The influence of obesity on incidence of complications in patients hospitalized with ovarian hyperstimulation syndrome.

Objective: To study the impact of body habitus on risk of complications resulting from ovarian hyperstimulation syndrome (OHSS) in hospitalized patients.

Methods: This is a retrospective observational study examining the National Inpatient Sample between January 2012 and September 2015. Patients were women < 50 years of age diagnosed with OHSS, classified as non-obese, class I-II obesity, or class III obesity.

Developmental potential of immature human oocytes aspirated after controlled ovarian stimulation.

Purpose: Intracytoplasmic sperm injection (ICSI) for initially immature oocytes that mature in vitro is controversial and practice varies widely. While it may increase the number of usable embryos, it may also be time-intensive and potentially low-yield. This study sought to elucidate which patients may benefit from ICSI of initially immature oocytes that matured in vitro.

What is the optimal timing of intracytoplasmic sperm injection (ICSI) after EGG retrieval? A randomized controlled trial.

Purpose: To determine if oocyte denudation and ICSI at 36.5 versus 39 h post HCG and/or Lupron trigger (2.5 h versus 5 h post-oocyte retrieval) influences fertilization and blastulation rates in good prognosis couples METHODS: We performed a prospective, randomized controlled trial of 12 patients undergoing IVF with ICSI at an academic fertility center, resulting in 206 MII oocytes analyzed.

A validated model for predicting live birth after embryo transfer.

Accurately predicting the probability of live birth and multiple gestations is important for determining a safe number of embryos to transfer after in vitro fertilization. We developed a model that can be fit to individual clinic data for predicting singleton, twin, and total live birth rates after human embryo transfer. The predicted and observed rates of singleton and twin deliveries were compared in a tenfold cross-validation study using data from a single clinic.

Effect of Age and Embryo Morphology on Live Birth Rate After Transfer of Unbiopsied Blastocysts.

Objective: To determine the rate of live birth per blastocyst based on morphology and oocyte age using data from a single center.

Methods: This is a mathematical analysis and model building study of autologous blastocyst stage embryo transfers at a University-affiliated center. A total of 448 blastocyst stage embryos were transferred in 244 fresh and frozen embryo transfers from May 2015 through April 2018.

Advanced paternal age and the risk of spontaneous abortion: an analysis of the combined 2011-2013 and 2013-2015 National Survey of Family Growth.

Background: Maternal and paternal age at first birth are increasing across the global population. Spontaneous abortion, one of the most common abnormal pregnancy outcomes, is known to occur more frequently with increasing maternal age. However, the relationship of advanced paternal age and spontaneous abortion is poorly understood, and previous results have yielded conflicting results.

Micro-RNAs involved in cellular proliferation have altered expression profiles in granulosa of young women with diminished ovarian reserve.

Purpose: The study aims to determine differences in micro-RNA (miRNA) expression in granulosa (GC) and cumulus cells (CC) between young women with diminished ovarian reserve (DOR) or normal ovarian reserve (NOR). Secondary objective was to identify downstream signaling pathways that could ultimately indicate causes of lower developmental competence of oocytes from young women with DOR.

Methods: The method of the study is prospective cohort study.

Pushing the limits of detection: investigation of cell-free DNA for aneuploidy screening in embryos.

Objective: To determine the accuracy of cell-free DNA (cfDNA) in spent embryo medium (SEM) for ploidy and sex detection at the cleavage and blastocyst stages. To determine if assisted hatching (AH) and morphologic grade influence cfDNA concentration and accuracy.

Design: Prospective cohort.

Blastulation timing is associated with differential mitochondrial content in euploid embryos.

Purpose: Preimplantation genetic screening (PGS) and assessment of mitochondrial content (MC) are current methods for selection of the best embryos for transfer. Studies suggest that time-lapse morphokinetics (TLM) may also be helpful for selecting embryos more likely to implant. In our study, we sought to examine the relationship between TLM parameters and MC to determine if they could be used adjunctively in embryo selection.

Clomiphene Stair-Step Protocol for Women With Polycystic Ovary Syndrome.

Objective: To compare time to ovulation, ovulation rates, and side effect profile of traditional and the stair-step protocol for ovulation induction using clomiphene citrate in women with polycystic ovary syndrome (PCOS).

Methods: We performed a retrospective study of women seeking care for infertility with a diagnosis of PCOS at a university-based infertility clinic from July 2012 to July 2014. We included patients who were resistant to the initial starting dose of 50 mg clomiphene.

A comparison of live birth rates and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos.

Purpose: Prior studies suggest that pregnancy outcomes after autologous oocyte cryopreservation are similar to fresh in vitro fertilization (IVF) cycles. It is unknown whether there are differences in pregnancy and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos.

Methods: This is a retrospective cohort study comparing pregnancy and perinatal outcomes between oocyte and embryo cryopreservation at a university-based fertility center.

The dilemma of counseling patients about poor prognosis: live birth after IVF with autologous oocytes in a 43-year-old woman with FSH levels above 30 mIU/mL.

Providing reasonable expectations to patients with diminished ovarian reserve prior to attempting pregnancy through in vitro fertilization (IVF) is one of the most challenging aspects of fertility care. In some instances, advice from the clinician to pursue more effective treatment, such as donor oocytes, may not be acceptable to the patient. In this case report, a patient is presented who represents a poor prognosis candidate for IVF treatment.

Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices.

Objective: To better understand practice patterns and opportunities for standardization of ET.

Design: Cross-sectional survey.

Setting: Not applicable.

ASRM standard embryo transfer protocol template: a committee opinion.

Standardization improves performance and safety. A template for standardizing the embryo transfer procedure is presented here with 12 basic steps supported by published scientific literature and a survey of common practice of SART programs; it can be used by ART practices to model their own standard protocol.

Low-dose human chorionic gonadotropin alone can complete follicle maturity: successful application to modified natural cycle in vitro fertilization.

Objective: To investigate the feasibility of utilizing low-dose hCG alone to complete follicle maturity in a natural cycle, without the need for antecedent exogenous FSH stimulation.

Design: Case series.

Setting: Academic fertility program.

Developmentally delayed cleavage-stage embryos maintain comparable implantation rates in frozen embryo transfers.

Purpose: In fresh IVF cycles, embryos reaching the eight-cell stage on day 3 of development are thought to have a higher chance of implantation than those reaching this stage on day 4. To determine whether this difference persists after cryopreservation, we compared pregnancy and implantation rates between frozen embryo transfer (FET) cycles using delayed cleavage-stage embryos (cryopreserved day 4) and normal cleavage-stage embryos (cryopreserved day 3).

Methods: Participants underwent FET between 2008 and 2012 using embryos cryopreserved on either day 3 (n = 76) or day 4 (n = 48), depending on the length of time needed to achieve the eight-cell stage.

Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.

Objective: To elucidate the role of vitamin D in reproduction by examining the relationship between recipient vitamin D levels and pregnancy rates in donor-recipient IVF cycles.

Design: Retrospective cohort study.

Setting: Academic tertiary care center.

Egg banking in the United States: current status of commercially available cryopreserved oocytes.

Objective: To estimate the current availability of donor cryopreserved oocytes and to describe the emerging phenomenon of commercial egg banks (CEBs) in the United States.

Design: Cross-sectional survey of CEBs.

Setting: E-mail, telephone, and fax survey of all CEB scientific directors, conducted April 2012.

Microdose gonadotropin-releasing hormone agonist in the absence of exogenous gonadotropins is not sufficient to induce multiple follicle development.

Because the effectiveness of the "microdose flare" stimulation protocol often is attributed to the dramatic endogenous gonadotropin release induced by the GnRH agonist, the aim of this study was to determine whether use of microdose GnRH agonist alone could induce multiple ovarian follicle development in normal responders. Based on these data, the duration of gonadotropin rise is approximately 24 to 48 hours and is too brief to sustain continued multiple follicle growth.

The status of oocyte cryopreservation in the United States.

Objective: To determine the current status of oocyte cryopreservation across the United States, and the perceived indications for its use.

Design: Cross-sectional survey of all IVF Centers in the United States.

Setting: Telephone and fax based survey of all IVF practice or laboratory directors, conducted March to June of 2009.

The outcome of intracytoplasmic sperm injection using occasional spermatozoa in the ejaculate of men with spermatogenic failure.

Purpose: Men with spermatogenic failure so profound that they are considered as having nonobstructive azoospermia occasionally have spermatozoa in the ejaculate. We compared intracytoplasmic sperm injection outcomes following the injection of ejaculated or surgically retrieved spermatozoa from these men.

Materials And Methods: A study was performed of intracytoplasmic sperm injection cycles with no spermatozoa on initial semen analysis and 100 or fewer following centrifugation (cryptozoospermia).

Outcome of in vitro fertilization in women 45 years and older who use autologous oocytes.

Objective: To determine the IVF outcome in women over the age of 44 years.

Design: Retrospective analysis.

Setting: University-based IVF center.

Evaluation of urine toxicology screens in an oocyte donor population.

Purpose: To assess the accuracy of drug self-reporting in oocyte donors.

Methods: Retrospective chart review of donors at Stanford University.

Results: 7% of the donor population had a significant positive urine toxicology screen.