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This retrospective cohort analysis compared the developmental competence of cryopreserved day-4 and 5 blastocysts, and investigated the effect of progesterone administration duration on the success of artificial frozen embryo transfers. Between October 2015 and March 2016, 868 intracytoplasmic sperm injection blastocyst cryo-all cycles were carried out, with 586 subsequently undergoing frozen embryo transfer. Of these, 243 were day-5 single blastocyst transfers (SBT) and 152 were day-4 SBT. Day-4 blastocysts were transferred on day-5 progesterone (day-4 group) and day-5 blastocysts were transferred on day-5 (short-protocol day-5 sub-group, n = 104) or day-6 (standard-protocol day-5 sub-group, n = 139) progesterone. Although more blastocysts were transferred in the standard-protocol day-5 sub-group ( P = 0.009), pregnancy, clinical pregnancy and live birth rates were similar to those of the day-4 group, but were significantly lower in the short-protocol day-5 sub-group ( P = 0.004, P = 0.008 and P = 0.02 respectively). For optimal outcomes, day-4 blastulating embryos should be prioritized for transfer on day 5 of progesterone and for day-5 blastocysts, transfer should be delayed by 1 day. The retrospective analysis and lack of adjustment for all known confounding variables limit the study. [ABSTRACT FROM AUTHOR]

In this retrospective observational study, the pregnancy, perinatal and obstetric outcomes of patients diagnosed with unicornuate uteri were compared with those of patients with normal uteri after undergoing intracytoplasmic sperm injection (ICSI) with fresh and cryopreserved embryo transfer. From a select population of 9676 infertile patients receiving IVF treatment, 75 (0.78%) were diagnosed with unicornuate uteri between January 2009 and December 2015. Fifty of them underwent ICSI treatment, with 90 fresh and cryopreserved embryo transfers. No significant differences were found between the biochemical, clinical and implantation rates of the first treatment cycles of the two groups; the ongoing pregnancy rate was significantly lower ( P = 0.042; 34.0 versus 53.0%) in the unicornis group, as the result of a clinically higher clinical pregnancy loss rates (22.0 versus 15.9%). Twenty-three clinical pregnancies resulted from the 50 first treatment cycles in the unicornis group, resulting in 14 live births, one ongoing pregnancy, five miscarriages, one ectopic pregnancy and two terminations. The 14 live births were delivered at 35.9 gestational weeks, with seven preterm (<37 weeks) and four low birth weight deliveries. Patients with unicornuate uteri are at increased risk of miscarriage, preterm delivery, low birth weight delivery and reduced live birth rates. [ABSTRACT FROM AUTHOR]

In this matched-controlled study ( n = 300), the effect of hysteroscopic surgery performed concurrently with oocyte retrieval on the reproductive outcomes of intracytoplasmic sperm injection (ICSI) freeze-all cycles was investigated in patients screened for intrauterine anomalies. Conventionally, hysterscopic surgery is performed in a different cycle from IVF, delaying treatment completion and increasing patient anxiety. One hundred and fifty patients who had hysteroscopic surgery concurrently with oocyte retrieval (hysteroscopy group) in ICSI freeze-all cycles were matched according to age and oocyte number with 150 ICSI freeze-all cycles, in which the patients required no hysteroscopy (control group). In the hysteroscopy group, hysteroscopy was performed for diagnostic ( n = 5) and therapeutic ( n = 145) purposes. Blastocyst culture and Cryotop vitrification was performed in both groups. Frozen embryo transfer (FET) was successfully performed in the hysteroscopy group from 35 days after oocyte retrieval. No significant differences were observed for implantation, pregnancy, clinical pregnancy and early pregnancy loss rates in the hysteroscopy and control groups (48.9%, 72.0%, 61.3% and 14.8% versus 48.3%, 75.3%, 64.7% and 14.3%, respectively). Performing hysteroscopic surgery concurrently with oocyte retrieval in a segmented-IVF programme has no negative impact on reproductive outcomes, increases efficiency, and provides patients with low-risk treatment. [ABSTRACT FROM AUTHOR]

This study investigated the use of hysteroscopic Essure device placement for the treatment of hydrosalpinx-related infertility in patients with laparoscopic contraindications and compared their pregnancy outcomes following assisted conception treatment with those of patients having had laparoscopic tubal ligation. A total of 102 infertile patients were diagnosed with unilateral or bilateral hydrosalpinges: 26 patients had laparoscopic contraindications and were treated hysterscopically and 76 patients were treated laparoscopically. In total, 66 intracytoplasmic sperm injection (ICSI) and 39 frozen embryo transfer (FET) procedures were performed. In the hysteroscopy group, 13 ICSI and eight FET in 16 patients resulted in 10 pregnancies (pregnancy rates 47.6% per transfer and 62.5% per patient), and in the laparoscopy group, 53 ICSI and 31 FET embryo transfers in 54 patients resulted in 36 pregnancies (pregnancy rates 42.9% per transfer and 66.7% per patient). Live birth rates per assisted reproduction procedure were 23.8% (5/21) in the hysteroscopy group and 32.1% (27/84) for the laparoscopy group. The hysteroscopic placement of Essure devices to isolate hydrosalpinx prior to assisted conception treatment produced pregnancy outcomes comparable to those produced following laparoscopic tubal ligation. The live birth rates indicate that a larger, more comparative, prospectively randomized study is required. [ABSTRACT FROM AUTHOR]

What is the effect of frozen embryo transfer (FET) on infant birth weight outcomes and which variables predic large-for-gestational age (LGA) infants. In a large cohort study, the birth weight of 1295 singleton live births from blastocyst freeze-all-IVF treatments carried out between February 2015 and February 2017 at a single IVF centre were analysed. All embryo transfers were vitrified–warmed blastocyst transfers in artificial FET cycles, with patients having one (n = 864) or two (n = 431) blastocysts transferred. All live births were from ultrasound confirmed single fetal heart pregnancies. The mean gestational age at delivery was 38.2 (±1.7) weeks, with a 1.11 : 1 female to male ratio for infants delivered. The small and large-for-gestational age rates were 5.02 and 13.28%, with 81.7% of infants appropriate for gestational age. In a multiple logistic regression analysis, the independent variables selected in the model to predict having an LGA infant were maternal parity, infant gender and maternal body mass index (BMI). The risk for LGA at term was significantly higher for male infants when adjusting for maternal parity and BMI (2.8 OR 1.805 to 4.450; P < 0.001). The present study showed that fetal growth of artificial cycle FET pregnancies resulted in an 13.28% LGA infant rate that was mostly male gender dependent. [ABSTRACT FROM AUTHOR]