimentary horn is possible after careful adhesiolysis without cutting the uterine artery to relief clinical symptoms, restore normal pelvic anatomy, and preserve future fertility.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"14 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVETo investigate the euploid rate of blastocysts in couples with balanced chromosomal rearrangements and to evaluate the accuracy of the mapping allele with resolved carrier status (MaReCs) technique in discriminating between non-carrier and carrier embryos.DESIGNMulticenter, retrospective, cohort study.SUBJECTSWe involved 2,002 couples with various types of balanced chromosomal rearrangements (reciprocal translocations, Robertsonian translocations, and inversions), who underwent in vitro fertilization (IVF) treatment between January 2017 and September 2023.EXPOSUREBlastocyst euploidy was assessed using preimplantation genetic testing for structural rearrangements (PGT-SR), and the carrier status of euploid embryos was determined using MaReCs. For the transferred euploid embryos, amniocentesis was performed at 16-20 weeks of gestation to examine fetal chromosomes. The amniocentesis results were used as the gold standard to evaluate the accuracy of the MaReCs technique.MAIN OUTCOME MEASURESThe euploid rate of blastocysts in couples with balanced chromosomal rearrangements and the accuracy of the MaReCs technique.RESULTSIn total, 13,730 embryos from 2,629 PGT-SR cycles among 2002 couples were analyzed. 64.3% (1287/2002) of couples obtained euploid embryos in the first controlled ovarian hyperstimulation (COH) cycle and the percentage was 63.5% (1,670/2,629) of all cycles. The total euploid rate of blastocysts was 24.2% (3,324/13,730). 332 couples in 360 cycles requested to distinguish the euploid embryos. A total of 1021 blastocysts were discriminated, in which 49.4% (505/1021) were non-carrier. 78.3% of patients (260/332) obtained non-carrier embryos in the first COH cycle. Follow-up data showed that among the 122 patients undergoing amniocentesis, the consistency between MaReCs and amniocentesis was 99.2% (121/122).CONCLUSIONMaReCs is a simple and precise method for distinguishing the carrier status of euploid embryos, providing a reliable solution for patients with balanced chromosomal rearrangements to stop the passing on of chromosome rearrangement to the next generation.
{"title":"Preimplantation Genetic Testing and Carrier Status Detection in Patients with Balanced Chromosomal Rearrangements: A Real-World Multicenter Retrospective Study.","authors":"Hao Shi,Wenbin Niu,Haiyan Bai,Li Wu,Xiao Bao,Shanjun Dai,Hui He,Yifan Zhou,Yaxin Yao,Jing Wang,Yidong Liu,Yangyun Zou,Sijia Lu,Lei Jin,Juan-Zi Shi,Yingpu Sun","doi":"10.1016/j.fertnstert.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.008","url":null,"abstract":"OBJECTIVETo investigate the euploid rate of blastocysts in couples with balanced chromosomal rearrangements and to evaluate the accuracy of the mapping allele with resolved carrier status (MaReCs) technique in discriminating between non-carrier and carrier embryos.DESIGNMulticenter, retrospective, cohort study.SUBJECTSWe involved 2,002 couples with various types of balanced chromosomal rearrangements (reciprocal translocations, Robertsonian translocations, and inversions), who underwent in vitro fertilization (IVF) treatment between January 2017 and September 2023.EXPOSUREBlastocyst euploidy was assessed using preimplantation genetic testing for structural rearrangements (PGT-SR), and the carrier status of euploid embryos was determined using MaReCs. For the transferred euploid embryos, amniocentesis was performed at 16-20 weeks of gestation to examine fetal chromosomes. The amniocentesis results were used as the gold standard to evaluate the accuracy of the MaReCs technique.MAIN OUTCOME MEASURESThe euploid rate of blastocysts in couples with balanced chromosomal rearrangements and the accuracy of the MaReCs technique.RESULTSIn total, 13,730 embryos from 2,629 PGT-SR cycles among 2002 couples were analyzed. 64.3% (1287/2002) of couples obtained euploid embryos in the first controlled ovarian hyperstimulation (COH) cycle and the percentage was 63.5% (1,670/2,629) of all cycles. The total euploid rate of blastocysts was 24.2% (3,324/13,730). 332 couples in 360 cycles requested to distinguish the euploid embryos. A total of 1021 blastocysts were discriminated, in which 49.4% (505/1021) were non-carrier. 78.3% of patients (260/332) obtained non-carrier embryos in the first COH cycle. Follow-up data showed that among the 122 patients undergoing amniocentesis, the consistency between MaReCs and amniocentesis was 99.2% (121/122).CONCLUSIONMaReCs is a simple and precise method for distinguishing the carrier status of euploid embryos, providing a reliable solution for patients with balanced chromosomal rearrangements to stop the passing on of chromosome rearrangement to the next generation.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"31 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-14DOI: 10.1016/j.fertnstert.2025.04.009
Emily Gleason,Lindsay Levine,Iris T Lee,Nathanael Koelper,Anastassia Amaro,Anuja Dokras
{"title":"Effect of Glucagon-Like Peptide 1 Agonist Medications on Weight Loss in Patients with and Without Polycystic Ovary Syndrome.","authors":"Emily Gleason,Lindsay Levine,Iris T Lee,Nathanael Koelper,Anastassia Amaro,Anuja Dokras","doi":"10.1016/j.fertnstert.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.009","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-11DOI: 10.1016/j.fertnstert.2025.04.007
Mili Thakur
{"title":"Not All Mosaic Embryos Are the Same: Time to Refine How We Report Mosaicism in PGT.","authors":"Mili Thakur","doi":"10.1016/j.fertnstert.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.007","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"136 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-11DOI: 10.1016/j.fertnstert.2025.04.006
Yael Eliner,Bridget Foley,Steven R Bayer,Kim L Thornton,Alan S Penzias,Denny Sakkas,Denis A Vaughan
OBJECTIVETo determine if utilizing pre-implantation genetic testing for aneuploidy (PGT-A) impacts time to pregnancy resulting in a live birth.DESIGNRetrospective cohort study.SETTINGSingle, large, university-affiliated fertility center in the United States.SUBJECTSPatients who underwent their first oocyte retrieval between January 1st, 2014, and December 31st, 2022, were included. Patients were categorized into a PGT-A group and a non-PGT-A group based on the use of PGT-A at the time of the first oocyte retrieval. Patients were then stratified by age: women <38 years old and women ≥38 years old at the time of the first retrieval. Propensity score matching was performed using nine criteria, matching 2,158 PGT-A patients to 2,158 non-PGT-A patients in the younger age group, and 1,343 PGT-A patients to 1,343 non-PGT-A patients in the older age group.EXPOSUREUse of PGT-A.MAIN OUTCOME MEASURESThe positive pregnancy rate leading to a live birth over a one-year period following the initial egg retrieval. This was used as an indicator of time to successful pregnancy.RESULTSFollowing the matching process, there were no statistically significant differences in the examined characteristics between PGT-A and non-PGT-A patients. The Kaplan-Meier curves showed that there was no significant difference in the probability of having a live birth in the younger group, with a live birth hazard ratio for the full year of 0.97 (95% CI 0.90-1.04), but was significantly shorter for PGT-A patients, with a live birth hazard ratio of 1.46 (95% CI 1.30-1.64) in the older group. Patients in the ≥38 age group who used PGT-A had a higher live birth rate over a one-year period, compared to non-PGT-A patients (51.2% versus 36.4%). In contrast, PGT-A and non-PGT-A patients in the <38 age group had similar cumulative one-year live birth rates (69.5% versus 67.1%). In both age groups, miscarriage rates and mean number of transfers were lower for PGT-A patients.CONCLUSIONPGT-A is associated with a shorter time to pregnancy resulting in a live birth for patients who are at least 38 years old but does not affect time to successful pregnancy in younger patients over a one-year period.
{"title":"The impact of PGT-A on time to live birth in IVF.","authors":"Yael Eliner,Bridget Foley,Steven R Bayer,Kim L Thornton,Alan S Penzias,Denny Sakkas,Denis A Vaughan","doi":"10.1016/j.fertnstert.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.006","url":null,"abstract":"OBJECTIVETo determine if utilizing pre-implantation genetic testing for aneuploidy (PGT-A) impacts time to pregnancy resulting in a live birth.DESIGNRetrospective cohort study.SETTINGSingle, large, university-affiliated fertility center in the United States.SUBJECTSPatients who underwent their first oocyte retrieval between January 1st, 2014, and December 31st, 2022, were included. Patients were categorized into a PGT-A group and a non-PGT-A group based on the use of PGT-A at the time of the first oocyte retrieval. Patients were then stratified by age: women <38 years old and women ≥38 years old at the time of the first retrieval. Propensity score matching was performed using nine criteria, matching 2,158 PGT-A patients to 2,158 non-PGT-A patients in the younger age group, and 1,343 PGT-A patients to 1,343 non-PGT-A patients in the older age group.EXPOSUREUse of PGT-A.MAIN OUTCOME MEASURESThe positive pregnancy rate leading to a live birth over a one-year period following the initial egg retrieval. This was used as an indicator of time to successful pregnancy.RESULTSFollowing the matching process, there were no statistically significant differences in the examined characteristics between PGT-A and non-PGT-A patients. The Kaplan-Meier curves showed that there was no significant difference in the probability of having a live birth in the younger group, with a live birth hazard ratio for the full year of 0.97 (95% CI 0.90-1.04), but was significantly shorter for PGT-A patients, with a live birth hazard ratio of 1.46 (95% CI 1.30-1.64) in the older group. Patients in the ≥38 age group who used PGT-A had a higher live birth rate over a one-year period, compared to non-PGT-A patients (51.2% versus 36.4%). In contrast, PGT-A and non-PGT-A patients in the <38 age group had similar cumulative one-year live birth rates (69.5% versus 67.1%). In both age groups, miscarriage rates and mean number of transfers were lower for PGT-A patients.CONCLUSIONPGT-A is associated with a shorter time to pregnancy resulting in a live birth for patients who are at least 38 years old but does not affect time to successful pregnancy in younger patients over a one-year period.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"40 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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