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Roque M.,Autonomous University of Barcelona | Roque M.,Origen Center for Reproductive Medicine | Lattes K.,Autonomous University of Barcelona | Serra S.,Autonomous University of Barcelona | And 7 more authors.
Fertility and Sterility | Year: 2013

Objective: To examine the available evidence to assess if cryopreservation of all embryos and subsequent frozen embryo transfer (FET) results in better outcomes compared with fresh transfer. Design: Systematic review and meta-analysis. Setting: Centers for reproductive care. Patient(s): Infertility patient(s). Intervention(s): An exhaustive electronic literature search in MEDLINE, EMBASE, and the Cochrane Library was performed through December 2011. We included randomized clinical trials comparing outcomes of IVF cycles between fresh and frozen embryo transfers. Main Outcome Measure(s): The outcomes of interest were ongoing pregnancy rate, clinical pregnancy rate, and miscarriage. Result(s): We included three trials accounting for 633 cycles in women aged 27-33 years. Data analysis showed that FET resulted in significantly higher ongoing pregnancy rates and clinical pregnancy rates. Conclusion(s): Our results suggest that there is evidence that IVF outcomes may be improved by performing FET compared with fresh embryo transfer. This could be explained by a better embryo-endometrium synchrony achieved with endometrium preparation cycles. Copyright © 2013 American Society for Reproductive Medicine, Published by Elsevier Inc. Source


Roque M.,Origen Center for Reproductive Medicine | Valle M.,Origen Center for Reproductive Medicine | Marques F.,Origen Center for Reproductive Medicine | Sampaio M.,Origen Center for Reproductive Medicine | And 2 more authors.
Andrologia | Year: 2016

Intracytoplasmic sperm injection (ICSI) may be performed with testicular frozen-thawed spermatozoa in patients with nonobstructive azoospermia (NOA). Sperm retrieval can be performed in advance of oocyte aspiration, as it may avoid the possibility of no recovery of spermatozoa on the day of oocyte pickup. There are few studies available in the literature concerning the use of frozen-thawed spermatozoa obtained from testicular sperm aspiration (TESA). To evaluate the effects and the outcomes of ICSI with frozen-thawed spermatozoa obtained by TESA, we performed a retrospective analysis of 43 ICSI cycles using frozen-thawed TESA. We obtained acceptable results with a fertilisation rate of 67.9%, an implantation rate (IR) of 17.1%, and clinical and ongoing pregnancy rates of 41.9% and 37.2% respectively. The results of this study suggest that performing ICSI using cryopreserved frozen-thawed testicular spermatozoa with TESA as a first option is a viable, safe, economic and effective method for patients with NOA. © 2016 Blackwell Verlag GmbH. Source


Roque M.,Origen Center for Reproductive Medicine | Sampaio M.,Origen Center for Reproductive Medicine | Geber S.,Origen Center for Reproductive Medicine | Geber S.,Federal University of Minas Gerais
Journal of Assisted Reproduction and Genetics | Year: 2012

Purpose: The purpose of this systematic review and meta-analysis was to examine the literature and identify randomized controlled trials (RCTs), in order to answer if performing follicular flushing during the oocyte retrieval may improve the assisted reproductive technologies (ART) outcomes. Methods: An exhaustive electronic search was performed using MEDLINE and EMBASE databases. Only RCTs comparing follicular flushing to aspiration only during ART, were included. We included 5 trials, with a total of 482 patients randomized, with median ages ranging from 30.5 to 37.1. Results: The data analyses did not show significant differences regarding live birth rate, clinical pregnancies rates, and the number of oocytes retrieved. The duration of oocyte retrieval was significantly increased in the follicular flushing group. Conclusions: The results from this systematic review and meta-analysis suggest that there is no advantage to use of routine follicular flushing during OR in an unselected group of patients. © 2012 Springer Science+Business Media New York. Source


Geber S.,Origen Center for Reproductive Medicine | Geber S.,Federal University of Minas Gerais | Bossi R.,Origen Center for Reproductive Medicine | Guimaraes F.,Origen Center for Reproductive Medicine | And 2 more authors.
Journal of Assisted Reproduction and Genetics | Year: 2012

Purpose: Several culture media are available to be used in ART. However it is uncertain whether embryos would preferably benefit from one type of medium or the association of different media. Methods: We performed this study to evaluate the impact of simultaneous transfer of embryos independently cultured in two distinct culture media, on pregnancy outcome. A total of 722 couples who underwent infertility treatment were sequentially allocated into three groups: those who had half of the embryos individually cultured in MEM and the other half cultured in sequential media (MEM + Seq Group) (n=243); those who had all embryos cultured only in sequential medium (Seq Group) (n=239); and those who had all embryos cultured only in MEM (MEM Group) (n=240). Results: The pregnancy rate was higher in the MEM + Seq group (51.8 %) than the Seq group (36.7 %) (p<0.001). However the pregnancy rate observed in the MEM group was similar to the others (44.2 %). When a logistic regression test was applied it demonstrated that the number of transferred embryos did not interfere in the pregnancy rates. Conclusions: Our results suggests that offering different culture conditions for sibling embryos with subsequent transfer of embryos that were kept in distinct culture media, might increase pregnancy rates in assisted reproduction cycles. © Springer Science+Business Media, LLC 2012. Source


Roque M.,Origen Center for Reproductive Medicine | Tostes A.C.I.,Origen Center for Reproductive Medicine | Valle M.,Origen Center for Reproductive Medicine | Sampaio M.,Origen Center for Reproductive Medicine | And 2 more authors.
Gynecological Endocrinology | Year: 2015

The objective of the present systematic review and meta-analysis was to examine the literature and to identify the results of randomized controlled trials (RCTs) comparing the use of letrozole to clomiphene citrate (CC) for ovulation induction in patients with polycystic ovary syndrome (PCOS). An exhaustive electronic literature search was performed using the MEDLINE and EMBASE databases until October 2014. Seven prospective RCTs comparing the use of letrozole to CC in PCOS patients met the inclusion criteria. Overall, the seven included studies accounted for 1833 patients (906 in the letrozole group and 927 in the CC group) and for 4999 ovulation induction cycles (2455 in the letrozole group and 2544 in the CC group). Five of the included studies reported data on live birth rates. There was a statistically significant increase in the live birth and pregnancy rates in the letrozole group when compared to the CC group, with a relative risk (RR) = 1.55 (95% confidence interval (CI): 1.26-1.90; I2= 0%) and RR = 1.38 (95% CI: 1.05-1.83; I2= 61%), respectively. There were no differences in the multiple pregnancy, miscarriage and ovulation rates between the two groups. Our study found that letrozole is superior to CC when considering the live birth and pregnancy rates in patients with PCOS. © 2015 Taylor & Francis. Source

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