Monthly IVF research brief for October 2024

Here you’ll find a brief summary of new IVF studies for October* that I think are helpful for patients. I’ll be updating this post each week of October with new studies, before making a separate post for next month.

*Note that the publication dates of these studies might be outside of the indicated period, mostly because of how PubMed indexes the article.

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Week 1 (Oct 1 – Oct 7)

Therapeutic management in women with a diminished ovarian reserve: a systematic review and meta-analysis of randomized controlled trials. This study examined the effectiveness of different treatments and protocols for women with diminished ovarian reserve (DOR). It found that testosterone supplementation was associated with higher live birth rates, while other treatments were associated with a higher number of eggs collected, including DHEA, high-dose gonadotropin and a delayed start protocol.

Excess of severe autoimmune diseases in women with premature ovarian insufficiency: a population-based study. This study explored the association between premature ovarian insufficiency (POI) and the incidence of severe autoimmune diseases. It found that women with POI are 2.6 times more likely to have an autoimmune disease, such as lupus, rheumatoid arthritis and inflammatory bowel disease.

Pregnancy rate and time to pregnancy after recurrent implantation failure (RIF)-a prospective cohort follow-up study. This study assessed the ongoing pregnancy rate, time to pregnancy, and number of embryo transfers required to achieve pregnancy in patients with recurrent implantation failure (RIF). The results indicated a cumulative ongoing pregnancy rate of 40.5% after one year, with a median time to pregnancy of four months, and an average of 7.3 embryo transfers needed to achieve pregnancy.

Success Rates with Preimplantation Genetic Testing for Aneuploidy (PGT-A) in Good Prognosis Patients is Dependent on Age. This study evaluated the impact of PGT-A using NGS on the cumulative live birth rates in patients aged 21-40 years undergoing single blastocyst transfer. The findings revealed that while the use of PGT-A was associated with a slightly lower cumulative live birth rate in individuals under 35, it increased the chances of cumulative live birth in older age groups (35-40 years), and also significantly reduced the likelihood of miscarriage in those aged 35 and above.

Unraveling the mysteries of early embryonic arrest: genetic factors and molecular mechanisms. This publication provides an updated review of embryonic arrest.

Oocyte quality in women with endometriosis. This publication reviews the effect of endometriosis on egg quality..

Week 2 (Oct 8 – Oct 14)

Impacts of double biopsy and double vitrification on the clinical outcomes following euploid blastocyst transfer: a systematic review and meta-analysis. This meta-analysis combined the results of 9 studies to evaluate whether ‘double biopsy + double freezing’ or ‘single biopsy + double freezing’ affected clinical outcomes following euploid transfer compared to the ‘single biopsy + single freezing’ approach. It found that both alternative methods were associated with reduced clinical pregnancy and live birth/ongoing pregnancy rates, though post-warming survival rates remained unchanged.

Do sperm factors influence embryonic aneuploidy? Long live the oocyte. This study examined the impact of male age and sperm-related factors on embryo aneuploidy. Male age and sperm quality wasn’t associated with aneuploidy, while female age, BMI, number of eggs retrieved and other factors were linked.

Incidence of haploidy and triploidy in trophectoderm biopsies of blastocysts derived from normally and abnormally fertilized oocytes. This study examined how common haploidy or triploidy were in “abnormally fertilized” eggs that are 1PN or 3PN, as opposed to being diploid with the correct chromosome configuration. They found that about half of 1PNs, and one-quarter of 3PNs, were diploid and had the correct chromosome configuration. Nearly 90% of 0PNs were diploid.

The effect of pipette- and laser-induced blastocyst collapse before vitrification on their re-expansion and clinical outcome after warming. Before freezing, blastocysts are collapsed by making a tiny hole in the embryo to allow water to escape, and this can be done using a laser or a pipette. This study found that using a laser resulted in better outcomes, including a shorter re-expansion time which was linked to improved live birth rates.

Metformin reverses infertility in a mouse model of endometriosis: unveiling disease pathways and implications for future clinical approaches. This study investigated whether metformin can reverse infertility in a mouse model of endometriosis. It found that metformin treatment restored fertility to normal levels by reducing fibrosis and oxidative stress in endometriosis lesions, suggesting its potential as a treatment for improving infertility in women with endometriosis.

Week 3 (Oct 15 – Oct 21)

Healthy live births achieved from embryos diagnosed as non-mosaic segmental aneuploid. This study evaluated pregnancy outcomes following the transfer of non-mosaic segmental aneuploids after PGT-A, finding a 24% live birth rate. While these embryos had better outcomes than those with whole chromosome aneuploidy, their success rates were lower than for segmental mosaics.

“Try until the last?”-the relevance of fresh embryo transfer outcomes for subsequent same-cohort vitrified-warmed cycles. Women who had a positive beta-hCG after a fresh transfer have a higher chance of success in a subsequent FET using a frozen embryo from the same cycle. There was no decrease in subsequent FET success rates if the fresh transfer didn’t work.

Initially categorized 46,XY embryo transfer ending with 45,X products of conception-a case report and a review of discordant result management. This case report describes a miscarriage following the transfer of a male embryo initially deemed euploid by PGT-A, with subsequent testing revealing Turner syndrome (45,X). It highlights the limitations of PGT, emphasizing the need for counseling about possible discrepancies and suggesting follow-up testing, such as short tandem repeat analysis, when discrepancies arise.

Effects of ovarian stimulation on embryo euploidy: an analysis of 12 874 oocytes and 3106 blastocysts in cycles with preimplantation genetic testing for monogenic disorders. This study found that ovarian stimulation and increasing doses of gonadotropins didn’t impact the chance of getting a euploid in women undergoing PGT-M.

Effect of Music Therapy on Anxiety in Pregnancy: A Systematic Review of Randomized Controlled Trials. This systematic review of 33 randomized controlled trials found that music therapy significantly reduces anxiety in pregnant women across various settings, including IVF treatments and high-risk pregnancies. The positive effects included decreased anxiety levels, improved pregnancy outcomes, and better maternal-fetal health, suggesting that music therapy could be a valuable, non-pharmacological addition to routine prenatal care.

Week 4 (Oct 22-28)

Impact of prolonged embryo storage on reproductive and neonatal outcomes: a systematic review and meta-analysis. This meta-analysis combined the results of 16 studies that investigated the impact of embryo storage on reproductive outcomes. They found that storage beyond 12 months was associated with a lower chance of live birth but no differences in rates of preterm delivery or congenital malformations. They noted that embryo quality and improper embryo handling, rather than storage time, may have played a role but they couldn’t evaluate this.

Two-year cumulative live-birth rates and maximum number of transfer cycles in women aged ≥ 40 years. This study evaluated the effectiveness and cost-effectiveness of frozen–thawed embryo transfers without PGT-A in women aged 40 and older. They found lower cumulative live birth rates, and increased costs between ages 40 and 46. The study took place in Japan (so the prices included may not reflect the prices in the US or elsewhere).

Analysis of the Predictive Factors for Chronic Endometritis Recurrence in Infertile Women. This study investigated the recurrence of chronic endometritis after antibiotic recovery and fertility treatment, finding that CE came back in about 30% of patients. They found that women who had a hysteroscopy had decreased recurrence, while those with a history of pregnancy loss had increased recurrence.

Short insemination during conventional in vitro fertilization increases embryo quality. During conventional IVF, where sperm are mixed with eggs for insemination rather than injection by ICSI, the sperm and eggs are normally incubated overnight. This study found that shorter incubation (3 hours) resulted in more blastocysts and better quality.

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About Embryoman

Embryoman (Sean Lauber) is a former embryologist and the founder of Remembryo, an IVF research and fertility education website. After working in an IVF lab in the US, he returned to Canada and now focuses on making fertility research more accessible. He holds a Master’s in Immunology and launched Remembryo in 2018 to help patients and professionals make sense of IVF research. Sean shares weekly study updates on Facebook, Instagram, and Reddit regularly. He also answers questions on Reddit or in his private Facebook group.

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