Monthly IVF research brief for May 2024

Here you’ll find a brief summary of new IVF studies for May* that I think are helpful for patients. I’ll be updating this post each week of April 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 (April 30 – May 6)

Autologous platelet-rich plasma for assisted reproduction. This meta-analysis combined the results of 12 randomized controlled trials to determine the effectiveness of platelet-rich plasma (PRP) injected into the ovary or the uterus. There was an increase in live birth rates with intrauterine PRP (very low quality evidence), but no difference in ongoing pregnancy rates in women who received intraovarian PRP injections.

The chromosomal characteristics of spontaneous abortion and its potential associated copy number variants and genes. This study compared the types of chromosomal abnormalities associated with miscarriage. They identified a number of whole chromosome abnormalities along with 86 genes.

Planned oocyte cryopreservation: a systematic review and meta-regression analysis. This meta-regression analysis combined the outcomes of 10 studies involving women who froze their eggs for fertility preservation. The thaw survival rate was 78.5%, with a live birth rate of 52% for women who froze their eggs before they were 36.

Cardiovascular disease hospitalizations among women who undergo fertility treatment. This study found that women who had fertility treatment were not at an increased risk of cardiovascular disease hospitalization.

Week 2 (May 7 – May 13)

Impact of transferring of a poor-quality embryo along with a good-quality embryo on pregnancy outcomes in IVF/ICSI cycles. This study compared outcomes for women who transferred either a single good quality embryo or a good quality and poor quality embryo together. Transferring two embryos together resulted in a higher live birth rate and multiple pregnancy rate than those who transferred one.

Mechanisms of mitochondrial dysfunction in ovarian aging and potential interventions. This article reviews how mitochondrial dysfunction can contribute to ovarian aging, and potential treatments to overcome it (ie. antioxidant supplements, mitochondrial DNA detection during PGT). Note that these potential treatments have limited evidence that is lower-quality.

Economic evaluations of assisted reproductive technologies in high-income countries: a systematic review. This article reviews the cost effectiveness of different IVF procedures, such as ICSI, PGT-A, natural cycle IVF, embryo transfer number, and more. They found that ICSI for non-male factor infertility was not clinically effective compared to conventional IVF and therefore wasn’t cost effective. They were uncertain about PGT-A.

Assessing the influence of preconception diet on male fertility: a systematic scoping review. This article reviews the impact of preconception diet on male fertility based on 37 studies, finding possible benefits in reducing sugar consumption, processed meat and total fat.

Week 3 (May 14 – May 20)

Effect of intraovarian platelet-rich plasma injection on IVF outcomes in women with poor ovarian response: the PROVA randomized controlled trial. A new randomized controlled trial (RCT) used intraovarian PRP in women with poor ovarian response who had a history of producing <3 eggs per cycle. They found no differences in the number of eggs retrieved, number of blastocysts obtained or number of euploids obtained.

Perinatal and postnatal outcomes up to the third year of life after the transfer of mosaic embryos compared with euploid embryos. This study examined perinatal and postnatal outcomes for mosaic embryos born up to the third year of life, compared to euploids. They didn’t find any differences in pregnancy and delivery complications, gestational age, birth weight, congenital anomalies and more. Postnatal karyotypes of mosaics was also normal.

Embryo development and live birth in women with one previously failed full IVF/ICSI cycle. This study compared IVF outcomes from a second round of IVF to the first round results. The second round had higher number of eggs retrieved, fertilized eggs, usable embryos and blastocysts, but the live birth rates were lower.

Assessment of reproductive outcomes of fresh versus cryopreserved ejaculated sperm samples-a retrospective analysis of 44 423 oocyte donation ICSI cycles. This study compared fresh and frozen sperm in egg donation cycles. Frozen sperm resulted in a lower chance of clinical and ongoing pregnancy, along with a slight increase in the biochemical miscarriage rate.

Week 4 (May 21 – May 27)

The use of preimplantation genetic testing for aneuploidy: a committee opinion. This is a committee opinion for the use of PGT-A published by the American Society for Reproductive Medicine (ASRM). It discusses its effectiveness as a routine treatment for patients, and highlights the limitations of the current research on the benefit of PGT-A.

Investigation of luteal HCG supplementation in GnRH-agonist-triggered fresh embryo transfer cycles: a randomized controlled trial. This randomized controlled trial (RCT) investigated different triggers for IVF to see which gave the best progesterone profile (so more patients could perform a fresh transfer): hCG, GnRH agonist + hCG on the day of egg retrieval, or GnRH agonist + hCG on the day of egg retrieval and hCG again five days later. The third strategy gave the best profile, although some patients developed OHSS.

The experiences of parents with a child born following pre-implantation genetic testing. This study surveyed parents who had children born after PGT, and their experiences in discussing PGT with their children.

Embryos derived from single pronucleus are suitable for preimplantation genetic testing. This study compared PGT-M results and IVF outcomes for normally fertilized 2PNs and abnormally fertilized 1PNs. 1PNs had a lower chance of becoming blastocysts and were less likely to be genetically normal compared to 2PNs.

A heatmap for expected cumulative live birth rate in preimplantation genetic testing for monogenic disorders and chromosomal structural rearrangements. This study developed a heat map for cumulative live birth rates for people doing PGT-M or PGT-SR. A CLBR of <10% was reached for women above 42 with an AMH of 1.25 ng/ml or less.

Week 4 (May 28 – June 3)

Parents’ disclosure to their donor-conceived children in the last 10 years and factors affecting disclosure: a narrative review. This review includes 34 studies of donor-conceived children and how their parents have disclosed their donor-conceived status to them. Most parents disclosed this information before the age of 10 years, with disclosure decisions being driven by intrapersonal, interpersonal and external factors.

IVF and obstetrics outcomes among women of very advanced maternal age (45+) using donor egg. This study compared cumulative live birth rates and obstetric outcomes (ie. C-section rates, preeclampsia, etc.) for women 45 years or older who used donor eggs during IVF. The live birth rate was 40% overall, with no differences in obstetric outcomes.

Protocol change improves live birth and recurrent cycle cancellation rates after a previous IVF cycle cancellation: an analysis of 13 000 autologous cycles reported to SART CORS. This study compared outcomes for patients who did or didn’t change their ovarian stimulation protocol after having a canceled IVF cycle. They found that patients who changed protocols had a lower chance of another canceled cycle, with most of the benefit seen in patients who switched from antagonist/agonist to an agonist/antagonist protocol.

Living in a low socioeconomic status neighbourhood is associated with lower cumulative ongoing pregnancy rate after IVF treatment. This study compared cumulative ongoing pregnancy rates for women with low-to-high socioeconomic status. They found that patients with a low socioeconomic status had a lower chance of achieving an ongoing pregnancy within 2.5 years compared to those with a high status.

Circadian serum progesterone variations on the day of frozen embryo transfer in a modified natural cycle protocol. This study investigated how serum progesterone levels can change on the day of frozen embryo transfer in a modified natural cycle. They found that P levels were similar at 8 AM, 12 PM and 8 PM (~14.6 ng/ml), but were lower at 4 PM (12.9 ng/ml).

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