Natural frozen embryo transfer with hCG booster leads to improved cycle outcomes: a retrospective cohort study.

Purpose: To determine whether luteal support with intramuscular injection of human chorionic gonadotropin 1 day post-LH surge in natural cycle frozen embryo transfer (nFETs) increases ongoing pregnancy rates (OPR).

Methods: Retrospective cohort study of women who underwent natural cycle FET with transfer of a single day-5 or - 6 euploid blastocyst between January 2017 and December 2018 at an academic medical center were divided into two groups based on whether they received hCG 1 day post-LH surge. Patients with uterine factor infertility were excluded.

Wnt inhibition promotes vascular specification of embryonic cardiac progenitors.

Several studies have demonstrated a multiphasic role for Wnt signaling during embryonic cardiogenesis and developed protocols that enrich for cardiac derivatives during differentiation of human pluripotent stem cells (hPSCs). However, few studies have investigated the role of Wnt signaling in the specification of cardiac progenitor cells (CPCs) toward downstream fates. Using transgenic mice and hPSCs, we tracked endothelial cells (ECs) that originated from CPCs expressing NKX2.

Risk factors for a suboptimal response to gonadotropin-releasing hormone agonist trigger during in vitro fertilization cycles.

Objective: To identify risk factors for a suboptimal response to gonadotropin-releasing hormone (GnRH) agonist trigger in in vitro fertilization (IVF) cycles.

Design: Retrospective cohort study.

Setting: Academic medical center.

Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles.

Purpose: To investigate the impact of elevated serum estradiol (E2) levels on the day of hCG trigger on the birth weight of term singletons after fresh In Vitro Fertilization (IVF)-Embryo Transfer (ET) cycles.

Methods: Retrospective cohort study of all patients initiating fresh IVF-ET cycles resulting in live births between January 2004 and February 2013. The incidence of low birthweight (LBW) term singletons in patients with E2 levels on day of hCG trigger above or below the 95 % cutoff for E2 values in our clinic (3,069.

Beyond the American Society for Reproductive Medicine transfer guidelines: how many cleavage-stage embryos are safe to transfer in women ≥43 years old?

Objective: To determine the number of cleavage-stage embryos that can be safely transferred in women ≥43 years old.

Design: Retrospective cohort.

Setting: Academic medical center.

Diminished ovarian reserve is the predominant risk factor for gonadotropin-releasing hormone antagonist failure resulting in breakthrough luteinizing hormone surges in in vitro fertilization cycles.

Objective: To identify risk factors for breakthrough LH surge despite GnRH antagonist (GnRH-ant) suppression in IVF cycles.

Design: Case-control study.

Setting: Academic medical center.

Value of antimüllerian hormone as a prognostic indicator of in vitro fertilization outcome.

Objective: To determine the predictive attributes of antimüllerian hormone (AMH) in terms of oocyte yield, cycle cancellation, and pregnancy outcomes.

Design: Retrospective cohort.

Setting: Academic center.

Fertility in patients with congenital adrenal hyperplasia.

Congenital adrenal hyperplasia (CAH) is the most frequently encountered genetic steroid disorder affecting fertility. Steroid hormones play a crucial role in sexual development and reproductive function; patients with either 21- hydroxylase or 11β-hydroxylase deficiency thus face immense challenges to their fertility. Given the relevance of CAH in reproductive medicine as well as the diagnostic challenges posed by the phenotypic overlap with polycystic ovary syndrome, we review the reproductive pahophysiology of both classic and nonclassic CAH and present contemporary treatment options.

In vitro fertilization versus conversion to intrauterine insemination in the setting of three or fewer follicles: how should patients proceed when follicular response falls short of expectation?

Objective: To determine whether in vitro fertilization (IVF) cycles with suboptimal response should be converted to intrauterine insemination (IUI) or proceed to oocyte retrieval (OR).

Design: Retrospective cohort.

Setting: Academic medical center.

In vitro fertilization for Orthodox Jewish couples: antagonist cycle modifications allowing for mikveh attendance before oocyte retrieval.

Objective: To describe a novel method of altering conventional gonadotropin-releasing hormone (GnRH) antagonist in vitro fertilization (IVF) cycles, thereby allowing for the observance of ritual Jewish practices, and to investigate the impact of these cycle modifications on IVF outcomes.

Design: Retrospective cohort study.

Setting: Academic medical center.

Consecutive gonadotropin-releasing hormone-antagonist in vitro fertilization cycles: does the elapsed time interval between successive treatments affect outcomes?

Objective: To determine whether patients who failed an in vitro fertilization (IVF) cycle can proceed with a subsequent IVF cycle after waiting only one menstrual cycle, or whether there is a benefit to allowing two or more menstrual cycles to elapse before proceeding.

Design: Retrospective cohort study.

Setting: Academic medical center.

Day 3 embryo shape as a morphologic selection parameter in in vitro fertilization.

Purpose: To investigate whether embryo shape is a useful morphologic predictor of developmental competence in IVF cycles.

Methods: Two hundred eighteen day 3 single embryo transfer (SET) cycles and 225 day 3 double embryo transfer (DET) cycles in which only 8-cell non-fragmented embryos with symmetric blastomeres were transferred and in which the developmental fate of each embryo was known were analyzed for IVF outcomes with respect to embryo shape. Embryo shape was quantitatively calculated after digitizing embryo images using MATLAB, where a score of 1.

Fertility preservation using controlled ovarian hyperstimulation and oocyte cryopreservation in a premenarcheal female with myelodysplastic syndrome.

Objective: To report the first case of fertility preservation in a premenarcheal female by use of controlled ovarian hyperstimulation and oocyte cryopreservation.

Design: Case report.

Setting: Reproductive endocrinology and infertility unit of a tertiary care university-based medical center.

Can in vitro fertilization cycles be salvaged by repeat administration of intramuscular human chorionic gonadotropin the day after failed injection?

Objective: To investigate the incidence of negative serum hCG level after initial IM trigger injection and whether such cycles can be salvaged through repeat administration of IM hCG.

Design: Retrospective cohort study.

Setting: Academic medical center.

Developmental potential of embryos from intracytoplasmic sperm injection cycles containing fragmented oocytes.

Objective: To determine the incidence of fragmented oocytes in intracytoplasmic sperm injection (ICSI) cycles, describe the developmental potential of their sibling oocytes, and define clinical outcomes from affected cycles.

Design: Case-control study.

Setting: Academic medical center.

Prevention of vulvovaginal sequelae in stevens-johnson syndrome and toxic epidermal necrolysis.

Vulvovaginal sequelae of Stevens-Johnson syndrome and toxic epidermal necrolysis are well documented in the literature, although little consensus exists about effective prevention strategies. This review summarizes the available literature and offers expert opinion about how to minimize long-term vaginal impairment from these rare but often devastating illnesses.

Effect of time between human chorionic gonadotropin injection and egg retrieval is age dependent.

Objective: To investigate whether egg retrieval at ≥36.5 hours improves IVF outcomes in women aged ≥40 years.

Design: Retrospective cohort study.

Extended in vitro maturation of immature oocytes from stimulated cycles: an analysis of fertilization potential, embryo development, and reproductive outcomes.

Purpose: To investigate 24 h in vitro maturation (IVM) of cumulus-stripped immature oocytes from stimulated cycles.

Methods: 263 oocytes identified as immature after cumulus stripping for ICSI were subjected to in vitro maturation (IVM). Fertilization rates and reproductive outcomes of matured oocytes were compared against 234 in vivo matured sibling oocytes (IVO-MII-Sib) from the same cycles (n = 41).

Mayer-Rokitansky-Küster-Hauser syndrome: fertility counseling and treatment.

To date, no literature has focused on the counseling of patients with Mayer-Rokitansky-Küster-Hauser syndrome as relates to their unique fertility challenges. This article is presented as a guide to practitioners in the counseling of patients with varying Mayer-Rokitansky-Küster-Hauser phenotypes regarding individual reproductive potential.

Reducing surgical site infections: a review.

Infection at or near surgical incisions within 30 days of an operative procedure contributes substantially to surgical morbidity and mortality each year. The prevention of surgical site infections encompasses meticulous operative technique, timely administration of appropriate preoperative antibiotics, and a variety of preventive measures aimed at neutralizing the threat of bacterial, viral, and fungal contamination posed by operative staff, the operating room environment, and the patient's endogenous skin flora. It is the latter aspect of contamination, and specifically mechanical methods of prevention, on which this review focuses.

Empty follicle syndrome--does repeat administration of hCG really work?

In this retrospective case series with historic control subjects, repeat administration of hCG after failure to retrieve oocytes from the first ovary in the setting of unexpectedly low serum hCG levels resulted in unsuccessful IVF outcomes. This represents the largest case series to date regarding repeat administration of hCG in so-called "false" empty follicle syndrome cycles and indicates that patients should be counseled regarding the low likelihood of cycle success after repeat administration of hCG in this setting.

Congenital uterine anomalies affecting reproduction.

The following review seeks to summarise the current data regarding reproductive outcomes associated with congenital uterine anomalies. Such malformations originate from adverse embryologic events ranging from agenesis to lateral and vertical fusion defects. Associated renal anomalies are common both for the symmetric and asymmetric malformations.

Incidence and development of zygotes exhibiting abnormal pronuclear disposition after identification of two pronuclei at the fertilization check.

Objective: To determine the incidence, developmental potential, and clinical implications of embryos having one pronucleus (1PN) or three pronuclei (3PN) at early cleavage, despite exhibiting 2PN at the fertilization check.

Design: Retrospective cohort study.

Setting: Hospital-based academic medical center.