Determinants of utilization of infertility services by race and ethnicity in a state with a comprehensive infertility mandate.

Objective: To examine the association between sociodemographic factors and utilization of infertility services by race and ethnicity in a state with a comprehensive infertility mandate.

Design: Retrospective cohort.

Setting: Academic-affiliated fertility center.

Meeting the demand for fertility services: the present and future of reproductive endocrinology and infertility in the United States.

The field of reproductive endocrinology and infertility (REI) is at a crossroads; there is a mismatch between demand for reproductive endocrinology, infertility and assisted reproductive technology (ART) services, and availability of care. This document's focus is to provide data justifying the critical need for increased provision of fertility services in the United States now and into the future, offer approaches to rectify the developing physician shortage problem, and suggest a framework for the discussion on how to meet that increase in demand. The Society of REI recommend the following: 1.

Black race associated with lower live birth rate in frozen-thawed blastocyst transfer cycles: an analysis of 7,002 Society for Assisted Reproductive Technology frozen-thawed blastocyst transfer cycles.

Objective: To evaluate if racial/ethnic differences in pregnancy outcomes persisted in frozen-thawed embryo transfer (FET) cycles on a national level.

Design: Retrospective cohort study.

Setting: Clinic-based data.

The effect of rapid and delayed insemination on reproductive outcome in conventional insemination and intracytoplasmic sperm injection in vitro fertilization cycles.

Purpose: The precise timing of insemination after oocyte retrieval is sometimes challenging. In this study, we have assessed the effect of the variation in insemination timing on reproductive outcome for both conventional insemination (CI) and intracytoplasmic sperm injection (ICSI) cycles.

Methods: A single-center retrospective cohort data analysis was performed on 6559 patients (9575 oocyte retrievals) from January 2017 to July 2019.

Multiple cryopreservation-warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes.

Research Question: Do multiple cryopreservation-warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes?

Design: Patients undergoing IVF with homologous single embryo transfer, and who underwent trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A) between 2013 and 2017, were divided into three groups based on degree of embryonic micromanipulation: once-biopsied, once-cryopreserved (group BC, n = 2603), once-biopsied, twice-cryopreserved (group CBC, n = 95) and twice-biopsied, twice-cryopreserved (group BCBC, n = 15). The primary outcome was live birth; secondary outcomes included positive serum pregnancy test, clinical pregnancy and miscarriage.

Results: Group CBC had a significantly lower chance of live birth (adjusted RR 0.

Association between in vitro fertilization and ischemic placental disease by gestational age.

Objective: To evaluate the association between in vitro fertilization (IVF) and ischemic placental disease (IPD), stratified by gestational age.

Design: We performed a secondary analysis of a retrospective cohort study of deliveries.

Setting: Deliveries were performed over 15 years at a single tertiary hospital.

Assisted reproductive technology outcomes in female-to-male transgender patients compared with cisgender patients: a new frontier in reproductive medicine.

Objective: To investigate assisted reproductive technology (ART) outcomes in a female-to-male transgender cohort and compare the results with those of a matched cisgender cohort.

Design: Matched retrospective cohort study.

Setting: In vitro fertilization clinic.

To test or not to test? A framework for counselling patients on preimplantation genetic testing for aneuploidy (PGT-A).

Study Question: What is the treatment path and cumulative live birth (CLB) rate from a single oocyte retrieval of patients who intend to pursue PGT-A at the start of an IVF cycle compared to matched controls?

Summary Answer: The choice of PGT-A at the start of the first IVF cycle decreases the CLB per oocyte retrieval for patients <38 years of age, however patients ≥38 years of age benefit significantly per embryo transfer (ET) when live birth (LB) is evaluated.

What Is Known Already: PGT-A has been shown to reduce the practice of transferring multiple embryos and to confer a higher live birth rate per transfer.

Study Design, Size, Duration: This is a retrospective cohort study from December 2014 to September 2016, involving 600 patients: those intending PGT-A for their first IVF cycle (N = 300) and their matched controls.

Magnetic resonance imaging performance for diagnosis of ovarian torsion in pregnant women with stimulated ovaries.

Background: To determine if asymmetric ovarian edema on non-contrast MRI can be used to distinguish torsed from non-torsed stimulated ovaries in pregnant women.

Methods: In this retrospective study, our radiology database was searched for women who were pregnant and who had undergone ovarian stimulation and underwent MRI abdomen/pelvis from 1/2000-12/2012. At our institution, ultrasound is typically performed as a first line study for pregnant women with pelvic pain, with MR for those patients with indeterminate findings.

Elevated progesterone and its impact on birth weight after fresh embryo transfers.

Purpose: The purpose of the study was to examine the association between serum progesterone levels on the day of hCG administration and birth weight among singleton live births after fresh embryo transfer.

Methods: This study was conducted as a retrospective cohort database analysis on patients who underwent IVF treatment cycles from January 2004 to April 2012. The study was performed at a University affiliated private infertility practice.

No change in live birthweight of IVF singleton deliveries over an 18-year period despite significant clinical and laboratory changes.

Study Question: Has live birthweight changed over 18 years of autologous fresh and frozen IVF?

Summary Answer: Regardless of changes in clinical care and laboratory practice over 18 years, birthweight has remained stable.

What Is Known Already: Birthweight has historically been used as a marker of neonatal health. Frozen embryo transfers lead to heavier live birthweights compared with fresh embryo transfers.

A randomized clinical trial to determine optimal infertility treatment in older couples: the Forty and Over Treatment Trial (FORT-T).

Objective: To determine the optimal infertility therapy for women at the end of their reproductive potential.

Design: Randomized clinical trial.

Setting: Academic medical centers and private infertility center in a state with mandated insurance coverage.

Effect of steroid and antibiotic treatment during assisted hatching on IVF outcomes.

There are limited data on the use of steroids and antibiotics in assisted reproductive technology (ART). Our aim was to evaluate the impact of these treatments on the outcome of IVF cycles in which Assisted Hatching (AH) was performed. We studied a retrospective cohort in a large university-affiliated infertility centre.

Race matters: a systematic review of racial/ethnic disparity in Society for Assisted Reproductive Technology reported outcomes.

Objective: To systematically review the reporting of race/ethnicity in Society for Assisted Reproductive Technology (SART) Clinic Outcome Reporting System (CORS) publications.

Design: Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology of literature published in PubMed on race/ethnicity that includes data from SART CORS.

Setting: Not applicable.

Contraceptive counseling for women who undergo bariatric surgery.

Background: Women are counseled to avoid becoming pregnant for 12-24 months after bariatric surgery. The aim of this study was to assess contraceptive counseling and use in women who undergo bariatric surgery.

Methods: A self-administered survey was completed by women aged 18-45 years at a postoperative clinic visit >2 months after bariatric surgery at an urban teaching hospital.

Follicular fluid-specific distribution of vascular endothelial growth factor isoforms and sFlt-1 in patients undergoing IVF and their correlation with treatment outcomes.

Objective: To investigate the distribution of vascular endothelial growth factor (VEGF) isoforms and soluble form of VEGF receptor 1 (sFlt-1) in the follicular fluid (FF) of in vitro fertilization (IVF) patients in relationship to age, body mass index (BMI), diagnosis of polycystic ovary syndrome (PCOS), and their correlation with IVF outcomes.

Design: Prospective study.

Main Outcome Measures: VEGF( 121) and VEGF(165) isoforms were detected using Western blotting and pixel density analysis.

Influence of embryo sex on development to the blastocyst stage and euploidy.

Objective: To compare the prevalence of blastocyst development and euploidy in XX versus XY embryos.

Design: Retrospective cohort study.

Setting: Boston IVF, a large university-affiliated reproductive medicine practice.

Influence of patient age on the association between euploidy and day-3 embryo morphology.

A retrospective cohort study conducted in 138 patients undergoing their first preimplantation genetic screening (PGS) cycle between January 1, 2006, and December 31, 2007, demonstrated that embryos with good day-3 morphology were more likely to be euploid for X/Y, 8, 15, and 18 than those with poor morphology. The strength of association between euploidy and day-3 morphology was not influenced by maternal age.

A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial.

Objective: To determine the value of gonadotropin/intrauterine insemination (FSH/IUI) therapy for infertile women aged 21-39 years.

Design: Randomized controlled trial.

Setting: Academic medical center associated with a private infertility center.

Assessment of day-3 morphology and euploidy for individual chromosomes in embryos that develop to the blastocyst stage.

Objective: To examine the relationship between day-3 morphology and euploidy for individual chromosomes in embryos that develop to the blastocyst stage by day 5.

Design: Retrospective cohort study.

Setting: Boston IVF, a large university-affiliated reproductive medicine practice.

Impact of subgroup analysis on estimates of infertility.

Conclusions regarding estimates of infertility may reflect study bias based on the definition of infertility used. Careful consideration of how the infertile population is defined, as well its use in subgroup analysis that may not be generalizable to the population of infertile women as a whole, is needed.