Fertility Flash - Issue 2

Successful Obstetrical Management of over 100-days Interval between Twin Delivery Effect of Delaying FET on Pregnancy and Live Birth Rates Preimplantation Genetic Screening and Diagnosis Various Techniques of Embryo Selection in ART Combination of Metformin+Letrozole is more Effective in Improving Reproductive Outcomes Impact of GnRH Agonist and Antagonist on Human Oocytes and Early Embryos Role of Medroxyprogesterone Acetate (MPA) in Women with Endometriosis undergoing IVF Clinical Practice Guidelines: Pregnancy Care 2018

2

Issue

HIGHLIGHTS

F e Flash

PREFACE

CASE STUDY

CONTENTS

1 3 IMAGE OF THE MONTH

4 5 7

CONFERENCE CALENDER

9

10

14 QUIZ

16

F e Flash

Contributed by:

1

F e Flash

2

F e Flash EVIDENCE UPDATE

25–35 days

35

Patients (%)

30 25

50–70 days 33.2 26.8

20

27.5 21.5

15 10 5 0 Pregnancies

Live births

3

F e Flash

4

F e Flash DIAGNOSTIC UPDATE

Methods aCGH

Complexity

Duration (h)

Medium

~12

Abnormalities detected l l

SNP microarray

High

qPCR

Low

Up to 72

l l

l

Whole chromosome aneuploidy Parental origin Translocations

l

l

Whole chromosome aneuploidy

l

l l

4

Whole chromosome aneuploidy Translocations

Limitations

l

l

NGS

High

<24

l l l l

Whole chromosome aneuploidy Mosaicism, mitochondrial copy number Single-gene disorders Translocations

l

False positives Unable to detect mosaicism

Resolution Medium

Inability to detect balanced chromosomal rearrangements Inability to detect mosaicism

High

Not designed to detect segmental aneuploidy Unable to detect mosaicism or translocations

Low

Limited ability to detect balanced chromosome translocations

High

aCGH=Comparative genome hybridization; SNP=Single nucleotide polymorphism; qPCR=Quantitative polymerase chain reaction; NGS=Next-generation sequencing.

5

F e Flash

6

F e Flash EMBRYO SELECTION TECHNIQUE Contributed by:

Nitiz Murdia

7

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8

F e Flash

# of blastocysts

% normal embryos Egg donors (%)

<35 years (%)

35–37 years (%)

38–40 years (%)

41–42 years (%)

>42 years (%)

1–3

58

61

51

39

22

13

4–6

62

60

52

38

23

17

7–10

65

62

51

36

21

14

>10

68

63

55

37

25

n/a

N=4,747 cycles and 29,803 embryos, up to 12/2013 Source: Ata, Munne et al. (2012) Reprod Biomed Online and unpublished data.

CONFERENCE CALENDER

9

F e Flash CONFERENCE UPDATE

10

F e Flash

Patients (%) 0

5

10 15 20 25 30 35 40 45 Antagonist group

Agonist group

11

F e Flash

Small sample size

12

F e Flash

13

F e Flash GUIDELINE UPDATE

14

F e Flash

15

#

F e Flash

#

#

QUIZ

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Be an early bird!

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