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ASRM Conference IVF Research Round-Up
Reducing the number of multiple births. The Practice Committees of the ASRM and the Society for Assisted Reproductive Technology (SART) issued a report calling for an increase in the use of elective single embryo transfer (SET) in good prognosis patients undergoing IVF. The committee examined a variety of studies to evaluate single vs. double embryo transfers. They concluded that in good prognosis patients transferring one embryo could dramatically reduce the rate of multiples while maintaining high pregnancy rates.Factors the committee cited for determining if the patient was a good candidate for single embryo transfer included:
- patient under 35
- more than one high quality embryo available for transfer
- women in their first or second IVF treatment cycle
- women with prior successful IVF cycles
- recipients of donated eggs
Mercury may not be bad for IVF. When eating seafood, even though it is nutritious, we are often warned about mercury levels. But a Harvard study has found that higher mercury levels in women undergoing IVF were associated with lower rates of implantation failure. The team measured mercury levels found in IVF patients hair. A smaller subset of the patients also completed a food survey to measure how much fish they ate. The women who ate more fish had higher levels of mercury in their hair; however, there was a negative relationship found between higher mercury levels and the rates of failure of the IVF embryos to implant into the patient’s uterus.
Natural disasters are not good for reproduction. Researchers reviewed national statistics on the results of assisted reproductive technology (ART) cycles from around the country and found that both miscarriage and preterm births among patients increased in the months following Hurricane Katrina. They found that ART cycles initiated before Hurricane Katrina were 87 percent less likely to sustain a first trimester miscarriage and 63 percent less likely to sustain a miscarriage at less than 16 weeks, than cycles initiated post Katrina. In addition, singleton pregnancies were also more likely to deliver pre-term post Katrina than they had been before the storm. The study points out the importance that external factors can have on attempts to successfully initiate and carry a pregnancy to full term.
Most studies show outcomes for IVF in obese patients are significantly poorer in IVF patients, but there are conflicting studies.
- One retrospective study at Walter Reed Army Medical Center found no significant differences between IVF outcomes in different BMI groups (underweight, normal weight, overweight, obese, morbidly obese). The doctors reviewed all fresh ART cycles conducted at Walter Reed Army Medical Center between January 2002 and 2010 and evaluated certain outcomes including the number of eggs retrieved, the percentages of mature eggs retrieved, and the percentage of women who became pregnant (not live birth).
- In contrast, a Beth Israel Deaconess Medical Center/Boston IVF study found that the odds of obese patients having a live birth were 30 percent to 61 percent lower than for normal weight patients, and the odds of morbidly obese patients having a live birth were 68 percent lower. Clinical pregnancy rates were also lower.
- A meta-analysis of controlled studies conducted by Egyptian researchers showed that obese women undergoing IVF and ICSI have significantly lower live birth and clinical pregnancy rates in addition to significantly higher cycle cancellation rates and miscarriage rates.
- The National Embryo Donation Center (NEDC) in Knoxville, TN, devised a study to compare the relationship of BMI to clinical pregnancy rates in patients undergoing transfer of donated embryos.The data showed that women with BMIs in the obese ranges were less likely to achieve a clinical pregnancy using their own eggs and about as likely as normal weight women to become pregnant using donor eggs. For donated embryo cycles, the data showed no consistent relationship between recipient BMI and the likelihood of a clinical pregnancy.
Laughter can reduce the stress of infertility treatments. South Korean researchers recruited 40 patients undergoing IVF and measured stress levels. Half o the patients were provided laughter therapy, and the researchers found those patients in the therapy group had significantly reduced depression and anxiety scores.