Monthly IVF research brief for September 2024

Here you’ll find a brief summary of new IVF studies for September* that I think are helpful for patients. I’ll be updating this post each week of September 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 (Aug 27 – Sept 2)

A nomogram and risk stratification to predict subsequent pregnancy loss in patients with recurrent pregnancy loss. This study created a tool to help calculate the chance of a pregnancy loss in patients with recurrent pregnancy loss. Using information like age, the number of previous losses, auto-antibody levels, blood clotting time and more, their tool predicted losses about 80% of the time.

Ovarian stimulation protocols: impact on oocyte and endometrial quality and function. This review goes over ovarian stimulation during IVF and how this can affect egg quality and endometrial function.

Culture media with antioxidants improved fertilization, preimplantation embryo development and clinical outcomes of advanced age patients. Researchers added antioxidants to embryo culture media, and found that this improved the rate of blastocyst formation and resulted in increased live birth rates for patients aged 35-40.

Protective effects of engineered Lactobacillus crispatus strains expressing G-CSF on thin endometrium of mice. Researchers engineered the bacterium Lactobacillus crispastus to express G-CSF to stimulate endometrial repair, and administered the bacteria into mouse uteruses. This led to higher G-CSF levels in the endometrium, resulting in a thickened endometrium and increased blood vessel growth.

Week 2 (Sept 3 – Sept 9)

Relationship between fresh single embryo morphology scores and serum HCG values at 14 days and 14-18-day doubling values. This study looked at how the grade of embryos affects β-hCG levels on day 14 and doubling of the hormone on days 14-18 after they are transferred in IVF. Higher quality embryos led to a higher β-HCG on day 14, with embryo expansion tied to day 14-18 doubling.

Effect of single blastocyst-stage versus single cleavage-stage embryo transfer on cumulative live births in women with good prognosis undergoing in vitro fertilization: Multicenter Randomized Controlled Trial. This high quality study (randomized controlled trial) compared outcomes for transferring a single blastocyst-stage embryo vs a cleavage-stage embryo in women with a good prognosis. After up to three transfers, the cumulative live birth rate was higher for blastocysts vs cleavage stage embryos. There was also a higher risk of preterm birth with blastocyst transfers.

Comparing the outcomes of in-vitro fertilization in patients receiving vaginal, subcutaneous, and intramuscular progesterone for luteal phase support: a three-armed randomized controlled trial. This high quality study (randomized controlled trial) compared outcomes in patients having a medicated FET with vagnial, subcutaneous or intramuscular progesterone for luteal phase support. Patients who used intramuscular progesterone had higher positive b-hCG rates, but there was no difference in clinical pregnancy rates.

Adenomyosis-A Call for Awareness, Early Detection, and Effective Treatment Strategies: A Narrative Review. This review provides a summary of the types of adenomyosis, how it’s diagnosed and different aspects of the condition.

Lessons learned from 64,071 embryos subjected to PGT for aneuploidies: results, recurrence pattern and indications analysis. This study examined over 64,000 embryos tested for chromosomal abnormalities (aneuploidies) and found that the rate of abnormalities was much higher in day 3 embryos than in blastocysts, and particularly higher in women over 35 years old. Despite producing many abnormal embryos, there was still a good chance (up to 95% after 10 biopsies) of finding a euploid embryo, especially in blastocysts.

Week 3 (Sept 10-16)

Fertility drugs and cancer: a guideline. A guideline from the ASRM that considers the risk of cancer from fertility drugs. Available data does not show a clear association between fertility drugs and breast, colon, or cervical cancer, though there may be an increased risk of ovarian and thyroid cancer, but it’s not clear if this is due to a connection with endometriosis, infertility, or nulliparity (women who haven’t given birth).

Effect of sperm DNA fragmentation on the cumulative live birth rate in patients undergoing in vitro fertilization/intracytoplasmic sperm injection treatment. This study aimed to investigate the effects of sperm DNA fragmentation (<10%, 10-20%, 20-30%, >30%) on cumulative live birth rates and other IVF outcomes. They found no association with any outcomes when looking at the total results (after adjustment), but they did find a decrease in fertilization and cumulative live birth rate in the subgroup of patients doing ICSI with >30% SDF vs those with <10% SDF.

Livebirth rates are influenced by an interaction between male and female partners’ age: analysis of 59 951 fresh IVF/ICSI cycles with and without male infertility. This study investigated the effect of male age on live birth rates. They found that live birth rates declined with advanced male age when the female partner was 35-39 years old, but not for younger or older female age groups, and no impact was observed with ICSI cycles.

Artificial oocyte activation improves ICSI outcomes following unexplained fertilization abnormalities. Artificial oocyte activation involves the administration of ionophores to culture media in cases with poor or no fertilization. This study found improved fertilization rates and clinical outcomes after AOA, especially in cases with PLCζ deficiency.

Impact of overweight and obesity on live birth rate in single euploid frozen embryo transfers: the key is in the preparation protocol! Previous studies have found that obesity results in lower live birth rates after euploid transfer. This study found that this was related to the type of FET performed, with natural cycles performing better than medicated cycles, especially for patients with a high BMI.

Week 4 (Sept 17-23)

Assessment of Repetitive Controlled Ovarian Stimulation (COS) Cycles on Oocyte Donors: Impact on Oocyte Quality and Viable Embryo Yield. This study explored how IVF outcomes changed with repeated donor ovarian stimulation cycles. In donors with six or more retrievals, there was an increase in maturation and fertilization rates but a decrease in good quality blastocyst and blastocyst formation rates.

Association between sleep quality and ovarian reserve in women of reproductive age: a cross-sectional study. This study evaluated the association between sleep quality and ovarian reserve. Women with poor sleep quality had reduced AMH and AFC, and were at higher risk of diminished ovarian reserve, particularly for those <35 or with a lower BMI.

Impact of Bisphenol A and its alternatives on oocyte health: a scoping review. This is a review of BPA and its effects on egg health. Most of the studies included in the review showed that BPA had negative effects on follicle development and spindle/chromosome alignment, with IVF patients showing reduced numbers of retrieved eggs and lower AFC.

Effect of estradiol supplementation on luteal support following a significant reduction in serum estradiol levels after hCG triggering: a prospective randomized controlled trial. This study examined if adding 4 mg of estradiol valerate improved fresh embryo transfer outcomes in patients with low serum E2 levels. There was no change in ongoing pregnancy rates, but there was a decrease in biochemical pregnancy losses and increased pregnancy rates for blastocyst stage transfers.

Week 5 (Sept 24-30)

Cumulative live birth rate of a blastocyst versus cleavage stage embryo transfer policy during in vitro fertilisation in women with a good prognosis: multicentre randomised controlled trial. A large randomized controlled trial evaluated outcomes after cleavage stage or blastocyst stage transfer in good prognosis patients. They found no difference in cumulative live birth rates, but blastocyst transfers resulted in a higher live birth rate after fresh transfer, lower cumulative pregnancy loss and a lower number of embryo transfers needed to result in a live birth.

Human embryos harbor complex mosaicism with broad presence of aneuploid cells during early development. One of the limitations of PGT is the use of a small biopsy to represent the whole embryo. In a new study, researchers isolated and sequenced every cell from 20 blastocysts, finding that all embryos were mosaic to some degree. They also sequenced single cells from day 8-14 cultured embryos, showing that 97% of the embryos/early organs were mosaic.

Chronic endometritis and recurrent reproductive failure: a systematic review and meta-analysis. This meta-analysis combined the results of 9 studies investigating chronic endometritis and recurrent pregnancy/implantation failure. CE was detected more frequently in women with infertility and RPL, but not in women with RIF.

Embryo retention and live birth in frozen embryo transfer cycles: a cohort study. Sometimes embryos are retained in the catheter after transfer, forcing the doctor to repeat the procedure. This study found that embryo retention resulted in a decrease in pregnancy and live birth rates.

Viral Infection in Endometritis: Is There an Important Role or Not? This study reviewed the role of viral infections on endometritis.

Endometriosis and infertility: a bibliometric analysis of the 100 most cited articles from 2000 to 2023. This paper listed the top 100 publications that related to endometriosis, revealing trends in endometriosis research.

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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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