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Open Access 01-12-2012 | Research

Minimal ovarian stimulation combined with elective single embryo transfer policy: age-specific results of a large, single-centre, Japanese cohort

Authors: Keiichi Kato, Yuji Takehara, Tomoya Segawa, Satoshi Kawachiya, Takashi Okuno, Tamotsu Kobayashi, Daniel Bodri, Osamu Kato

Published in: Reproductive Biology and Endocrinology | Issue 1/2012

Abstract

Background

The two main complications associated with the use of assisted reproduction techniques, ovarian hyperstimulation syndrome and multiple pregnancies, could be eliminated by milder ovarian stimulation protocols and the increased use of a single embryo transfer (SET) policy. A retrospective, cohort study was performed in private infertility centre to evaluate the embryological and clinical results of a large exclusively SET program according to patient age (lower or equal 29, 30–34, 35–39, 40–44 and equal or higher 45 years).

Materials

A total of 7,244 infertile patients have undergone 20,244 cycles with a clomiphene-based minimal stimulation or natural cycle IVF protocol during 2008. Following oocyte retrieval, fertilization and embryo culture a total of 10,401 fresh or frozen single embryo transfer procedures were performed involving cleavage-stage embryos or blastocysts.

Results

Successful oocyte retrieval rate (78.0 %) showed no age-dependent decrease until 45 years. Fertilization (80.3 %) and cleavage (91.1 %) rates were not significantly different between age groups. Blastocyst formation (70.1 % to 22.8 %) and overall live birth rates (35.9 % to 2 %) showed an age-dependent decrease. Frozen-thawed blastocyst transfer cycles gave the highest chance of live birth per embryo transfer (41.3 % to 6.1 %).

Conclusions

High fertilization and cleavage rates were obtained regardless of age whereas blastocyst formation and live birth rates showed an age-dependent decrease. An elective single embryo transfer program based on a minimal ovarian stimulation protocol yields acceptable live birth rates per embryo transfer in infertile patients up until their mid-forties. However in very advanced age patients (equal or higher 45 years old) success rates fall below 1 %.

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Devroey P, Aboulghar M, Garcia-Velasco J, Griesinger G, Humaidan P, Kolibianakis E, Ledger W, Tomas C, Fauser BC: Improving the patient's experience of IVF/ICSI: a proposal for an ovarian stimulation protocol with GnRH antagonist co-treatment. Hum Reprod. 2009, 24: 764-774.CrossRefPubMed

Teramoto S, Kato O: Minimal ovarian stimulation with clomiphene citrate: a large-scale retrospective study. Reprod Biomed Online. 2007, 15: 134-148. 10.1016/S1472-6483(10)60701-8.CrossRefPubMed

Matsuura T, Takehara Y, Kaijima H, Teramoto S, Kato O: Natural IVF cycles may be desirable for women with repeated failures by stimulated IVF cycles. J Assist Reprod Genet. 2008, 25: 163-167. 10.1007/s10815-008-9204-7.PubMedCentralCrossRefPubMed

Kawachiya S, Matsumoto T, Bodri D, Kato K, Takehara Y, Kato O: Short-term, low-dose, non-steroidal anti-inflammatory drug application diminishes premature ovulation in natural-cycle IVF. Reprod Biomed Online. 24: 308-313.

Kuwayama M, Vajta G, Kato O, Leibo SP: Highly efficient vitrification method for cryopreservation of human oocytes. Reprod Biomed Online. 2005, 11: 300-308. 10.1016/S1472-6483(10)60837-1.CrossRefPubMed

Bodri D, Colodron M, Garcia D, Obradors A, Vernaeve V, Coll O: Transvaginal versus transabdominal ultrasound guidance for embryo transfer in donor oocyte recipients: a randomized clinical trial. Fertil Steril. 95: 2263-2268. 2268 e2261

Kawachiya S, Segawa T, Kato K, Takehara Y, Teramoto S, Kato O: The effectiveness of clomiphene citrate in supressing the LH surge in the minimal stimulation protocol. Fertil Steril. 2006, 86 (412): 751-

Orief Y, Dafopoulos K, Al-Hassani S: Should ICSI be used in non-male factor infertility?. Reprod Biomed Online. 2004, 9: 348-356. 10.1016/S1472-6483(10)62152-9.CrossRefPubMed

Tesarik J: Paternal effects on cell division in the human preimplantation embryo. Reprod Biomed Online. 2005, 10: 370-375. 10.1016/S1472-6483(10)61798-1.CrossRefPubMed

10.

Baart EB, Martini E, Eijkemans MJ, Van Opstal D, Beckers NG, Verhoeff A, Macklon NS, Fauser BC: Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo: a randomized controlled trial. Hum Reprod. 2007, 22: 980-988. 10.1093/humrep/del484.CrossRefPubMed

11.

Baird DT, Collins J, Egozcue J, Evers LH, Gianaroli L, Leridon H, Sunde A, Templeton A, Van Steirteghem A, Cohen J, et al: Fertility and ageing. Hum Reprod Update. 2005, 11: 261-276.CrossRefPubMed

12.

van Loendersloot LL, van Wely M, Limpens J, Bossuyt PM, Repping S, van der Veen F: Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis. Hum Reprod Update. 16: 577-589.

13.

Veleva Z, Vilska S, Hyden-Granskog C, Tiitinen A, Tapanainen JS, Martikainen H: Elective single embryo transfer in women aged 36–39 years. Hum Reprod. 2006, 21: 2098-2102. 10.1093/humrep/del137.CrossRefPubMed

14.

Fertility treatment when the prognosis is very poor or futile. Fertil Steril. 2009, 92: 1194-1197.

15.

Bodri D, Guillen JJ, Galindo A, Mataro D, Pujol A, Coll O: Triggering with human chorionic gonadotropin or a gonadotropin-releasing hormone agonist in gonadotropin-releasing hormone antagonist-treated oocyte donor cycles: findings of a large retrospective cohort study. Fertil Steril. 2009, 91: 365-371. 10.1016/j.fertnstert.2007.11.049.CrossRefPubMed

16.

Humaidan P, Papanikolaou EG, Tarlatzis BC: GnRHa to trigger final oocyte maturation: a time to reconsider. Hum Reprod. 2009, 24: 2389-2394. 10.1093/humrep/dep246.CrossRefPubMed

17.

Kawachiya S, Bodri D, Shimada N, Kato K, Takehara Y, Kato O: Blastocyst culture is associated with an elevated incidence of monozygotic twinning after single embryo transfer. Fertil Steril. 95: 2140-2142.

18.

Chang HJ, Suh CS: Ectopic pregnancy after assisted reproductive technology: what are the risk factors?. Curr Opin Obstet Gynecol. 22: 202-207.

Title: Minimal ovarian stimulation combined with elective single embryo transfer policy: age-specific results of a large, single-centre, Japanese cohort
Authors: Keiichi Kato
Yuji Takehara
Tomoya Segawa
Satoshi Kawachiya
Takashi Okuno
Tamotsu Kobayashi
Daniel Bodri
Osamu Kato
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Reproductive Biology and Endocrinology / Issue 1/2012
Electronic ISSN: 1477-7827
DOI: https://doi.org/10.1186/1477-7827-10-35

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Minimal ovarian stimulation combined with elective single embryo transfer policy: age-specific results of a large, single-centre, Japanese cohort

Abstract

Background

Materials

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Materials

Results

Conclusions

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