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16. Cervical conization doubles the risk of preterm and very preterm birth in assisted reproductive technology twin pregnancies

Author

Pinborg, A, Ortoft, G, Loft, A, Rasmussen, S C, Ingerslev, H J, Pinborg, A, Ortoft, G, Loft, A, Rasmussen, S C, and Ingerslev, H J

Abstract

STUDY QUESTION: Does cervical conization add an additional risk of preterm birth (PTB) in assisted reproduction technology (ART) singleton and twin pregnancies?SUMMARY ANSWER: Cervical conization doubles the risk of preterm and very PTB in ART twin pregnancies.WHAT IS KNOWN ALREADY: ART and cervical conization are both risk factors for PTB.STUDY DESIGN, SIZE, DURATION: In this national population-based controlled cohort study, we included all ART singletons and twin deliveries from 1995 to 2009 in Denmark by cross-linkage of maternal and child data from the National IVF register and the Medical Birth register. Furthermore, control groups of naturally conceived (NC) singletons and twins were extracted. Cervical diagnoses were obtained from the Danish Pathology register. Cervical conization included both cold knife cone and LEEP (loop electrosurgical excision procedure) but not cervical biopsies. The main outcomes measures were PTB (PTB ≤ 37 + 0 gestational weeks), very preterm birth (VPTB ≤ 32 + 0 gestational weeks) and preterm premature rupture of membranes (PPROM).PARTICIPANTS/MATERIALS, SETTING, METHODS: In all 16 923 ART singletons and 4829 ART twin deliveries were included. A random sample of NC singletons, 2-fold the size of the ART singleton group matched by date and year of birth (n = 33 835) and all NC twin deliveries (n = 15 112), was also extracted. Multiple logistic regression analyses were performed to adjust for the following confounders: maternal age, parity, year of child birth and sex of child.MAIN RESULTS AND THE ROLE OF CHANCE: Cervical morbidity (dysplasia and conization) was more often observed in ART pregnancies (6.2% of ART singletons and 5.4% ART twins) than in NC pregnancies (4.2% for NC singletons and 4.5% for NC twins), both for singletons and twins. In ART singleton deliveries, the PTB rate was 13.1 versus 8.2% in women with and without conization, respectively, with an adjusted odds ratio (aOR) of 1.5

Published
2015

17. Elective embryo transfers on Day 6 reduce implantation compared with transfers on Day 5.

Author

Poulsen, V., Ingerslev, H. J., and Kirkegaard, K.

Subjects
*EMBRYO transfer, *BLASTOCYST, *PREGNANCY, *HUMAN embryos, *ENDOMETRIOSIS, *INFERTILITY treatment, *BIRTH rate, *COMPARATIVE studies, *CRYOPRESERVATION of organs, tissues, etc., *FAMILIES, *FERTILIZATION in vitro, *HUMAN reproduction, *INFERTILITY, *LONGITUDINAL method, *MATERNAL age, *RESEARCH methodology, *MEDICAL cooperation, *MEDICAL protocols, *RESEARCH, *TIME, *LOGISTIC regression analysis, *EVALUATION research, *RETROSPECTIVE studies
Abstract

Study Question: Is there a difference in pregnancy rates between embryos transferred electively on Day 5 and Day 6, respectively?Summary Answer: The chance of pregnancy is significantly reduced (odds ratio (OR): 0.34; 95% CI 0.22-0.52) if transfer is performed on Day 6 compared with Day 5.What Is Known Already: Several studies report that Day 5 transfers have higher implantation rates (IRs) when compared with Day 6 transfers. These studies were based on non-elective Day 6 transfers, where transfers on Day 6 were performed with developmentally delayed embryos. Traditionally, difference in IRs has therefore been explained by an impaired embryo quality. An alternative explanation is that endometrial receptivity is higher on Day 5 compared with Day 6.Study Design, Size, Duration: The study was conducted as a retrospective cohort follow-up study on single blastocyst transfers from February 2011 until August 2015 in patients aged <38 years, with ≥eight oocytes retrieved and no diagnosis of endometriosis. Non-elective Day 6 transfers were excluded. Post hoc power-calculations (two-sided level of significance 0.05, power of 0.80) indicate that 91 embryos were needed in each group to detect a reduction in IR (primary outcome) from 40 to 20%.Participants/materials, Setting, Methods: Day 5 or Day 6 transfers were implemented accordingly: from 2011 till 2013, transfers were performed on Day 6. If Day 6 was a Sunday, patients received Day 5 transfers. From 2013 onward, blastocysts were transferred on Day 5. If Day 5 was a Sunday, the transfer was delayed to Day 6. Univariable logistic regression analysis was performed to identify potential confounders. Factors with a P-value <0.1 were included in the multivariable logistic regression analysis.Main Results and the Role Of Chance: We included 334 single elective Day 5 and 268 elective Day 6 transfers. The unadjusted odds for implantation between Day 5 and Day 6 groups were 0.35 (95% CI 0.25-0.49). A univariable logistic regression analysis identified maternal age, BMI, cumulative FSH dose, number of cryopreserved embryos, score of inner cell mass and trophectoderm and day of transfer as predictors of clinical pregnancy. When adjusting for these variables in a multivariable logistic regression analysis, the implantation odds for Day 5 transfer remained significantly higher than Day 6 (OR 0.34; 95% CI 0.22-0.52).Limitations, Reasons For Caution: The study was conducted on good prognosis patients. The majority of Day 6 transfers were performed in the beginning of the study period. Day 5 transfers were generally performed in the end of the study period. This difference in time of recruitment may cause a minor variation in the data but a subanalysis indicates that this potential variation is negligible. Day 5 scores were higher in the Day 5 transfer group.Wider Implications Of the Findings: Based on the findings in this study, transfers should be performed on Day 5. If Day 5 transfers are logistically impossible to perform, it is be preferable to cryopreserve the blastocyst and transfer in another cycle on Day 5, as Day 6 transfers should be avoided.Study Funding/competing Interest(s): None. [ABSTRACT FROM AUTHOR]

Published
2017
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25. Session 57: Time lapse: the real revolution for ambryo assessment?

Author

Tejera, A., primary, Herrero, J., additional, Rubio, I., additional, Castello, D., additional, Pellicer, A., additional, Meseguer, M., additional, Iwata, K., additional, Yumoto, K., additional, Ueda, M., additional, Matoba, Y., additional, Kamada, Y., additional, Furuyama, S., additional, Mizoguchi, C., additional, Sargent, H. C., additional, Kai, Y., additional, Tsuchie, Y., additional, Iba, Y., additional, Mio, Y., additional, Wirka, K. A., additional, Suraj, K., additional, Conaghan, J., additional, Gvakharia, M., additional, Ivani, K., additional, Murugesan, R., additional, Chen, A. A., additional, Shen, S., additional, Sundvall, L., additional, Ingerslev, H. J., additional, Knudsen, U. B., additional, Kirkegaard, K., additional, Best, L., additional, Campbell, A., additional, Duffy, S., additional, Montgomery, S., additional, Fishel, S., additional, Montag, M., additional, Toth, B., additional, Weigert, J., additional, Strowitzki, T., additional, Kumtepe, Y., additional, Kahraman, S., additional, Cetinkaya, M., additional, Pirkevi, C., additional, and Yelke, H., additional

Published
2013
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26. Session 15: Embryo and culture environment

Author

Kirkegaard, K., primary, Svane, A. S. P., additional, Hindkjaer, J. J., additional, Nielsen, N. C., additional, Ingerslev, H. J., additional, Gook, D. A., additional, Riordan, K., additional, Edgar, D. H., additional, Sheedy, J. R., additional, Gardner, D. K., additional, Wolff, H., additional, Fredrickson, J., additional, Baumann, N., additional, Moyer, T., additional, Matern, D., additional, Morbeck, D., additional, Scalici, E., additional, Astruc, K., additional, Jimenez, C., additional, Duvillard, L., additional, Gautier, T., additional, Huot, M. N., additional, Girod, S., additional, Schmutz, E., additional, Lagrost, L., additional, Sagot, P., additional, Drouineaud, V., additional, Drury, S. L., additional, Taylor, D., additional, Gadd, S. C., additional, and Hartshorne, G. M., additional

Published
2013
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29. SESSION 16: EMBRYOLOGY - EMBRYO IN MOTION

Author

Ingerslev, H., primary, Hindkjaer, J., additional, Kirkegaard, K., additional, Teranishi, Y., additional, Ando, H., additional, Takayanagi, T., additional, Suzuki, N., additional, Moroi, H., additional, Mukai, M., additional, Shen, S., additional, Chen, A. A., additional, Willman, S. P., additional, Chenette, P. E., additional, Boostanfar, R., additional, Baker, V. L., additional, Abusief, M., additional, Suraj, V., additional, Wirka, K., additional, Loewke, K., additional, Meseguer, M., additional, Tejera, A., additional, Herrero, J., additional, de los Santos, M., additional, Viloria, T., additional, Remohi, J., additional, Gamiz, P., additional, Basile, N., additional, Munoz, M., additional, Marcos, J., additional, and Requena, A., additional

Published
2012
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30. SESSION 02: EMBRYOLOGY - BIOMARKERS

Author

Zaninovic, N., primary, Rosenwaks, Z., additional, Iager, A. E., additional, Kocabas, A. M., additional, Otu, H. H., additional, Ruppel, P., additional, Langerveld, A., additional, Schnarr, P., additional, Suarez, M., additional, Jarrett, J. C., additional, Conaghan, J., additional, Rosa, G. J. M., additional, Fernandez, E., additional, Rawlins, R. G., additional, Cibelli, J. B., additional, Crosby, J., additional, Kirkegaard, K., additional, Hindkjaer, J., additional, Ingerslev, H. J., additional, Lykke-Hartmann, K., additional, Himaya, E., additional, Jamal, W., additional, Phillips, S., additional, Delrieu, D., additional, Hamamah, S., additional, Kadoch, I. J., additional, Cortezzi, S. S., additional, Cabral, E. C., additional, Ferreira, C. R., additional, Trevisan, M. G., additional, Figueira, R. C. S., additional, Eberlin, M. N., additional, Iaconelli, A., additional, Borges, E., additional, Chimote, N. M., additional, Chimote, N. N., additional, Nath, N. M., additional, Chimote, M. N., additional, and Mehta, B. N., additional

Published
2012
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31. SESSION 53: CONFOUNDING FACTORS IN ART

Author

Matteo, M., primary, Greco, P., additional, Levi Setti, P., additional, Stracci, F., additional, De Rosario, F., additional, Massenzio, F., additional, Albani, E., additional, Falagario, T., additional, Liso, A., additional, Chavarro, J. E., additional, Colaci, D. S., additional, Afeiche, M., additional, Gaskins, A. J., additional, Wright, D., additional, Toth, T. L., additional, Hauser, R., additional, Schram, C., additional, Tullis, E., additional, Stephenson, A., additional, Hannam, T., additional, Kesmodel, U. S., additional, Cristensen, M. W., additional, Degn, B., additional, and Ingerslev, H. J., additional

Published
2012
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33. POSTER VIEWING SESSION - EMBRYOLOGY

Author

Fourati Ben Mustapha, S., primary, Khrouf, M., additional, Kacem Ben Rejeb, K., additional, Elloumi Chaabene, H., additional, Merdassi, G., additional, Wahbi, D., additional, Ben Meftah, M., additional, Zhioua, F., additional, Zhioua, A., additional, Azzarello, A., additional, Host, T., additional, Mikkelsen, A. L., additional, Theofanakis, C. P., additional, Dinopoulou, V., additional, Mavrogianni, D., additional, Partsinevelos, G. A., additional, Drakakis, P., additional, Stefanidis, K., additional, Bletsa, A., additional, Loutradis, D., additional, Rienzi, L., additional, Cobo, A., additional, Paffoni, A., additional, Scarduelli, C., additional, Capalbo, A., additional, Garrido, N., additional, Remohi, J., additional, Ragni, G., additional, Ubaldi, F. M., additional, Herrer, R., additional, Quera, M., additional, GIL, E., additional, Serna, J., additional, Grondahl, M. L., additional, Bogstad, J., additional, Agerholm, I. E., additional, Lemmen, J. G., additional, Bentin-Ley, U., additional, Lundstrom, P., additional, Kesmodel, U. S., additional, Raaschou-Jensen, M., additional, Ladelund, S., additional, Guzman, L., additional, Ortega, C., additional, Albuz, F. K., additional, Gilchrist, R. B., additional, Devroey, P., additional, Smitz, J., additional, De Vos, M., additional, Bielanska, M., additional, Leveille, M. C., additional, Borghi, E., additional, Magli, M. C., additional, Figueroa, M. J., additional, Mascaretti, G., additional, Ferraretti, A. P., additional, Gianaroli, L., additional, Szlit, E., additional, Leocata Nieto, F., additional, Maggiotto, G., additional, Arenas, G., additional, Tarducci Bonfiglio, N., additional, Ahumada, A., additional, Asch, R., additional, Sciorio, R., additional, Dayoub, N., additional, Thong, J., additional, Pickering, S., additional, Ten, J., additional, Carracedo, M. A., additional, Guerrero, J., additional, Rodriguez-Arnedo, A., additional, Llacer, J., additional, Bernabeu, R., additional, Tatone, C., additional, Heizenrieder, T., additional, Di Emidio, G., additional, Treffon, P., additional, Seidel, T., additional, Eichenlaub-Ritter, U., additional, Cortezzi, S. S., additional, Cabral, E. C., additional, Ferreira, C. R., additional, Trevisan, M. G., additional, Figueira, R. C. S., additional, Braga, D. P. A. F., additional, Eberlin, M. N., additional, Iaconelli Jr., A., additional, Borges Jr., E., additional, Zabala, A., additional, Pessino, T., additional, Blanco, L., additional, Rey Valzacchi, G., additional, Leocata, F., additional, Vanden Meerschaut, F., additional, Heindryckx, B., additional, Qian, C., additional, Deforce, D., additional, Leybaert, L., additional, De Sutter, P., additional, De las Heras, M., additional, De Pablo, J. L., additional, Navarro, B., additional, Agirregoikoa, J. A., additional, Barrenetxea, G., additional, Cruz, M., additional, Perez-Cano, I., additional, Gadea, B., additional, Herrero, J., additional, Martinez, M., additional, Roldan, M., additional, Munoz, M., additional, Pellicer, A., additional, Meseguer, M., additional, Galindo, N., additional, Scarselli, F., additional, Alviggi, E., additional, Colasante, A., additional, Minasi, M. G., additional, Rubino, P., additional, Lobascio, M., additional, Ferrero, S., additional, Litwicka, K., additional, Varricchio, M. T., additional, Giannini, P., additional, Piscitelli, P., additional, Franco, G., additional, Zavaglia, D., additional, Nagy, Z. P., additional, Greco, E., additional, Urner, F., additional, Wirthner, D., additional, Murisier, F., additional, Mock, P., additional, Germond, M., additional, Amorocho Llanos, B., additional, Calderon, G., additional, Lopez, D., additional, Fernandez, L., additional, Nicolas, M., additional, Landeras, J., additional, Finn-Sell, S. L., additional, Leandri, R., additional, Fleming, T. P., additional, Macklon, N. S., additional, Cheong, Y. C., additional, Eckert, J. J., additional, Lee, J. H., additional, Jung, Y. J., additional, Hwang, H. K., additional, Kang, A., additional, An, S. J., additional, Jung, J. Y., additional, Kwon, H. C., additional, Lee, S. J., additional, Palini, S., additional, Zolla, L., additional, De Stefani, S., additional, Scala, V., additional, D'Alessandro, A., additional, Polli, V., additional, Rocchi, P., additional, Tiezzi, A., additional, Pelosi, E., additional, Dusi, L., additional, Bulletti, C., additional, Fadini, R., additional, Lain, M., additional, Mignini Renzini, M., additional, Brambillasca, F., additional, Coticchio, G., additional, Merola, M., additional, Guglielmo, M. C., additional, Dal Canto, M., additional, Figueira, R., additional, Setti, A. S., additional, Worrilow, K. C., additional, Uzochukwu, C. D., additional, Eid, S., additional, Le Gac, S., additional, Esteves, T. C., additional, van Rossem, F., additional, van den Berg, A., additional, Boiani, M., additional, Kasapi, E., additional, Panagiotidis, Y., additional, Goudakou, M., additional, Papatheodorou, A., additional, Pasadaki, T., additional, Prapas, N., additional, Prapas, Y., additional, Vanderzwalmen, P., additional, Norasing, S., additional, Atchajaroensatit, P., additional, Tawiwong, W., additional, Thepmanee, O., additional, Saenlao, S., additional, Aojanepong, J., additional, Hunsajarupan, P., additional, Sajjachareonpong, K., additional, Punyatanasakchai, P., additional, Maneepalviratn, S., additional, Jetsawangsri, U., additional, Tejera, A., additional, Rubio, I., additional, Romero, J. L., additional, Nordhoff, V., additional, Schlatt, S., additional, Schuring, A. N., additional, Kiesel, L., additional, Kliesch, S., additional, Azambuja, R., additional, Okada, L., additional, Lazzari, V., additional, Dorfman, L., additional, Michelon, J., additional, Badalotti, M., additional, Badalotti, F., additional, Petracco, A., additional, Schwarzer, C., additional, Versieren, K., additional, De Croo, I., additional, Lierman, S., additional, De Vos, W., additional, Van den Abbeel, E., additional, Gerris, J., additional, Milacic, I., additional, Borogovac, D., additional, Veljkovic, M., additional, Arsic, B., additional, Jovic Bojovic, D., additional, Lekic, D., additional, Pavlovic, D., additional, Garalejic, E., additional, Albertini, D. F., additional, De Ponti, E., additional, Sanges, F., additional, Talevi, R., additional, Papini, L., additional, Mollo, V., additional, Rienzi, L. F., additional, Gualtieri, R., additional, Orteg, C., additional, Choi, J., additional, Lee, H., additional, Ku, S., additional, Kim, S., additional, Choi, Y., additional, Kim, J., additional, Moon, S., additional, Demilly, E., additional, Assou, S., additional, Moussaddykine, S., additional, Dechaud, H., additional, Hamamah, S., additional, Takisawa, T., additional, Doshida, M., additional, Hattori, H., additional, Nakamura, Y., additional, Kyoya, T., additional, Shibuya, Y., additional, Nakajo, Y., additional, Tasaka, A., additional, Toya, M., additional, Kyono, K., additional, Novo, S., additional, Penon, O., additional, Gomez, R., additional, Barrios, L., additional, Duch, M., additional, Santalo, J., additional, Esteve, J., additional, Nogues, C., additional, Plaza, J. A., additional, Perez-Garcia, L., additional, Ibanez, E., additional, Chavez, S., additional, Loewke, K., additional, Behr, B., additional, Reijo Pera, R., additional, Huang, S., additional, Wang, H., additional, Soong, Y., additional, Chang, C., additional, Okimura, T., additional, Kuwayama, M., additional, Mori, C., additional, Morita, M., additional, Uchiyama, K., additional, Aono, F., additional, Kato, K., additional, Takehara, Y., additional, Kato, O., additional, Minasi, M., additional, Casciani, V., additional, Arizzi, L., additional, Mencacci, C., additional, Piscitelli, C., additional, Cucinelli, F., additional, Tocci, A., additional, Wydooghe, E., additional, Vandaele, L., additional, Dewulf, J., additional, Van Soom, A., additional, Moon, J. H., additional, Son, W. Y., additional, Mahfoudh, A., additional, Henderson, S., additional, Jin, S. G., additional, Shalom-Paz, E., additional, Dahan, M., additional, Holzer, H., additional, Mahmoud, K., additional, Triki-Hmam, C., additional, Terras, K., additional, Hfaiedh, T., additional, Ben Aribia, M. H., additional, Otsubo, H., additional, Egashira, A., additional, Tanaka, K., additional, Matsuguma, T., additional, Murakami, M., additional, Murakami, K., additional, Otsuka, M., additional, Yoshioka, N., additional, Araki, Y., additional, Kuramoto, T., additional, Smit, J. G., additional, Sterrenburg, M. D., additional, Eijkemans, M. J. C., additional, Al-Inany, H. G., additional, Youssef, M. A. F. M., additional, Broekmans, F. J. M., additional, Willoughby, K., additional, DiPaolo, L., additional, Deys, L., additional, Lagunov, A., additional, Amin, S., additional, Faghih, M., additional, Hughes, E., additional, Karnis, M., additional, Ashkar, F., additional, King, W. A., additional, Neal, M. S., additional, Antonova, I., additional, Veleva, L., additional, Petkova, L., additional, Shterev, A., additional, Nogales, C., additional, Martinez, E., additional, Ariza, M., additional, Cernuda, D., additional, Gaytan, M., additional, Linan, A., additional, Guillen, A., additional, Bronet, F., additional, Cottin, V., additional, Fabian, D., additional, Allemann, F., additional, Koller, A., additional, Spira, J. C., additional, Agudo, D., additional, Martinez-Burgos, M., additional, Arnanz, A., additional, Basile, N., additional, Rodriguez, A., additional, Cho, Y. S., additional, Filioli Uranio, M., additional, Ambruosi, B., additional, Paternoster, M. S., additional, Totaro, P., additional, Sardanelli, A. M., additional, Dell'Aquila, M. E., additional, Zollner, U., additional, Hofmann, T., additional, Zollner, K. P., additional, Kovacic, B., additional, Roglic, P., additional, Vlaisavljevic, V., additional, Sole, M., additional, Boada, M., additional, Coroleu, B., additional, Veiga, A., additional, Martiny, G., additional, Molinari, M., additional, Revelli, A., additional, Chimote, N. M., additional, Chimote, M., additional, Mehta, B., additional, Chimote, N. N., additional, Sheikh, N., additional, Nath, N., additional, Mukherjee, A., additional, Rakic, K., additional, Reljic, M., additional, Ingerslev, H. J., additional, Kirkegaard, K., additional, Hindkjaer, J., additional, Agerholm, I., additional, Kitasaka, H., additional, Fukunaga, N., additional, Nagai, R., additional, Yoshimura, T., additional, Tamura, F., additional, Kitamura, K., additional, Hasegawa, N., additional, Nakayama, K., additional, Katou, M., additional, Itoi, F., additional, Asano, E., additional, Deguchi, N., additional, Ooyama, K., additional, Hashiba, Y., additional, Asada, Y., additional, Michaeli, M., additional, Rotfarb, N., additional, Karchovsky, E., additional, Ruzov, O., additional, Atamny, R., additional, Slush, K., additional, Fainaru, O., additional, Ellenbogen, A., additional, Chekuri, S., additional, Chaisrisawatsuk, T., additional, Chen, P., additional, Pangestu, M., additional, Jansen, S., additional, Catt, S., additional, Molinari, E., additional, Racca, C., additional, Ryu, C., additional, Kang, S., additional, Lee, J., additional, Chung, D., additional, Roh, S., additional, Chi, H., additional, Yokota, Y., additional, Yokota, M., additional, Yokota, H., additional, Sato, S., additional, Nakagawa, M., additional, Komatsubara, M., additional, Makita, M., additional, Oyama, K., additional, Naruse, K., additional, Kilani, S., additional, Chapman, M. G., additional, Kwik, M., additional, Chapman, M., additional, Guven, S., additional, Odaci, E., additional, Yildirim, O., additional, Kart, C., additional, Unsal, M. A., additional, Yulug, E., additional, Isachenko, E., additional, Maettner, R., additional, Strehler, E., additional, Isachenko, V., additional, Hancke, K., additional, Kreienberg, R., additional, Sterzik, K., additional, Zheng, X. Y., additional, Wang, L. N., additional, Liu, P., additional, Qiao, J., additional, Inoue, F., additional, Dashtizad, M., additional, Wahid, H., additional, Rosnina, Y., additional, Daliri, M., additional, Hajarian, H., additional, Akbarpour, M., additional, Abbas Mazni, O., additional, Knez, K., additional, Tomaevic, T., additional, Vrtacnik Bokal, E., additional, Zorn, B., additional, Virant Klun, I., additional, Koster, M., additional, Liebenthron, J., additional, Nicolov, A., additional, van der Ven, K., additional, van der Ven, H., additional, Montag, M., additional, Fayazi, M., additional, Salehnia, M., additional, Beigi Boroujeni, M., additional, Khansarinejad, B., additional, Deignan, K., additional, Emerson, G., additional, Mocanu, E., additional, Wang, J. J., additional, Andonov, M., additional, Linara, E., additional, Ahuja, K. K., additional, Nachef, S., additional, Pasqualotto, F. F., additional, Pasqualotto, E., additional, Chang, C. C., additional, Bernal, D. P., additional, Elliott, T. A., additional, Shapiro, D. B., additional, Toledo, A. A., additional, Economou, K., additional, Davies, S., additional, Argyrou, M., additional, Doriza, S., additional, Sisi, P., additional, Moschopoulou, M., additional, Karagianni, A., additional, Mendorou, C., additional, Polidoropoulos, N., additional, Papanicopoulos, C., additional, Stefanis, P., additional, Karamalegos, C., additional, Cazlaris, H., additional, Koutsilieris, M., additional, Mastrominas, M., additional, Gotts, S., additional, Doshi, A., additional, Harper, J., additional, Serhal, P., additional, Borini, A., additional, Guzeloglu-Kayisli, O., additional, Bianchi, V., additional, Seli, E., additional, Lappi, M., additional, Bonu, M. A., additional, Mizuta, S., additional, Hashimoto, H., additional, Kuroda, Y., additional, Matsumoto, Y., additional, Mizusawa, Y., additional, Ogata, S., additional, Yamada, S., additional, Kokeguchi, S., additional, Noda, Y., additional, Shiotani, M., additional, Stojkovic, M., additional, Ilic, M., additional, Markovic, N., additional, Stojkovic, P., additional, Feng, G., additional, Zhang, B., additional, Zhou, H., additional, Zhou, L., additional, Gan, X., additional, Qin, X., additional, Shu, J., additional, Wu, F., additional, Molina Botella, I., additional, Lazaro Ibanez, E., additional, Debon Aucejo, A., additional, Pertusa, J., additional, Fernandez Colom, P. J., additional, Li, C., additional, Zhang, Y., additional, Cui, Y., additional, Zhao, H., additional, Liu, J., additional, Oliveira, J. B. A., additional, Petersen, C. G., additional, Mauri, A. L., additional, Massaro, F. C., additional, Silva, L. F. I., additional, Ricci, J., additional, Cavagna, M., additional, Pontes, A., additional, Vagnini, L. D., additional, Baruffi, R. L. R., additional, Franco Jr., J. G., additional, Felipe, V., additional, Vilela, M., additional, Tiveron, M., additional, Lombardi, C., additional, Viglierchio, M. I., additional, Marconi, G., additional, Rawe, V., additional, Wale, P. L., additional, Gardner, D. K., additional, Nakagawa, K., additional, Sugiyama, R., additional, Nishi, Y., additional, Kuribayashi, Y., additional, Jyuen, H., additional, Yamashiro, E., additional, Shirai, A., additional, Inoue, M., additional, Hovatta, O., additional, Tohonen, V., additional, Inzunza, J., additional, Parmegiani, L., additional, Cognigni, G. E., additional, Bernardi, S., additional, Ciampaglia, W., additional, Infante, F. E., additional, Tabarelli de Fatis, C., additional, Pocognoli, P., additional, Arnone, A., additional, Maccarini, A. M., additional, Troilo, E., additional, Filicori, M., additional, Radwan, P., additional, Polac, I., additional, Borowiecka, M., additional, Bijak, M., additional, and Radwan, M., additional

Published
2011
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34. POSTER VIEWING SESSION - PSYCHOLOGY AND COUNSELLING

Author

Daly, I., primary, Lampic, C., additional, Skoog Svanberg, A., additional, Sydsjo, G., additional, Fryk, N., additional, Shyshak, O., additional, Donarelli, Z., additional, Lo Coco, G., additional, Gullo, S., additional, Marino, A., additional, Volpes, A., additional, Allegra, A., additional, Hinton, L., additional, Kurinczuk, J. J., additional, Ziebland, S., additional, Frederiksen, Y., additional, Zachariae, R., additional, Schmidt, L., additional, Ingerslev, H. J., additional, Vercammen, L., additional, Stoop, D., additional, De Vos, M., additional, Polyzos, N. P., additional, Nekkebroeck, J., additional, Devroey, P., additional, Graham, S., additional, Jadva, V., additional, Morrissette, M., additional, Golombok, S., additional, Hamilton, J., additional, Behan, H., additional, Venables, R., additional, Maher, B., additional, Moorhead, C., additional, Hughes, C., additional, Mocanu, E., additional, Smeenk, J. M. J., additional, Verhaak, C. M., additional, Valladolid, N., additional, Guijarro, J. A., additional, Brod, M., additional, Simone Crespi, M. P. H., additional, Hein Fennema, P., additional, Blake, L., additional, Readings, J., additional, Casey, P., additional, Jordan, C., additional, Broderick, P., additional, Winter, C., additional, Belva, F., additional, Bondulle, M., additional, Van den Broeck, U., additional, Vandermeeren, M., additional, Vanderschueren, D., additional, Enzlin, P., additional, Demyttenaere, K., additional, D'Hooghe, T. M., additional, Harrison, C., additional, Bunting, L., additional, Tsibulsky, I., additional, Boivin, J., additional, Overbeek, A., additional, van den Berg, M. H., additional, Louwe, L., additional, Hilders, C., additional, Veening, M. A., additional, Lambalk, C. B., additional, Stiggelbout, A. M., additional, van Dulmen-den Broeder, E., additional, Ter Kuile, M. M., additional, Indekeu, A., additional, D'Hooghe, T., additional, De Sutter, P., additional, Vanderschot, B., additional, Welkenhuysen, M., additional, Rober, P., additional, Colpin, H., additional, Riedel, P., additional, Baeckert-Sifedine, I. T., additional, Iversen C., V., additional, Ludwig, O., additional, Ludwig, S., additional, Kentenich, H., additional, Brandstrom, S., additional, Geijervall, A. L., additional, Gudmundsson, J., additional, Karlstrom, P. O., additional, Solensten, N. G., additional, Van Dongen, A. J. C. M., additional, Kremer, J. A. M., additional, Van Sluisveld, P. H. J., additional, Nelen, W. L. D. M., additional, Galhardo, A., additional, Cunha, M., additional, Pinto-Gouveia, J., additional, Huppelschoten, D. A., additional, Aarts, J. W. M., additional, van Empel, I. W. H., additional, Nelen, W. L., additional, Ockhuysen, H., additional, Hoogen, A., additional, Macklon, N. S., additional, Aarts, A., additional, van den Haak, P., additional, Nelen, W., additional, Tuil, W., additional, Faber, M., additional, Kremer, J., additional, Bak, C. W., additional, Seok, H. H., additional, Song, S. H., additional, Yoo, S. W., additional, Lee, W. S., additional, and Yoon, T. K., additional

Published
2011
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35. SELECTED ORAL COMMUNICATION SESSION, SESSION 36: ANEUPLOIDY, Tuesday 5 July 2011 10:00 - 11:30

Author

Brezina, P., primary, Nguyen, K. H. D., additional, Benner, A. T., additional, Du, L., additional, Ross, R., additional, Barker, A., additional, Anchan, R. M., additional, Richter, K., additional, Kearns, W. G., additional, Kirkegaard, K., additional, Hindkjaer, J., additional, Ingerslev, H. J., additional, Garcia-Guixe, E., additional, Jimenez-Macedo, A., additional, Arjona, C., additional, Gimenez, C., additional, Sandalinas, M., additional, Mizutani, E., additional, Suzumori, N., additional, Ozaki, Y., additional, Oseto, K., additional, Yamada-Namikawa, C., additional, Nakanishi, M., additional, Sugiura-Ogasawara, M., additional, Borges, E., additional, Figueira, R. C. S., additional, Braga, D. P. A. F., additional, Pasqualetto, F. F., additional, Setti, A. S., additional, Iaconelli, A., additional, Tolmacheva, E. N., additional, Kashevarova, A. A., additional, Sukhanova, N. N., additional, and Lebedev, I. N., additional

Published
2011
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40. Timing of human preimplantation embryonic development is confounded by embryo origin.

Author

Kirkegaard, K., Sundvall, L., Erlandsen, M., Hindkjær, J. J., Knudsen, U. B., and Ingerslev, H. J.

Subjects
EMBRYO transfer, BIOMARKERS, FERTILITY clinics, OVUM, BLASTOCYST, CONCEPTION, FERTILIZATION in vitro, FOLLICLE-stimulating hormone, HUMAN reproductive technology, LONGITUDINAL method, MATERNAL age, EVALUATION of medical care, MULTIVARIATE analysis, PREGNANCY, REGRESSION analysis, TIME, FETAL development, THERAPEUTICS
Abstract

Study Question: To what extent do patient- and treatment-related factors explain the variation in morphokinetic parameters proposed as embryo viability markers?Summary Answer: Up to 31% of the observed variation in timing of embryo development can be explained by embryo origin, but no single factor elicits a systematic influence.What Is Known Already: Several studies report that culture conditions, patient characteristics and treatment influence timing of embryo development, which have promoted the perception that each clinic must develop individual models. Most of the studies have, however, treated embryos from one patient as independent observations, and only very few studies that evaluate the influence from patient- and treatment-related factors on timing of development or time-lapse parameters as predictors of viability have controlled for confounding, which implies a high risk of overestimating the statistical significance of potential correlations.Study Design, Size, Duration: Infertile patients were prospectively recruited to a cohort study at a hospital fertility clinic from February 2011 to May 2013. Patients aged <38 years without endometriosis were eligible if ≥8 oocytes were retrieved. Patients were included only once. All embryos were monitored for 6 days in a time-lapse incubator.Participants/materials, Setting, Methods: A total of 1507 embryos from 243 patients were included. The influence of fertilization method, BMI, maternal age, FSH dose and number of previous cycles on timing of t2-t5, duration of the 2- and 3-cell stage, and development of a blastocoel (tEB) and full blastocoel (tFB) was tested in multivariate, multilevel linear regression analysis. Predictive parameters for live birth were tested in a logistic regression analysis for 223 single transferred blastocysts, where time-lapse parameters were investigated along with patient and embryo characteristics.Main Results and the Role Of Chance: Moderate intra-class correlation coefficients (0.16-0.31) were observed for all parameters except duration of the 3-cell stage, which demonstrates that embryos from one patient elicit clustering at a patient level. No single patient- and treatment-related factor was found to systematically influence the timing from cleavage to blastocyst stage, which indicates that no individual patient-related factor can be identified that separately explains the clustering throughout the entire developmental stages. The blastocyst parameters were more affected by patient-related factors than cleavage stage parameters, as tEB occurred significantly later with older age (0.29 h/year (95% confidence interval: CI 0.03; 0.56)), while both tEB and tFB occurred significantly later with increasing dose of FSH (tEB: 0.12 h/100 IU FSH (95% CI 0.01;0.24); tFB 0.14 h/100 IU FSH (95% CI 0.03;0.27)) and with more previous attempts (tEB: 1.2 h/attempt (95% CI 0.01;2.5); tFB 1.4 h/attempt (0.10;2.7)). Fertilization method affected timing of the first division, with ICSI embryos cleaving significantly faster than IVF embryos (-3.6% (95% CI -6.4; -0.77)), whereas no difference was found in the subsequent divisions. The univariable regression analysis identified female age, cumulative FSH dose, degree of blastocyst expansion, score of the inner cell mass and timing of full blastocyst formation as predictors of live birth. The timing of full blastocyst formation (tFB) did not remain significant when adjusting for age, number of previous cycles and cumulative FSH dose, which were the parameters shown to influence tFB in the mixed regression model.Limitations, Reasons For Caution: Only good prognosis patients were enrolled, so these results may not be generalized to all infertile women. Not all patient-related factors were investigated.Wider Implications Of the Findings: Our findings underline the importance of treating embryos as dependent observations and suggest a high risk of patient-based confounding in retrospective studies. The impact of confounders and the embryo origin needs to be addressed in order to apply appropriate statistical models in observational studies. Furthermore, this observation emphasizes the need for RCTs for evaluating use of time-lapse parameters for embryo selection.Study Funding/competing Interests: Funding for the cohort study was provided by the Lippert Foundation, the Toyota Foundation, the Aase og Einar Danielsen foundation and NordicInfu Care research grant. Research at the Fertility Clinic, Aarhus University Hospital is supported by an unrestricted grant from MSD and Ferring. K.K. is funded by a grant from the Danish Council for Independent Research Medical Sciences. The authors declare no competing interest. [ABSTRACT FROM AUTHOR]

Published
2016
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41. Cervical conization doubles the risk of preterm and very preterm birth in assisted reproductive technology twin pregnancies.

Author

Pinborg, A., Ortoft, G., Loft, A., Rasmussen, S. C., and Ingerslev, H. J.

Subjects
CERVICAL intraepithelial neoplasia, MULTIPLE pregnancy, PREMATURE infants, COHORT analysis, LOGISTIC regression analysis, DISEASE prevalence, HUMAN embryo transfer
Abstract

STUDY QUESTION: Does cervical conization add an additional risk of preterm birth (PTB) in assisted reproduction technology (ART) singleton and twin pregnancies? SUMMARY ANSWER: Cervical conization doubles the risk of preterm and very PTB in ART twin pregnancies. WHAT IS KNOWN ALREADY: ART and cervical conization are both risk factors for PTB. STUDY DESIGN, SIZE, DURATION: In this national population-based controlled cohort study, we included all ART singletons and twin deliveries from 1995 to 2009 in Denmark by cross-linkage of maternal and child data from the National IVF register and the Medical Birth register. Furthermore, control groups of naturally conceived (NC) singletons and twins were extracted. Cervical diagnoses were obtained from the Danish Pathology register. Cervical conization included both cold knife cone and LEEP (loop electrosurgical excision procedure) but not cervical biopsies. The main outcomes measures were PTB (PTB ≤ 37 + 0 gestational weeks), very preterm birth (VPTB ≤ 32 + 0 gestational weeks) and preterm premature rupture of membranes (PPROM). PARTICIPANTS/MATERIALS, SETTING, METHODS: In all 16 923 ART singletons and 4829 ART twin deliveries were included. A random sample of NC singletons, 2-fold the size of the ART singleton group matched by date and year of birth (n = 33 835) and all NC twin deliveries (n = 15 112), was also extracted. Multiple logistic regression analyses were performed to adjust for the following confounders: maternal age, parity, year of child birth and sex of child. MAIN RESULTS AND THE ROLE OF CHANCE: Cervical morbidity (dysplasia and conization) was more often observed in ART pregnancies (6.2% of ART singletons and 5.4% ART twins) than in NC pregnancies (4.2% for NC singletons and 4.5% for NC twins), both for singletons and twins. In ART singleton deliveries, the PTB rate was 13.1 versus 8.2% in women with and without conization, respectively, with an adjusted odds ratio (aOR) of 1.56 [95% confidence interval (CI) 1.21-2.01]. In ART twin deliveries, the prevalence of PTB was 58.2 versus 41.3% in women with and without conization, respectively, with an aOR 1.94 (95% CI 1.36-2.77), and the risk of VPTB was also doubled. Furthermore, previous dysplasia (without conization) increased the risk of VPTB in ART twins (aOR 1.74, 95% CI 1.04-2.94). Cervical dysplasia did not increase the risk of any of the other adverse outcomes in ART singletons or twins. The risk of PPROM was increased in both in ART and NC singleton deliveries with conization versus no conization; however, this increased risk of PPROM after conization was not observed in either ART or NC twin pregnancies. LIMITATIONS, REASONS FOR CAUTION: We were not able to adjust for the height of the cervical cone or the severity of the cervical intraepithelial neoplasia (CIN) or the time window between diagnosis of CIN and ART treatment. The finding on an increased risk of VPTB in ART twin pregnancies after dysplasia without conization may be random as we found no other increased risk after dysplasia alone either in singletons or in twins. WIDER IMPLICATIONS OF THE FINDINGS: After ART and prior conization, 58% of twin pregnancies versus 13% of ART singleton pregnancies result in PTB. There is a doubled risk of preterm delivery in ART twins with conization versus ART twins with no prior conization. Single-embryo transfer should always be recommended in women with prior conization irrespective of female age, embryo quality and prior number of ART attempts. STUDY FUNDING/COMPETING INTERESTS: No external funding was achieved for this project. [ABSTRACT FROM AUTHOR]

Published
2015
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45. Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study.

Author

Ebbesen, S. M. S., Zachariae, R., Mehlsen, M. Y., Thomsen, D., Højgaard, A., Ottosen, L., Petersen, T., and Ingerslev, H. J.

Subjects
FERTILIZATION in vitro, PSYCHOLOGICAL stress, PREGNANCY, LIFE change events, HUMAN reproductive technology
Abstract

BACKGROUND: There is preliminary evidence to suggest an impact of stress on chances of achieving a pregnancy with in-vitro fertilization (IVF). The majority of the available research has focused on stress related to infertility and going through IVF-treatment, and it is still unclear whether non-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months. [ABSTRACT FROM PUBLISHER]

Published
2009
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47. Association between coffee or caffeine consumption and fecundity and fertility: a systematic review and dose–response meta-analysis

Author

Lyngsø J, Ramlau-Hansen CH, Bay B, Ingerslev HJ, Hulman A, and Kesmodel US

Subjects
Coffee, Caffeine, Fecundity, Fertility, Spontaneous abortion, Assisted Reproduction, Infectious and parasitic diseases, RC109-216
Abstract

Julie Lyngsø,1 Cecilia Høst Ramlau-Hansen,1 Bjørn Bay,2 Hans Jakob Ingerslev,3 Adam Hulman,1,4 Ulrik Schiøler Kesmodel5 1Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, 2The Fertility Clinic, Regional Horsens Hospital, Horsens, 3Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, 4Danish Diabetes Academy, Odense, 5Department of Obstetrics and Gynaecology, Herlev and Gentofte Hospital, Herlev, Denmark Objective: The aim was to investigate whether coffee or caffeine consumption is associated with reproductive endpoints among women with natural fertility (ie, time to pregnancy [TTP] and spontaneous abortion [SAB]) and among women in fertility treatment (ie, clinical pregnancy rate or live birth rate). Design: This study was a systematic review and dose–response meta-analysis including data from case–control and cohort studies. Methods: An extensive literature search was conducted in MEDLINE and Embase, with no time and language restrictions. Also, reference lists were searched manually. Two independent reviewers assessed the manuscript quality using the Newcastle–Ottawa Scale (NOS). A two-stage dose–response meta-analysis was applied to assess a potential association between coffee/caffeine consumption and the outcomes: TTP, SAB, clinical pregnancy, and live birth. Heterogeneity between studies was assessed using Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger’s regression test. Results: The pooled results showed that coffee/caffeine consumption is associated with a significantly increased risk of SAB for 300 mg caffeine/day (relative risk [RR]: 1.37, 95% confidence interval [95% CI]: 1.19; 1.57) and for 600 mg caffeine/day (RR: 2.32, 95% CI: 1.62; 3.31). No association was found between coffee/caffeine consumption and outcomes of fertility treatment (based on two studies). No clear association was found between exposure to coffee/caffeine and natural fertility as measured by fecundability odds ratio (based on three studies) or waiting TTP (based on two studies). Conclusion: Results from this meta-analysis support the growing evidence of an association between coffee/caffeine intake and the risk of SAB. However, viewing the reproductive capacity in a broader perspective, there seems to be little, if any, association between coffee/caffeine consumption and fecundity. In general, results from this study are supportive of a precautionary principle advised by health organizations such as European Food Safety Authority (EFSA) and World Health Organization (WHO), although the advised limit of a maximum of two to three cups of coffee/200–300 mg caffeine per day may be too high. Keywords: coffee, caffeine, fecundity, fertility, spontaneous abortion, assisted reproduction

Published
2017

48. Serological investigation of Mycoplasma genitalium in infertile women.

Author

Clausen, Helle Friis, Fedder, Jens, Drasbek, Mette, Nielsen, Pernille K., Toft, Bente, Ingerslev, Hans Jakob, Birkelund, Svend, Christiansen, Gunna, Clausen, H F, Fedder, J, Drasbek, M, Nielsen, P K, Toft, B, Ingerslev, H J, Birkelund, S, and Christiansen, G

Abstract

Background: The role of Mycoplasma genitalium in the pathogenesis of pelvic inflammatory disease has not been characterized.Methods: Sera from 308 infertile women were investigated for antibodies to M. genitalium by immunoblotting. Women with tubal factor infertility (TFI) made up 132 of the patients, 67 of the women had an infertile male partner and 109 were infertile for unknown reasons.Results: Of the TFI patients 29 (22.0%) were seropositive to the major adhesin, MgPa, of M. genitalium versus 11 (6.3%) in the group of women with normal tubes. No cross-reactions between MgPa and P1 of the related Mycoplasma pneumoniae were found. Besides, MgPa positive sera were confirmed by immunoblotting using a cloned fragment of the C-terminal part of MgPa specific to M. genitalium. Chlamydia trachomatis is known to be able to cause infertility as a result of salpingitis. Therefore, the sera were tested against C. trachomatis using a commercial ELISA test. Seventy-five (56.8%) of the TFI patients were seropositive to C. trachomatis. Eight (27.6%) TFI patients seropositive to MgPa were negative to C. trachomatis.Conclusions: This study indicates that M. genitalium may be an independent risk factor in the development of an inflammatory process leading to scarring of the uterine tubes in women and thereby causing infertility. [ABSTRACT FROM AUTHOR]

Published
2001
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49. Friendly IVF: patient opinions.

Author

Højgaard, Astrid, Ingerslev, Hans Jakob, Dinesen, Jakob, Højgaard, A, Ingerslev, H J, and Dinesen, J

Abstract

Background: The present trend towards low stimulation protocols in IVF calls for evaluation of patient attitudes.Methods: This study compared results of a 23-item questionnaire mailed to 167 patients receiving a low stimulation type of regimen (LS-IVF) (unstimulated cycle or clomiphene) and to 116 patients treated by a standard protocol (S-IVF) (long-down regulation with gonadotrophin-releasing hormone analogue and FSH or human menopausal gonadotrophin).Results: Around two-thirds of all responders in both groups deemed side-effects important, but side-effects and stress associated with hormone treatment were more prevalent in patients receiving S-IVF than LS-IVF. Stress due to cycle cancellation was acceptable, mild or not perceptible in significantly (P < 0.005) more patients receiving LS-IVF [48% (36/75)] compared with patients having S-IVF [26% (8/31)]. Of patients having tried the LS-IVF protocol, 93% (125/135) would suggest either LS-IVF or a sequence of this and S-IVF as a future treatment "package" compared with only 53% (33/63) in the S-IVF group (chi(2) = 43.08, P < 0.0001). The LS-IVF group showed a significant trend towards acceptance of higher number of treatment cycles.Conclusions: The patients seemed to prefer the simplicity and short duration of a low stimulation regimen in spite of drawbacks such as a high risk of cycle cancellations and accordingly the necessity for more treatment cycles. [ABSTRACT FROM AUTHOR]

Published
2001
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50. A randomized study comparing IVF in the unstimulated cycle with IVF following clomiphene citrate.

Author

Ingerslev, Hans Jakob, Højgaard, Astrid, Hindkjær, Johnny, Kesmodel, Ulrik, Ingerslev, H J, Højgaard, A, Hindkjaer, J, and Kesmodel, U

Abstract

The efficiency of IVF in unstimulated cycles was compared with that following ovarian stimulation with clomiphene citrate in a simple protocol with ultrasound monitoring only. A total of 132 couples with no previous IVF attempts, selected by female age <35 years, indication for intracytoplasmic sperm injection or infertility caused by tubal factor or unexplained infertility were randomized to the two protocols. Randomization yielded two comparable groups. The clomiphene group (68 couples) performed significantly better than the unstimulated group (64 couples) in terms of number of cycles with oocyte harvest (90/111 or 81% versus 65/114 or 57%; χ2 = 9.21, P < 0.002), embryo transfers per started cycle (59/111 or 53% versus 29/114 or 25%; χ2 = 18.14, P < 0.0001), live intrauterine pregnancy rate per started cycle (20/111 or 18% versus 4/114 or 4%; χ2 = 12.42, P < 0.0001), live intrauterine pregnancy rate per embryo transfer (20/59 or 34% versus 4/29 or 14%; χ2 = 3.96, P = 0.047), but not in terms of implantation rate (22/85 or 26% versus 4/29 or 14%; χ2 = 1.65). Only two twin pregnancies occurred. Modest side-effects were recorded following clomiphene. Accordingly, a simple clomiphene citrate protocol, but not IVF in unstimulated cycles, seems compatible with the concept of `friendly IVF', yielding a fair pregnancy rate both per cycle started and per embryo transfer in selected patients. The results do not substantiate any important negative anti-oestrogenic effects of clomiphene. [ABSTRACT FROM PUBLISHER]

Published
2001
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