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BAŞARISIZ İN VİTRO FERTİLİZASYON SİKLUSU SONRASINDA GEBELİK SONUÇLARINI ETKİLEYEN FAKTÖRLERİN RETROSPEKTİF İNCELENMESİ

Year 2021, Volume: 84 Issue: 1, 20 - 26, 15.01.2021
https://doi.org/10.26650/IUITFD.2020.0029

Abstract

Amaç: İn vitro fertilizasyon protokollerinde kullanılan tedavi modalitelerinin başarısının, tedavinin uygulandığı çiftlerin başarısız oldukları siklusları ile başarılı oldukları siklusları retrospektif olarak karşılaştırarak, başarıyı etkileyen faktörleri incelemektir. Gereç ve Yöntem: Çalışmamızda Mart 2007-Mart 2011 tarihleri arasında Zeynep Kamil Eğitim ve Araştırma Hastanesi Tüp Bebek Merkezi’ne başvuran, çalışmaya dahil edilme kriterlerini sağlayan 96 hastanın verileri retrospektif olarak değerlendirildi. Aynı çiftlere ait gebelik elde edilmeyen ilk siklus (Grup 1) ile gebeliğin elde edildiği takip eden siklusa (Grup 2) ait veriler karşılaştırılmıştır. Ovulasyon indüksiyonu için uzun, antagonist ve mikrodoz protokolleri uygulanmıştır. Primer sonuç, siklus başına elde edilen ‘klinik gebelik’ olarak kabul edilmiştir. Bulgular: Gonadotropin kullanım süresi, gonadotropin başlangıç dozu, toplam gonadotropin dozu, antagonist başlangıç günleri, siklus başına antagonist kullanılan gün sayısı her iki siklusta aynı tedavi protokolünü kullanan hastalar arasında karşılaştırıldığında, aradaki fark istatiksel olarak anlamlı bulunmamıştır (p>0.05). Buna karşılık iki grup arasında protokol değişikliğinin yapılmasının elde edilen gebelik oranını arttırması istatiksel açıdan anlamlı bulunmuştur (p<0,05). Gebelik elde edilen siklusta daha ileri gündeki embriyonun transfer edildiği (Grup 1: 2,66±0,76 gün vs Grup 2: 3,02±1,1 gün) ve daha az sayıda embriyo transferi yapıldığı (Grup 1: 2,52±0,64 vs Grup 2: 2,32±0,7) tespit edilmiştir (p<0,05). Sonuç: Protokol değişikliği hastanın tedaviye cevabını, dolayısıyla gelişen folikül sayısını ve elde edilen matur oosit sayısını olumlu yönde etkileyebilir. Ayrıca çalışmamızda matur ve az sayıdaki embriyo transferinin tedavi sonuçlarını olumlu şekilde etkilediği gösterilmiş ve başarısız IVF siklusları için en önemli faktörün embriyo kalitesi olduğu bir kez daha vurgulanmıştır.

References

  • 1. Cramer DW, Walker AM, Schiff I. Statistical methods in evaluating the outcome of infertility therapy Fertil Steril 1979;32(1):80-6. [CrossRef]
  • 2. Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril 2002;77(6):1148. [CrossRef]
  • 3. Hull MG, Fleming CF, Hughes AO, Mc Dermott A. The age-related decline in female fecundity: a quantitative controlled study of implanting capacity and survival of individual embryos after in vitro fertilization. Fertil Steril 1996;65(4):783-90. [CrossRef]
  • 4. Kalu E, Thum MY, Abdalla H. Prognostic value of first IVF cycle on success of a subsequent cycle. J Assist Reprod Genet 2011;28(4):379-82. [CrossRef]
  • 5. Baker VL, Jones CE, Cometti B, Hoehler F, Salle B, Urbancsek J et al. Factors affecting success rates in two concurrent clinical IVF trials: an examination of potential explanations for the difference in pregnancy rates between the United States and Europe. Fertil Steril 2010; 94(4):1287- 91. [CrossRef]
  • 6. Jun SH, Choi B, Shahine L, Westphal LM, Behr B, Reijo Pera RA et al. Defining human embryo phenotypes by cohort-specific prognostic factors. PLoS One 2008;3(7):1-7. [CrossRef]
  • 7. Kasius A, Smit JG, Torrance HL. Eijkemans MJ, Mol BW, Opmeer BC, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod update 2014;20(4):530-41. [CrossRef]
  • 8. Papageorgiou T, Guibert J, Goffinet F, Patrat C, Fulla Y, Janssens Y, et al. Percentile curves of serum estradiol levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high estradiol is not detrimental to IVF outcome. Hum Reprod 2002;17(11):2846-50. [CrossRef]
  • 9. Gordts S, Campo R, Puttemans P, Brosens I, Valkenburg M, Norre J, et al. Belgian legislation and the effect of elective single embryo transfer on IVF outcome. Reprod Biomed Online 2005;10(4):436-41. [CrossRef]
  • 10. Gleicher N, Barad D. The relative myth of elective single embryo transfer. Hum Reprod 2006;21(6):1337-44. [CrossRef]
  • 11. Feil D, Henshaw RC, Lane M. Day 4 embryo selection is equal to Day 5 using a new embryo scoring system validated in single embryo transfers. Hum Reprod 2008;23(7):1505-10. [CrossRef]
  • 12. Marci R, Caserta D, Dolo V, Tatone C, Pavan A, Moscarini M. GnRH antagonist in IVF poor-responder patients: results of a randomized trial. Reprod Biomed Online 2005;11(2):189- 93. [CrossRef]
  • 13. Tazegul A, Gorkemli H, Ozdemir S, Aktan M. Comparison of multiple dose GnRH antagonist and minidose long agonist protocols in poor responders undergoing in vitro fertilization: a randomized controlled trial. Arch Gynecol Obstet 2008;278(5):467-72. [CrossRef]

INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE

Year 2021, Volume: 84 Issue: 1, 20 - 26, 15.01.2021
https://doi.org/10.26650/IUITFD.2020.0029

Abstract

Objective: Our aim was to compare the success of the treatment modalities used in in vitro fertilization protocols by comparing the cycles of same patients with failed and successful results to determine the factors affecting the success. Material and Method: The study was conducted in the In Vitro Fertilization - Fertility Center of the Zeynep Kamil Training and Research Hospital, between March 2007 and March 2011, where a total of 96 patients’ files were reviewed retrospectively. The data of the first cycle (Group 1), where the pregnancy was not achieved from the same couples, and the following cycle (Group 2), where pregnancy was achieved were compared. Long, antagonist or microdose protocols have been applied for ovulation induction. The primary outcome was the ‘clinical pregnancy’ achieved per cycle. Results: When the duration of gonadotropin use, gonadotropin start dose, total gonadotropin dose, antagonist start days, number of days using antagonist per cycle were compared between the patients who used the same treatment protocol in both cycles, the difference was not statistically significant (p>0.05). The effect of protocol changes on pregnancy rates between the two groups was statistically significant (p<0.05). It was found that embryo transfer day was more advanced (Group 1: 2.66±0.76 vs Group 2: 3.02±1.1 days) and the number of embryos transferred was less (Group 1: 2.52±0.64 vs Group 2: 2.32±0.7) in pregnancy cycles (p<0.05). Conclusion: The protocol change can positively affect the success rate of the IVF cycle, thus the number of developing follicles and the number of mature oocytes obtained. Beside this, it was shown that embryo transfer count and sufficient quality embryos positively affect the treatment results, and it was emphasized once again that embryo quality is the most important factor for unsuccessful IVF cycles.

References

  • 1. Cramer DW, Walker AM, Schiff I. Statistical methods in evaluating the outcome of infertility therapy Fertil Steril 1979;32(1):80-6. [CrossRef]
  • 2. Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril 2002;77(6):1148. [CrossRef]
  • 3. Hull MG, Fleming CF, Hughes AO, Mc Dermott A. The age-related decline in female fecundity: a quantitative controlled study of implanting capacity and survival of individual embryos after in vitro fertilization. Fertil Steril 1996;65(4):783-90. [CrossRef]
  • 4. Kalu E, Thum MY, Abdalla H. Prognostic value of first IVF cycle on success of a subsequent cycle. J Assist Reprod Genet 2011;28(4):379-82. [CrossRef]
  • 5. Baker VL, Jones CE, Cometti B, Hoehler F, Salle B, Urbancsek J et al. Factors affecting success rates in two concurrent clinical IVF trials: an examination of potential explanations for the difference in pregnancy rates between the United States and Europe. Fertil Steril 2010; 94(4):1287- 91. [CrossRef]
  • 6. Jun SH, Choi B, Shahine L, Westphal LM, Behr B, Reijo Pera RA et al. Defining human embryo phenotypes by cohort-specific prognostic factors. PLoS One 2008;3(7):1-7. [CrossRef]
  • 7. Kasius A, Smit JG, Torrance HL. Eijkemans MJ, Mol BW, Opmeer BC, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod update 2014;20(4):530-41. [CrossRef]
  • 8. Papageorgiou T, Guibert J, Goffinet F, Patrat C, Fulla Y, Janssens Y, et al. Percentile curves of serum estradiol levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high estradiol is not detrimental to IVF outcome. Hum Reprod 2002;17(11):2846-50. [CrossRef]
  • 9. Gordts S, Campo R, Puttemans P, Brosens I, Valkenburg M, Norre J, et al. Belgian legislation and the effect of elective single embryo transfer on IVF outcome. Reprod Biomed Online 2005;10(4):436-41. [CrossRef]
  • 10. Gleicher N, Barad D. The relative myth of elective single embryo transfer. Hum Reprod 2006;21(6):1337-44. [CrossRef]
  • 11. Feil D, Henshaw RC, Lane M. Day 4 embryo selection is equal to Day 5 using a new embryo scoring system validated in single embryo transfers. Hum Reprod 2008;23(7):1505-10. [CrossRef]
  • 12. Marci R, Caserta D, Dolo V, Tatone C, Pavan A, Moscarini M. GnRH antagonist in IVF poor-responder patients: results of a randomized trial. Reprod Biomed Online 2005;11(2):189- 93. [CrossRef]
  • 13. Tazegul A, Gorkemli H, Ozdemir S, Aktan M. Comparison of multiple dose GnRH antagonist and minidose long agonist protocols in poor responders undergoing in vitro fertilization: a randomized controlled trial. Arch Gynecol Obstet 2008;278(5):467-72. [CrossRef]
There are 13 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section RESEARCH
Authors

Tuğba Saraç Sivrikoz This is me 0000-0001-5482-9429

Bahar Yüksel Özgör This is me 0000-0003-3728-3414

Bülent Emre Bilgiç This is me 0000-0002-7298-8949

Hüseyin Tayfun Kutlu This is me 0000-0001-9855-0331

Publication Date January 15, 2021
Submission Date March 28, 2020
Published in Issue Year 2021 Volume: 84 Issue: 1

Cite

APA Saraç Sivrikoz, T., Yüksel Özgör, B., Bilgiç, B. E., Kutlu, H. T. (2021). INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE. Journal of Istanbul Faculty of Medicine, 84(1), 20-26. https://doi.org/10.26650/IUITFD.2020.0029
AMA Saraç Sivrikoz T, Yüksel Özgör B, Bilgiç BE, Kutlu HT. INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE. İst Tıp Fak Derg. January 2021;84(1):20-26. doi:10.26650/IUITFD.2020.0029
Chicago Saraç Sivrikoz, Tuğba, Bahar Yüksel Özgör, Bülent Emre Bilgiç, and Hüseyin Tayfun Kutlu. “INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE”. Journal of Istanbul Faculty of Medicine 84, no. 1 (January 2021): 20-26. https://doi.org/10.26650/IUITFD.2020.0029.
EndNote Saraç Sivrikoz T, Yüksel Özgör B, Bilgiç BE, Kutlu HT (January 1, 2021) INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE. Journal of Istanbul Faculty of Medicine 84 1 20–26.
IEEE T. Saraç Sivrikoz, B. Yüksel Özgör, B. E. Bilgiç, and H. T. Kutlu, “INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE”, İst Tıp Fak Derg, vol. 84, no. 1, pp. 20–26, 2021, doi: 10.26650/IUITFD.2020.0029.
ISNAD Saraç Sivrikoz, Tuğba et al. “INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE”. Journal of Istanbul Faculty of Medicine 84/1 (January 2021), 20-26. https://doi.org/10.26650/IUITFD.2020.0029.
JAMA Saraç Sivrikoz T, Yüksel Özgör B, Bilgiç BE, Kutlu HT. INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE. İst Tıp Fak Derg. 2021;84:20–26.
MLA Saraç Sivrikoz, Tuğba et al. “INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE”. Journal of Istanbul Faculty of Medicine, vol. 84, no. 1, 2021, pp. 20-26, doi:10.26650/IUITFD.2020.0029.
Vancouver Saraç Sivrikoz T, Yüksel Özgör B, Bilgiç BE, Kutlu HT. INVESTIGATION OF FACTORS AFFECTING THE SUCCESS RATES OF IN VITRO FERTILIZATION FOLLOWED BY A FAILED CYCLE. İst Tıp Fak Derg. 2021;84(1):20-6.

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