SpainFertility

Assessing pregnancy rates in the partners of men who undergo varicocele embolization and predictors of success.
Varicocele embolization is a useful addition to IVF when treating infertile men with varicoceles and associated oligoteratoasthenospermia, leading to pregnancy in about a quarter of their partners, researchers claim.  

Their study, of 223 infertile men aged between 18 and 50 years with at least one varicocele, also showed that those with high sperm motility before the procedure were most likely to achieve a pregnancy.

Varicocele embolization is a minimally invasive alternative to surgery that allows many patients to return to work the next day. During the procedure, a catheter is inserted at the groin and steered towards the varicocele guided by an X-ray. A tiny platinum coil is then inserted through the catheter.

Semen analysis performed on a sample (n = 173) of the patients 3 months after the procedure showed that the men’s sperm motility and sperm count had both significantly improved.

By 6 months, 26 percent of the couples (n = 45) reported a pregnancy, say Sebastian Flacke (Tufts University School of Medicine, Boston, Massachusetts, USA) and co-workers.
 
Hormone levels, varicocele grade, Doppler ultrasound findings, and other semen parameters showed no significant association with pregnancy rates. But sperm motility prior to the procedure was an “important” predictor of pregnancy, Flacke et al say.

Flacke said: “Venous embolization, a simple treatment using a catheter through the groin, can help to improve sperm function in infertile men.”

ORGYN.com

Determining the impact of paternal age on pregnancy rates and outcomes among couples undergoing intrauterine insemination. 
Couples undergoing infertility treatment experience lower pregnancy and higher miscarriage rates if the father is over 40 years of age than if he is younger, French scientists have discovered.

Stéphanie Belloc, from the Eylau Center for Assisted Reproduction in Paris, France, and colleagues studied 21,239 intrauterine inseminations (IUIs) carried out in 12,236 infertile couples treated between 2002 and 2006.

At the time of IUI, the sperm were examined for sperm count, motility, and morphology. In addition, clinical pregnancy, miscarriage, and delivery rates were recorded.

As expected, maternal age affected the pregnancy rate, which was 8.9 percent in women aged over 35 years compared with 14.5 percent in younger women. Miscarriage rates also increased with maternal age.

“But we also found that the age of the father was important in pregnancy rates-men over 40 had a negative effect,” Belloc commented. “And, perhaps more surprisingly, miscarriage rates increased where the father was over 40.”

She added: “How DNA damage in older men translates into clinical practice has not been shown up to now. Our research proves for the first time that there is a strong paternal age-related effect on IUI outcomes, and this information should be considered by both doctors and patients in assisted reproduction programs.”

ORGYN.com

Comparing the neonatal outcomes of babies conceived from frozen-thawed and fresh embryo transfers. 
The outcomes of IVF pregnancies conceived from frozen-thawed embryos appear to be healthier, with fewer multiple pregnancies and low-birthweight babies, compared with fresh transfers, study findings suggest.

Presenting author Dr. Anja Pinborg (Copenhagen University Hospital Rigshospitalet, Denmark) told delegates at the 24th annual conference of the European Society of Human Reproduction and Embryology that their findings lay to rest concerns about the effects of freezing and thawing embryos.

The team compared the outcomes of 1,267 children born in Denmark as a result of frozen embryo transfer between 1995 and 2006 with those of 17,857 children conceived from fresh embryos, who served as controls.

Rates of multiple pregnancy were considerably lower among women who underwent IVF or ICSI with cryo-preserved embryos (14.2 and 11.7 percent, respectively) than those who underwent fresh embryo transfer (27.3 and 24.8 percent, respectively), Pinborg et al reveal.

Accordingly, pregnancy duration was significantly longer with frozen-thawed embryos than fresh embryos, birthweight was about 200g higher, and there was no increased risk for congenital malformations.

Fewer children conceived from frozen-thawed embryos were admitted to neonatal intensive care, overall, although this difference disappeared when multiple births were excluded from the analysis, the investigators report. 

“The findings are reassuring, although we still lack sub-analyses regarding malformations and neurological sequelae of the frozen embryo replacement,” Pinborg said.

“If our results continue to be positive, frozen embryo replacement can be accepted as a completely safe procedure, which can be used even more frequently than it is currently.”

ORGYN.com

The transfer of a single embryo into the uterus decreases the number of twin pregnancies without adversely affecting pregnancy outcomes, according to a report in the current issue of Fertility and Sterility.

Recent efforts have focused on transferring fewer embryos as a means of reducing the rising rate of twin pregnancies, the authors explain. Several studies have shown similar pregnancy  outcomes, but a  lower   rate of twin   births, after  the transfer of  a single embryo in women under the age of 37 years.

Dr. Aaron K. Styer and colleagues from Massachusetts General Hospital, Boston, compared the pregnancy outcomes of 52 women who underwent in vitro fertilization (IVF) with a single-embryo transfer versus 187 women who underwent a double-embryo transfer. All of the subjects were 37 years old or younger.

 IVF cycle characteristics did not differ between the single- and double-embryo transfer groups, the report indicates.

 Single-embryo and double-embryo cycles also did not differ in the rates of pregnancy - 61 percent versus 63.4 percent - or in rates of pregnancy loss - 20 percent versus 18.6 percent, retrospectively, the authors report. However the rate of implantation was significantly greater for single-embryo transfer cycles (70.5 percent) than for double-embryo cycles (47.8 percent).

No single-embryo transfer cycles resulted in ectopic pregnancies. An ectopic pregnancy occurs when the embryo does not implant on the lining of the uterus, but somewhere else, usually the fallopian tubes. If not detected early, the consequences can be serious. In contrast, 2 percent of double-embryo transfer cycles did result in ectopic pregnancies, despite the lack of risk factors.

More double-embryo transfer cycles (51 percent) than single-embryo transfer cycles (3.1 percent) resulted in twin pregnancies, the researchers note.

 Moreover, there was no difference in live-birth rates between the single-embryo-transfer group (53.8 percent) and the double-embryo transfer group (54.4 percent).

 ”This study provides further evidence that elective (single-embryo) transfer is not only a feasible but a realistic option in the young patient who has a favorable reproductive profile and several good-quality embryos available for transfer and cryopreservation,” the authors conclude.

Candidates for the single-embryo transfer may include patients who don’t want to risk multiple pregnancies or who have a preexisting medical condition for which a multiple pregnancy would not be safe, the researchers explain.

The most important factor in the decision to proceed with elective single-embryo transfer, they add, may be for women with a “favorable reproductive profile.”

SOURCE: Fertility and Sterility
Reuters.com