Biological relevance of trophectoderm morphology: initial β-hCG measurements correlate with trophectoderm grading on euploid frozen embryo transfers.

Objective: To analyze the correlation between TE grading and initial β-hCG serum level after single euploid embryo transfer. Secondarily, to explore the association between TE grading with subsequent IVF outcomes.

Design: Retrospective cohort analysis.

Hysteroscopic endometrial peeling as a different approach to endometrial scratching. Case series report.

Study Question: Does hysteroscopic endometrial peeling improve reproductive outcomes in women with implantation failure?

Design: In this case series, 66 women underwent an hysteroscopic endometrial peeling and subsequently, a single frozen embryo transfer.

Results: After the exclusion of patients with intraoperative incidental findings, pregnancy was achieved in 63% (42/66) of the women who underwent hysteroscopic endometrial peeling and subsequently a single frozen embryo transfer, clinical pregnancy rate was observed in 57% (38/66) of the patients and, clinical pregnancy loss occurred in 10% (4/38).

Conclusion: this novel surgical technique seems to increase implantation as well as clinical pregnancy rates in women with repeated implantation failure.

Parental chromosomal heteromorphisms are not associated with an increased risk of embryo aneuploidy.

Objective: Although chromosomal heteromorphisms are commonly found in the general population, some researchers have suggested a correlation with higher rates of embryo aneuploidy. This study aimed to assess the rates of embryo aneuploidy in couples who carry a chromosome heteromorphism.

Methods: The study included couples who had G-banding karyotype testing and underwent an IVF/PGT-A cycle between January 2012 and March 2018.

Late follicular phase progesterone elevation during ovarian stimulation is not associated with decreased implantation of chromosomally screened embryos in thaw cycles.

Study Question: What is the impact of a late follicular phase progesterone elevation (LFPE) during controlled ovarian hyperstimulation (COH) on embryonic competence and reproductive potential in thaw cycles of preimplantation genetic testing for aneuploidy (PGT-A) screened embryos?

Summary Answer: Our study findings suggest that LFPE, utilizing a progesterone cutoff value of 2.0 ng/ml, is neither associated with impaired embryonic development, increased rate of embryonic aneuploidy, nor compromised implantation and pregnancy outcomes following a euploid frozen embryo transfer (FET) cycle.

What Is Known Already: Premature progesterone elevation during COH has been associated with lower pregnancy rates due to altered endometrial receptivity in fresh IVF cycles.

Expanded carrier screening for preconception reproductive risk assessment: Prevalence of carrier status in a Mexican population.

Objective: Genetic carrier screening has the potential to identify couples at risk of having a child affected with an autosomal recessive or X-linked disorder. However, the current prevalence of carrier status for these conditions in developing countries is not well defined. This study assesses the prevalence of carrier status of selected genetic conditions utilizing an expanded, pan-ethnic genetic carrier screening panel (ECS) in a large population of Mexican patients.

Conservative treatment versus surgical excision of ovarian dermoid cysts: Impact on ovarian stimulation and IVF cycle success.

Objective: To analyze outcomes of IVF treatment among women diagnosed with an ovarian dermoid cyst (DC).

Methods: Retrospective analysis of women with an ovarian DC who underwent IVF with fresh blastocyst transfer at a single center in New York from January 2010 to March 2018. Outcomes were compared between women with conservative treatment and those with surgical excision of the DC.

Infertile patients with inflammatory bowel disease have comparable in vitro fertilization clinical outcomes to the general infertile population.

To assess clinical outcomes of females diagnosed with Inflammatory Bowel Disease (IBD) and infertility, which underwent in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy. (PGT-A). Retrospective cohort study comparing clinical outcomes of patients with Inflammatory bowel disease who underwent IVF with PGT-A with a subsequent euploid single embryo transfer (SET) against a matched control group.

What is the reproductive potential of day 7 euploid embryos?

Study Question: What is the rate of euploidy and the reproductive potential of embryos biopsied after 6 days of development?

Summary Answer: Embryos biopsied after 6 days of development have higher rates of aneuploidy; however, day 7 euploid embryos selected at transfer can achieve acceptable pregnancy rates and live birth (LB) outcomes.

What Is Known Already: Recent publications have shown promising treatment results after euploid day 7 embryo transfers (ETs), albeit these studies were limited by small sample sizes. Whereas the current clinical standard has been to discard embryos that do not reach expansion by day 6 of development, the lack of robust data surrounding the clinical utility of day 7 embryos warrants further evaluation.

Endometrial preparation before the transfer of single, vitrified-warmed, euploid blastocysts: does the duration of estradiol treatment influence clinical outcome?

Objective: To investigate whether the duration of estrogen administration before euploid embryo transfer affects clinical outcome.

Design: Retrospective cohort study.

Setting: Private, academic fertility center.

Embryo aneuploidy is not impacted by selective serotonin reuptake inhibitor exposure.

Objective: To study whether maternal exposure to selective serotonin reuptake inhibitors (SSRIs) has any influence on rates of blastocyst aneuploidy and/or in vitro fertilization (IVF) cycle outcomes.

Design: Retrospective cohort analysis.

Setting: Private and academic IVF center.

Hatching status before embryo transfer is not correlated with implantation rate in chromosomally screened blastocysts.

Study Question: Do the reproductive outcomes from the transfer of fully hatched (FH) blastocysts differ from those of not fully hatched (NFH) blastocysts?

Summary Answer: Biochemical pregnancy rate (BPR), implantation rate (IR), live birth rate (LBR) and early pregnancy loss (EPL) rate are similar in FH and NFH single euploid blastocyst embryo transfers.

What Is Known Already: The use of extended culture and PGS often leads to transfer of an embryo that is well developed and frequently FH from the zona pellucida. Without the protection of the zona, an FH embryo could be vulnerable to trauma during the transfer procedure.

Comparision of Letrozole with Timed Intercourse Versus Clomiphene Citrate with Intrauterine Insemination in Patients with Unexplained Infertility.

Objective: To evaluate outcomes of patients with unexplained infertility who underwent letrozole (LET)- stimulated controlled ovarian stimulation (COS) with timed sexual intercourse (IC) as compared to patients treated with clomiphene citrate (CC) and intrauterine insemination (IUI).

Study Design: A non- randomized, retrospective study where unexplained in- fertility patients (n=7,764). underwent a COS cycle with both LET and timed IC or with CC and IUI from January 2010-June 2014.

Do elevated TSH levels predict early pregnancy loss in ART patients?

Introduction: The upper limit of normal TSH has been revised from 5 mIU/L to 2.5 mIU/L. We sought to evaluate IVF patients and the association between abnormal TSH and early pregnancy loss.

Reproductive outcome is optimized by genomic embryo screening, vitrification, and subsequent transfer into a prepared synchronous endometrium.

Purpose: The aim of this study is to compare implantation and live birth rates (LBR) between fresh euploid embryo transfers versus cryo-all cycles with a subsequent embryo transfer into a prepared endometrium.

Material And Methods: This is a retrospective cohort study. Patients who underwent an IVF cycle with PGS with trophectoderm biopsy from January 2011 to July 2015 were included.

Embryo selection versus natural selection: how do outcomes of comprehensive chromosome screening of blastocysts compare with the analysis of products of conception from early pregnancy loss (dilation and curettage) among an assisted reproductive technology population?

Objective: To compare the incidence of numerical chromosomal abnormalities (NCAs) reported after preimplantation genetic screening (PGS) analysis compared with that reported after cytogenetic analysis of products of conception after spontaneous abortion.

Design: Retrospective study.

Setting: Private academic in vitro fertilization center.

Maximum basal FSH predicts reproductive outcome better than cycle-specific basal FSH levels: waiting for a "better" month conveys limited retrieval benefits.

Background: Elevated follicle stimulating hormone (FSH) is associated with poor vaginal oocyte retrieval (VOR) outcomes and cycle cancellations but intercycle variability in basal FSH reportedly does not predict ovarian response.

Methods: We conducted a retrospective cohort study of basal FSH (n = 15573 cycles) in couples (n = 9132) who initiated IVF cycle(s) with basal estradiol (E2) <100 pg/mL between 2002 and 2014 to reevaluate this hypothesis. The most recent (current) FSH, maximum FSH (Max FSH) and prior cycle maximum basal FSH (PMax FSH) were computed for each cycle.

Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers.

Objective: To evaluate the relationship of endometrial thickness (EnT) and endometrial pattern (EnP) to euploid embryo transfer (ET) outcomes.

Design: Retrospective cohort.

Setting: Private academic clinic.

Beauty, brains or health: trends in ovum recipient preferences.

Background: What do ovum donation (OD) recipients request most from their ideal donor: beauty, brains, health or physical self-resemblance? Previous data have shown recipients primarily requested "similar appearance or gene pool." We consider the possibility that these criteria may have changed due to a positive social shift towards OD participation and have evaluated recipients' requests for donor criteria over a span of 5 years.

Methods: Donor trait preferences of OD recipients (n=438) enrolled in a private, academic OD program from 2008-2012 were assessed in this retrospective cohort analysis.

Should ICSI be recommended routinely in patients with four or fewer oocytes retrieved?

Purpose: To determine if patients with a low response to controlled ovarian hyperstimulation during IVF benefit from intracytoplasmic sperm injection (ICSI) METHODS: Retrospective analysis of 350 IVF cycles in which four or fewer oocytes were retrieved. Severe male factor cases were excluded from analysis. Conventional insemination (CI) and ICSI were compared, with primary outcome measures of fertilization rate, implantation rate, clinical pregnancy rate per embryo transfer, and pregnancy loss rate.

Parental karyotype may reveal the source of a pregnancy loss even in the presence of a reportedly euploid fetal karyotype.

Objective: To present a case of a fetal loss in which a normal fetal karyotype was obtained by banding studies. Identification of an abnormal maternal karyotype prompted subsequent reanalysis using fluorescence in situ hybridization (FISH).

Design: Case report.

Monozygotic pregnancies conceived by in vitro fertilization: understanding their prognosis.

Objective: To analyze the outcomes and particular characteristics of monozygotic (MZ) pregnancies conceived by in vitro fertilization (IVF).

Design: Retrospective data analysis.

Setting: Large private-academic fertility center.

Advances and controversies in assisted reproductive technology.

As the incidence and awareness of infertility have increased in the last decades, reproductive endocrinologists and scientists have striven to improve the therapeutic options being offered to patients. One of the most advanced and efficient technologies currently being offered is assisted reproductive technology. Among the various techniques that are comprised by assisted reproductive technology, in vitro fertilization is the most widely studied and used, being responsible for approximately 1% of all live births in the United States.

Paternal age and assisted reproductive technology outcome in ovum recipients.

This study suggests that paternal age may be inversely associated with reproductive outcome, as demonstrated by a decline in fertilization, blastocyst formation, implantation and cryopreservation rates with advancing age.

Patients' return to referring physicians and its relation to their infertility duration.

Objective: To determine if length of patient-reported infertility prior to referral to a specialist is related to the likelihood that the patient will return to the referring physician for obstetrical care.

Methods: A review of our medical record database identified 430 consecutive pregnant patients, discharged between January 1, 2003, and March 1, 2004. The name of the referring and discharge obstetrician(s), duration of infertility, prior use of clomiphene citrate, and number of previous clomiphene treatment cycles were recorded.