Publications by authors named "Alyssa Hochberg"
Article Synopsis
- - The study aimed to identify serum anti-Müllerian hormone (AMH) and antral follicle count (AFC) thresholds that signal a higher risk of hyper-response to ovarian stimulation in women undergoing their first IVF cycle, following the HERA definition.
- - A total of 4220 women were analyzed, revealing thresholds of AMH≥4.38ng/mL and AFC≥16 for the overall cohort, with varying thresholds based on age groups.
- - The findings highlighted that factors like AMH, AFC, and age significantly predict the likelihood of hyper-response during ovarian stimulation, with older women requiring more hormonal treatment.
Article Synopsis
- This study explores how the daily dose of follicle-stimulating hormone (FSH) impacts the chances of suboptimal ovarian response during IVF, specifically using POSEIDON's criteria.
- It examines a group of 4005 women with normal hormone levels undergoing their first IVF/ICSI cycle, assessing whether varying FSH doses (≤300 IU vs >300 IU) influence the retrieval of 4-9 oocytes.
- Results show that increasing the FSH dose did not decrease the risk of suboptimal response, while factors like female age, and hormone levels were found to be significant predictors instead.
Background: With the advancement in embryology and the introduction of time-lapse monitoring system, the embryologists' goal might be to find not only the embryo with the highest probability of live birth, but also the embryo with the highest probability to progress to a healthy full-term delivery. Thus, we aimed to investigate the association between morphokinetic time-lapse parameters and obstetrical and perinatal complications.
Methods: A cohort study reviewing fertility and delivery files of all singletone births from IVF patients whose embryos were cultured in a time-lapse monitoring system and had a single fresh embryo transfer at our center between 2013-2019.
Purpose: Optimal sperm DNA integrity is essential for fertilization and embryo health. Research indicates that testicular sperm (TS), obtained via TESA or TESE, typically show lower sperm DNA fragmentation (SDF) than ejaculated sperm after standard abstinence. Shortening abstinence to less than 2 days might reduce SDF, offering a less invasive and more cost-effective alternative to surgical sperm retrieval.
View Article and Find Full Text PDFThe utility of pre-implantation genetic testing (PGT-A) is controversial, with older meta-analyses demonstrating improved pregnancy outcomes, while newer trials have not shown benefit. Therefore, we performed a meta-analysis which aimed to evaluate the benefits of PGT-A using comprehensive chromosome screening (CCS) and its effects on fertilization (IVF) outcomes among randomized controlled trials (RCTs). We conducted a systematic search to identify RCTs comparing women undergoing PGT-A with CSS with women not undergoing PGT-A, from inception to December 2020.
View Article and Find Full Text PDFThe objective was to examine the association between poor ovarian response to gonadotropin stimulation for in vitro fertilization (IVF) and adverse perinatal outcomes in singleton gestations in young patients. This was a retrospective cohort study including women aged 17-39 who underwent fresh embryo transfer and delivered a singleton neonate at a single center (pre-implantation genetic testing excluded) (2007-2022). Patients were classified as one of the following categories: poor responders-daily follicle-stimulating hormone (FSH) ≥ 150 IU yielding ≤ 3 retrieved oocytes; normal responders-4-15 oocytes; and high responders with ≥16 oocytes.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates how bariatric surgery affects pregnancy and neonatal outcomes in women with polycystic ovary syndrome (PCOS) using data from the Healthcare Cost and Utilization Project from 2004-2014.
- The findings reveal that pregnant PCOS patients who underwent bariatric surgery had significantly lower rates of pregnancy-induced hypertension and gestational diabetes compared to those who did not have the surgery.
- Additionally, while bariatric surgery led to a higher cesarean section rate in PCOS patients compared to non-PCOS patients, overall obstetric and neonatal outcomes were similar between these groups.
Article Synopsis
- - The study investigates clinical factors linked to unexpected poor or suboptimal responses in IVF ovarian stimulation, identifying specific thresholds for AMH and AFC that could predict these outcomes according to POSEIDON's criteria.
- - Conducted from 2015 to 2017, this tri-centre retrospective cohort study analyzed data from 7,625 first-time IVF and ICSI cycles, revealing that 9.3% were poor responders and 90.7% were suboptimal responders.
- - The findings suggest that higher than expected AMH and AFC threshold values can predict poor or suboptimal responses, emphasizing the importance of these markers for customizing IVF treatment plans.
Risk factors for relaparotomy after a cesarean delivery: a case-control study.
BMC Pregnancy Childbirth
April 2024
Background: Relaparotomy following a cesarean delivery (CD) is an infrequent complication, with inconsistency regarding risk factors and indications for its occurrence. We therefore aimed to determine risk factors and indications for a relaparotomy following a CD at a single large tertiary center.
Methods: A retrospective case-control single-center study (2013-2023).
Article Synopsis
- - The study aimed to investigate the risks associated with differing ovarian reserve markers (AMH and AFC) in women undergoing IVF, particularly when one indicates normal reserve and the other suggests poor reserve according to Poseidon's criteria.
- - In a cohort of 8,797 women, 13.3% had discordant AMH and AFC values; 72.9% of these women still retrieved 4 or more oocytes, indicating that discordant markers don't always predict poor ovarian response.
- - The findings suggest that an AFC of 6 is a good predictor of successful oocyte retrieval even when AMH is low, while low AFC paired with higher AMH indicates a lower likelihood of poor response to stimulation.
Clinical significance of true umbilical cord knot: a propensity score matching study.
BMC Pregnancy Childbirth
January 2024
Objective: True umbilical cord knot (TUCK) is a rare finding that often leads to intensified surveillance and patient anxiety. This study sought to evaluate the incidence, risk factors, and obstetric and neonatal outcomes of TUCK.
Methods: A retrospective cohort study was conducted at a tertiary university medical center in 2007-2019.
Objective: Women are often concerned about the absolute quantity and quality of sperm in a thawed donor sample at the time of intrauterine insemination (IUI). The aim of this study was to determine how the total motile sperm count (TMSC) of donor sperm obtained from commercial sperm banks affects the pregnancy rate after IUI.
Study Design: We performed a retrospective cohort study including single women and women in same-sex relationships undergoing IUI at a single academic fertility center between January 2011 and March 2018.
Objective: The primary aim of this study is to utilize a neural network model to predict adverse neonatal outcomes in pregnancies complicated by gestational diabetes (GDM).
Design: Our model, based on XGBoost, was implemented using Python 3.6 with the Keras framework built on TensorFlow by Google.
Article Synopsis
- The study aimed to assess how low socioeconomic status (SES) affects pregnancy and neonatal complications in women with polycystic ovary syndrome (PCOS).
- The research involved analyzing data from over 9 million women between 2004 and 2014, focusing on 12,322 with PCOS and their SES classifications.
- Results showed that women in the lowest SES group were more likely to face complications like pregnancy-induced hypertension and pre-eclampsia, emphasizing the need for careful monitoring during pregnancy for this demographic.
Objective: To determine perinatal outcomes following uterine rupture during a trial of labor after one previous cesarean delivery (CD) at term.
Methods: A retrospective single-center study examining perinatal outcomes in women with term singleton pregnancies with one prior CD, who underwent a trial of labor after cesarean (TOLAC) and were diagnosed with uterine rupture, between 2011 and 2022. The primary outcome was a composite maternal outcome, and the secondary outcome was a composite neonatal outcome.
Article Synopsis
- This study investigates the pregnancy, delivery, and neonatal outcomes in women with chronic hypoparathyroidism compared to those without this condition, given that data is previously inconclusive on the topic.
- The research utilized an extensive retrospective analysis of data from over 9 million pregnancies between 2004 and 2014, employing statistical methods to account for various confounding factors.
- Results indicated that mothers with chronic hypoparathyroidism had higher rates of complications such as preterm births, blood transfusions, and congenital anomalies in their neonates, emphasizing the need for awareness of this condition in prenatal care.
Article Synopsis
- The study aimed to compare pregnancy outcomes between in-vitro fertilization (IVF) and spontaneous conceptions in women aged 38-43, as well as to assess the impact of maternal age on IVF outcomes.
- Over 309,000 pregnant women were analyzed, revealing that those who conceived through IVF had higher risks of various complications, including hypertension and preterm delivery, though neonatal outcomes were similar across groups.
- Women aged 38 and older using IVF experienced greater complications than younger IVF patients, highlighting the increased risks associated with advanced maternal age in IVF pregnancies.
Objective: To determine the prevalence of positive antiphospholipid (aPL) antibodies among pregnant women with placenta-mediated complications delivered at >34 weeks of gestation.
Methods: This was a single-center retrospective observational study conducted between 2017 and 2022. Inclusion criteria included pregnant or post-partum women, >18 years, diagnosed with any of the following placenta-mediated complications and delivered at >34 weeks of gestation: small-for-gestational-age neonate (SGA ≤ 5th percentile according to local birthweight charts), preeclampsia with severe features, and placental abruption.
Article Synopsis
- The study investigates perinatal outcomes for women who have undergone liver transplants and examines the impact of low-dose aspirin on pregnancy complications like hypertensive disease.
- It involved a review of 14 deliveries in 11 liver transplant recipients, noting that 50% had Wilson's disease as the primary condition, and found that aspirin users did not develop hypertension-related issues.
- The findings suggest favorable pregnancy outcomes for this unique group and recommend low-dose aspirin for preeclampsia prevention, while highlighting the need for larger studies to confirm these results.
Background: The number of nulliparous women over the age of 35 is consistently increasing, and the optimal delivery strategy is a subject of ongoing discussion. This study compares perinatal outcomes in nulliparous women aged ≥35 years undergoing a trial of labor (TOL) versus a planned cesarean delivery (CD).
Methods: A retrospective cohort study including all nulliparous women ≥ 35 years who delivered a single term fetus at a single center between 2007-2019.
Article Synopsis
- Pregnant women with PCOS have a higher risk of complications during IVF pregnancies, particularly related to placental issues.
- A study evaluated the placentas of women with PCOS and found they were more likely to experience conditions like gestational diabetes, circumvallate placentas, and hypercoiled umbilical cords compared to women without PCOS.
- The research indicates that IVF pregnancies in women with PCOS exhibit significant placental histopathological changes, affecting both anatomical structure and vascular health.
Introduction: We aimed to evaluate the neuroimaging findings and long-term neurodevelopmental outcomes of fetuses and children following intrauterine blood transfusion (IUT) for parvo B19 infection-induced anemia compared to those with RBC alloimmunization.
Methods: We conducted a retrospective cohort study including women who underwent an IUT due to fetal anemia between 2006 and 2019 in a tertiary, university-affiliated medical center. The cohort was divided into two groups: a study group - fetuses affected by congenital parvo B19 infection; and a control group - fetuses affected by RBC alloimmunization.
Article Synopsis
- The study aims to compare pregnancy outcomes for women with polycystic ovary syndrome (PCOS), specifically examining those with and without hypothyroidism.
- Out of 14,882 women analyzed, those with hypothyroidism were generally older and had a higher rate of multiple pregnancies, but most pregnancy outcomes were similar between both groups, with the exception of a slight increase in small-for-gestational-age (SGA) neonates among those with hypothyroidism.
- The research concludes that while hypothyroidism raises the risk of preeclampsia in women with PCOS, it doesn't significantly impact other common pregnancy complications due to the already high risks associated with PCOS.
Purpose: To determine maternal outcomes and risk factors for composite maternal morbidity following uterine rupture during pregnancy.
Methods: A retrospective cohort study including all women diagnosed with uterine rupture during pregnancy, between 2011 and 2023, at a single-center. Patients with partial uterine rupture or dehiscence were excluded.
Oocyte maturation is affected by various patient and cycle parameters and has a key effect on treatment outcome. A prediction model for oocyte maturation rate formulated by using machine learning and neural network algorithms has not yet been described. A retrospective cohort study that included all women aged ≤ 38 years who underwent their first IVF treatment using a flexible GnRH antagonist protocol in a single tertiary hospital between 2010 and 2015.
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