embryology-2017-scientifictracks-abstracts

2 / 20

Page 19
Notes:
allied
academies
Res Rep Gynaecol Obstet 2017 | Volume 1 Issue 4
November 02-03, 2017 | Chicago, USA
Embryology and In vitro Fertilization
World Congress on
Is the cumulative live birth rate following in vitro fertilization (IVF) lower with provincial government
coverage than prior to coverage?
Khudhari A¹, ², Hemmings R 1,4, Sampalis J3, Phillips S1,5 and Sylvestre C1,2
¹OVO Clinic, Canada
²Université de Montreal, Canada
Introduction: To determine if there is a difference between
the cumulative live birth rate per IVF cycle in good prognosis
patients before and after IVF provincial coverage.
Background: Most studies conclude that the cumulative
pregnancy rate depends on embryo quality and quantity, which
is directly related to patient’s age. In the best-case scenario, the
cumulative pregnancy rate reaches 79% when the number of
embryos reaches 15. Other studies reported 75% probability of
live birth after six cycles of controlled ovarian stimulation and
IVF.
Design of Study: Retrospective cohort study comparing IVF
cycles between January 2008 to December 2009 (before
coverage), and between January 2012 to December 2013
(during coverage).
Methodology: The study was carried out at a University-
affiliated private IVF clinic. 298 good prognosis IVF patients from
2008-2009and610patients from2012-2013were included. The
cumulative LBR per IVF cycle was the main outcome measure;
the secondary outcome measures were the type of protocol
used, percentage of ICSI cycles, fertilization rate, proportion of
day 3 versus (vs.) day 5 embryo transfers, average number of
embryos transferred, average number of frozen embryos, the
clinical pregnancy rate and the multiple pregnancies.
Results: No statistically significant difference in the cumulative
LBR was seen; it was 44.8% in 2008-2009 but 40.3% in 2012-
2013 with p=0.134. The long agonist protocol was used the
most during 2008-2009 (75.5% of the cycles) compared to
antagonist protocol in 2012-2013 (77.2%) p<0.01. There
was no difference in the use of ICSI, but the fertilization rate
in 2012-2013 (60.9% vs. 65.9%, p=0.001). The proportion of
day 3 embryos transferred in 2008-2009 (82.2%) and 2012-
2013 (43.9%), p=0.005, and the proportion of day 5 embryos
transferred is 3.7% in 2008-2009 but 54.9% in 2012-2013,
p<0.001. The average number of embryos transferred in 2008-
2009 was 1.96 vs. 1.08 in 2012-2013. The average number of
frozen embryos per cycle was not significantly different. The
clinical pregnancy rate was not significantly different (56.8%
vs. 54.3%). The multiple pregnancy rates were 19.4% in 2008-
2009 and 0.5% in 2012-2013. In good prognosis IVF patients,
the cumulative LBR per cycle started was not significantly
different after IVF provincial coverage and the move towards
eSET on day 3 or day 5. No advantage of transferring multiple
embryos in this group of patients, and that transferring one at
a time reduces significantly the multiple pregnancy rate and its
complications.
Limitation & Conclusion: Not all of the patients have had all of
their embryos transferred. The design of the provincial coverage
influenced themanagement of the patients to a certain degree.
Patients undergoing an IVF cycle will be able to know their CLBR
from that cycle.
Speaker Biography
Dr Adwaa Khudhari is a Consultant in Obstetrics & Gynecology at Reproductive
endocrinology & Infertility which is located at Jeddah, K.S.A
e: