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Single Euploid Embryo Transfer Outcomes after Uterine Septum Resection

Study Objective: To study pregnancy outcomes after single euploid embryo transfer (SEET) in patients who underwent prior uterine septum resection to those with uteri of normal contour, without M€ullerian anomalies or uterine abnormalities including polyps or fibroids, and without a history of prior uterine surgeries.

Design: Retrospective cohort study.

Setting: Single academic affiliated center.

Patients: 60 cycles of patients with prior hysteroscopic uterine septum resection who underwent an autologous SEET
between 2012 and 2020 were used as the investigational cohort. A 3:1 ratio propensity score matched control cohort of 180 single euploid embryo transfer cycles from patients without a history of uterine septa were used as the control group.

Interventions: No interventions administered.

Measurements and Main Results: Pregnancy, clinical pregnancy loss, ongoing clinical pregnancy, and live birth rates in patients with a history of uterine septum resection compared with matched patients without M€ullerian anomalies or uterine surgeries.
Patients with a prior uterine septum had significantly lower rates of chemical pregnancy (58.33% vs 77.2%, p = .004), implantation (41.67% vs 65.6%, p = .001), and live birth (33.33% vs 57.8%, p = .001) per transfer. No statistical difference in clinical pregnancy loss rates was found when comparing septum patients with controls (8.33% vs 7.8%, p = .89).

Conclusion: Patients with a history of hysteroscopic resection who undergo in vitro fertilization are more susceptible to suboptimal clinical outcomes compared with patients with normal uteri. Early pregnancy loss rates in patients with a uterine septum are higher than in those without; however, after resection, the rates are comparable. Patients born with septate uteri require assessment of surgical intervention prior to SEET, and to optimize their reproductive outcomes. Journal of Minimally Invasive Gynecology (2024) 00, 1−6. © 2024 AAGL. All rights reserved.

Correlation of self‑reported racial background to euploidy status and live birth rates in assisted reproductive technology cycles

Purpose To determine whether the embryonic euploidy rate and live birth outcomes following single, euploid embryo
transfer (SEET) difer among women of self-reported racial and ethnic backgrounds.

Methods This retrospective cohort study included all infertile patients of diferent self-reported racial backgrounds who underwent In vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) and an autologous single euploid embryo transfer (SEET) from December 2015 to December 2019 at a single private and academic assisted reproduction technology center. Primary outcome measures included ploidy rates among diferent racial groups. Secondary outcomes included clinical pregnancy, clinical pregnancy loss, and live birth rates.

Results Five thousand fve hundred sixty-two patients who underwent an IVF cycle with ICSI-PGT-A were included. A
total of 24,491 blastocysts were analyzed. White participants had on average more euploid embryos and higher euploidy
rates when compared to their counterparts (p≤0.0001). However, after controlling for confounding factors, there was no
association between race and the odds of having a higher euploidy rate (aOR 1.31; 95% CI 0.63–2.17, p=0.42). A total of
4949 patients underwent SEET. Pregnancy outcomes did not difer among patients of varying self-reported races.

Conclusions Euploidy rates and pregnancy outcomes were comparable among patients of diferent racial backgrounds who underwent a SEET.

Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation: a retrospective cohort study

Research question: Do the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)?

Design: This retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus
oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts.

Results: A total of 4059 oocyte freezing cycles were included in the analysis. Eight types of contraceptive method were recognized in patients undergoing ovarian stimulation: intrauterine device (IUD), copper (n = 84); IUD, levonorgestrel low dose (<52 mg) (n = 37); IUD, levonorgestrel (n = 192); subdermal etonogestrel implant (n = 14); injectable medroxyprogesterone acetate (n = 11); etonogestrel vaginal ring (n = 142); combined oral contraceptive pills (n = 2349); and norelgestromin transdermal patch (n = 10). The control group included patients not using contraceptives or using barrier or calendar methods (n = 1220). Among all the cohorts the median number of cumulus
oocyte complexes retrieved during oocyte retrieval was comparable (P = 0.054), and a significant difference in oocyte maturity rate with median number of vitrified oocytes was found (P = 0.03, P < 0.001, respectively). After adjusting for confounders a multivariate analysis found no association between the type of contraceptive and proportion of metaphase II oocytes available for cryopreservation.

Conclusions: Among the various forms of contraception, none was shown to have an adverse association with oocyte yield or maturation rate in patients undergoing POC

Recent clomiphene citrate exposure does not impact subsequent clinical outcomes in single euploid frozen embryo transfer cycles

Carlos Hernandez-Nieto,, Joseph Lee, Tamar Alkon-Meadows, Luz Soto-Cossio, Benjamin Sandler, Tanmoy …

Assessing the clinical viability of micro 3 pronuclei zygotes

Canon C, Thurman A, Li A, Hernandez-Nieto C, Lee JA, Roth RM, Slifkin R, Briton-Jones C, Stein D, …

In Vitro Fertilization and Early Pregnancy Outcomes After Coronavirus Disease 2019 {COVID-19} Vaccination

Aharon D, Lederman M, Ghofranian A, Hernandez-Nieto C, Canon C, Hanley W, Gounko D, Lee JA, Stein …

Clinical implementation of algorithm-based embryo selection is associated with improved pregnancy outcomes in single vitrified warmed euploid embryo transfers

Friedenthal J, Hernandez-Nieto C, Roth RM, Slifkin R, Gounko D, Lee JA, Nazem T, Briton-Jones C, …

Parental chromosomal heteromorphisms are not associated with an increased risk of embryo aneuploidy

Hernandez-Nieto, C., Gayete-Lafuente, S., Alkon-Meadows, T., Lee, J., Luna-Rojas, M., Mukherjee, …

Expanded carrier screening for preconception reproductive risk assessment: Prevalence of carrier status in a Mexican population

Hernandez-Nieto, C., Alkon-Meadows, T., Lee, J., Cacchione, T., Iyune-Cojab, E., Garza-Galvan, M., …

What is the reproductive potential of day 7 euploid embryos?

Hernandez-Nieto, C., Lee, J. A., Slifkin, R., Sandler, B., Copperman, A. B., & Flisser, E. …

Embryo aneuploidy is not impacted by selective serotonin reuptake inhibitor exposure

Carlos Hernandez-Nieto, M.D., Joseph Lee, B.A., Taraneh Nazem, M.D., Dmitry Gounko, M.A., Alan …