In Vitro Fertilization Unit

Rehovot, Israel

In Vitro Fertilization Unit

Rehovot, Israel
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Machtinger R.,In Vitro Fertilization Unit | Machtinger R.,Tel Aviv University | Duvdevani N.-R.,In Vitro Fertilization Unit | Duvdevani N.-R.,Tel Aviv University | And 8 more authors.
Journal of Assisted Reproduction and Genetics | Year: 2017

Purpose: Surrogacy remains the only option for having a biologic child for a unique population of women with severe medical conditions. However, no study has looked at surrogacy outcome as a result of the type of ovarian stimulation of the intended mother [controlled ovarian stimulation (COH), modified natural cycle (MNC), and in vitro maturation (IVM)] for oocyte retrieval. Methods: This is a retrospective study, including all intended mothers and gestational carriers in a tertiary, university affiliated, medical center, from 1998 to 2016. Results: Fifty-two women underwent 252 oocyte retrieval cycles. The pregnancy outcome of 212 embryo transfer cycles (64 gestational carriers) was reviewed according to the origin of the embryo. The number of retrieved oocytes was significantly higher following COH (n = 132) compared with IVM (n = 58) and MNC cycles (n = 62) (p = 0.013 and p < 0.0001, respectively). Pregnancy rates for embryos transferred according to each protocol were similar. All pregnancies that ended in live births when oocytes from IVM cycles were used derived from transfers of retrieved mature and mixed mature and immature oocytes. Pregnancies that involved embryos derived solely from immature oocytes that further matured in vitro and were transferred to gestational carriers were unsuccessful. Conclusions: MNC protocol is a good option to achieve pregnancy for intended mothers using gestational surrogacy who have contraindications to COH. The yield of IVM cycles in which immature oocytes are retrieved is inconclusive. © 2017 Springer Science+Business Media New York

Hasson J.,Lis Maternity Hospital | Hasson J.,Tel Aviv University | Limoni D.,Tel Aviv University | Malcov M.,Lis Maternity Hospital | And 12 more authors.
Reproductive BioMedicine Online | Year: 2017

Preimplantation genetic diagnosis (PGD) may pose risks to pregnancy outcome owing to the invasiveness of the biopsy procedure. This study compares outcome of singleton and twin clinical pregnancies conceived after fresh embryo transfers of PGD (n = 89) and matched intracytoplasmic sperm injection (ICSI) pregnancies (n = 166). The study was carried out in a single university affiliated centre. Because of the paucity of available data, a literature-based meta-analysis of studies comparing neonatal outcome of PGD and ICSI pregnancies was also conducted. In the retrospective cohort study, obstetric and neonatal outcome were available in 67 PGD and 118 ICSI pregnancies. Perinatal outcomes were comparable between PGD and ICSI pregnancies. Meta-analysis revealed similar outcomes, except for higher rate of low birth weight (<2500 g) neonates in ICSI twin pregnancies (RR 0.86, 95% CI 0.74 to 1.0). Mean birth weight, gestational age at birth, pre-term deliveries (<37 weeks) and malformations were all comparable. In this cohort study and subsequent meta-analysis, no association was found between PGD conceived pregnancies and risks of adverse neonatal or obstetrical outcomes compared with ICSI pregnancies. Hence, blastomere biopsy for PGD does not seem to increase the risk for adverse perinatal outcome compared with ICSI pregnancies. © 2017 Reproductive Healthcare Ltd.

Svirsky R.,Assaf Harofe Medical Center | Maymon R.,Assaf Harofe Medical Center | Vaknin Z.,Assaf Harofe Medical Center | Mendlovic S.,Assaf Harofe Medical Center | And 4 more authors.
Fertility and Sterility | Year: 2010

Objective: To present four cases of twin tubal pregnancies and discuss possible etiologies. Twin tubal pregnancies are a rare event, with incidence rates estimated as 1 out of 725-1,580 of tubal pregnancies. Design: Case series. Setting: Department of obstetrics and gynecology at a tertiary health care facility. Patient(s): All women with twin tubal pregnancy diagnosed and treated in the department during the years 2007-2009, according to electronic files and histologic reports. Intervention(s): None. Main Outcome Measure(s): Artificial reproductive technique preceding twin tubal pregnancies Result(s): We diagnosed four twin pregnancies of 163 tubal pregnancies, an incidence of 2.4%. Of the four cases, two conceived after gonadotropin stimulation and intrauterine insemination. The third conceived following in vitro fertilization and intracytoplasmic sperm injection. The fourth was a spontaneous conception diagnosed as monochorial monoamniotic twin tubal pregnancy. Conclusion(s): Twin tubal pregnancies may not be as rare as previously thought. Three of the four cases indentified during a 2-year period followed artificial reproductive technique. We hope that this report will promote the study of the epidemiology of this event, improve diagnosis, and encourage the development of treatment modalities. Copyright © 2010 American Society for Reproductive Medicine, Published by Elsevier Inc.

Or Y.,In Vitro Fertilization Unit | Appelman Z.,Genetics Unit
Journal of Gynecologic Surgery | Year: 2014

Background: A septate uterus is a relatively common Müllerian defect that has an impact on fertility; this effect has been debated. Operative hysteroscopy is the preferred method of treatment in patients with recurrent abortions or poor obstetric histories, but it has not yet been determined whether or not to perform prophylactic metroplasty when a septum is incidentally diagnosed in an otherwise healthy patient. Methods: This article reviews existing literature on the clinical significance of a septate uterus, its diagnosis, surgical treatment, and reproductive outcome after hysteroscopic metroplasty. Complications and the controversy surrounding this procedure are also discussed. Results: Available literature suggests that untreated Müllerian defects could impair pregnancy outcomes significantly. Hysteroscopic metroplasty is generally preferred over expectant management in patients with septate uteri and poor obstetrical histories. Conclusions: Although controversial, prophylactic metroplasty may be recommended for nulliparous patients with incidentally diagnosed uterine septa if there is unexplained infertility in patients>35 years of age and in whom assisted reproductive technologies are used. (J GYNECOL SURG 30:325) © Mary Ann Liebert, Inc. 2014.

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