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Montréal, Canada

Jamal W.,Ovo Clinic | Velez M.P.,Ovo Clinic | Velez M.P.,University of Montreal | Zini A.,Ovo Clinic | And 6 more authors.
Reproductive BioMedicine Online | Year: 2012

A retrospective cohort study was performed to evaluate the outcome of modified natural IVF-intracytoplasmic sperm injection (mnIVF-ICSI) cycles to compare 81 mnIVF-ICSI first cycles using ejaculated spermatozoa with 44 mnIVF-ICSI first cycles using surgically retrieved spermatozoa. There were no differences between the two groups in terms of number of oocytes retrieved, oocyte maturity or female age. However, male age was significantly higher in the surgically retrieved compared with the ejaculated group (41.5 versus 36.5 years, P = 0.001). There were no significant differences in fertilization rate or cleavage rate between the ejaculated and the surgically retrieved groups; however the prevalence of embryo transfer was higher in the surgically retrieved group (65.9% versus 45.7%, P = 0.03). Only single-embryo transfer was performed. Biochemical (34.5% versus 37.8%) and clinical (31.0% versus 35.1%) pregnancy rates per embryo transfer were similar between the ejaculated and the surgically retrieved groups. The data suggest that mnIVF-ICSI is an alternative treatment option in couples with severe male factor infertility where surgical sperm retrieval is required. The aim of the present study was to evaluate and compare the outcomes of modified natural IVF-intracytoplasmic sperm injection (mnIVF-ICSI) with surgically retrieved spermatozoa (in male partners with obstructive azoospermia) and ejaculated spermatozoa (in couples with mild-to-moderate male factor). Eighty-one mnIVF-ICSI first cycles using ejaculated spermatozoa were compared with forty-four mnIVF-ICSI first cycles using surgically retrieved spermatozoa. There were no differences between the two groups in terms of number of oocytes retrieved, oocyte maturity or female age. However, male age was significantly higher in the surgically retrieved compared with the ejaculated group. There were no significant differences in fertilization rate, or cleavage rate between the two groups; however, there were more patients having embryo transfers in the surgically retrieved group. Only single-embryo transfer was performed. Biochemical and clinical pregnancy rates per embryo transfer were similar between both groups. The data suggest that mnIVF-ICSI is an alternative treatment option in couples with severe male factor infertility where surgical sperm retrieval is required. © 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. Source


Kadoch I.-J.,Ovo Clinic | Kadoch I.-J.,University of Montreal | Phillips S.J.,Ovo Clinic | Bissonnette F.,Ovo Clinic | Bissonnette F.,University of Montreal
Fertility and Sterility | Year: 2011

The use of modified natural-cycle in vitro fertilization (IVF) is a valuable alternative to controlled ovarian hyperstimulation in young poor responders and should be considered in patients who require IVF and demonstrate endocrinologic evidence of ovarian aging and in those who have had one or two canceled controlled ovarian hyperstimulation cycles. © 2011 American Society for Reproductive Medicine. Source


Velez M.P.,Ovo Clinic | Velez M.P.,University of Montreal | Kadoch I.-J.,Ovo Clinic | Kadoch I.-J.,University of Montreal | And 3 more authors.
Reproductive BioMedicine Online | Year: 2013

Public financing of IVF aims at increasing access to treatment while decreasing the expenses associated with multiple pregnancies. Critics argue that it is associated with lower pregnancy rates. This study compared cycles performed during 2009 (before implementation of Quebec's public IVF programme; period I) to those performed in the year following implementation (period II) in a single IVF centre. First fresh cycles in period I (499 women) and first fresh cycles (815 women) along with their corresponding first vitrified-warmed transfer (271 women) in period II were evaluated. From period I to period II, single-embryo transfer increased from 17.3% to 85.0% (P < 0.001), multiple ongoing pregnancy rate decreased from 25.8% to 1.6% (P < 0.001) and ongoing pregnancy rate decreased from 31.9% to 23.3% (P = 0.001). During period II, the ongoing pregnancy rate per vitrified-warmed embryo transfer was 19.2%, leading to a cumulative ongoing pregnancy rate per initiated cycle of 29.7%, which was not different to the pregnancy rate per fresh cycle during period I (31.9%). To conclude, Quebec's public IVF programme decreased multiple pregnancy rates while maintaining an acceptable cumulative ongoing pregnancy rate, a more precise outcome to evaluate the impact of public IVF programmes. © 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. Source


Delrieu D.,Ovo Clinic | Delrieu D.,University of Montreal | Himaya E.,Ovo Clinic | Himaya E.,University of Montreal | And 3 more authors.
Reproductive BioMedicine Online | Year: 2012

Monozygotic multiple pregnancies are three times more common after assisted reproduction (with or without IVF) than after spontaneous conception (1.2% versus 0.4%). These pregnancies are associated with multiple maternal and fetal risks. This article is a description of nine cases of monozygotic pregnancies following IVF at the OVO Clinic (Montreal) between January 2007 and August 2011 and a scientific review of the literature on monozygotic multiple pregnancies after assisted reproductive treatment found in the MEDLINE and Cochrane Databases. In this retrospective series, 3522 embryos were transferred and 1033 pregnancies were obtained, of which there were nine monozygotics (0.87%). The exact mechanism behind this increased frequency remains uncertain. Possible explanations associated with fertility treatments include alterations of the zona pellucida, transfers at the blastocyst stage, prolonged culture, preimplantation genetic diagnosis, ovarian stimulation and maternal age. Assisted reproduction treatment appears to increase monozygotic pregnancies; however, the rate is still low and therefore it is difficult to exactly conclude the real mechanism. There are two types of multiple pregnancy: the dizygotic (two different embryos) and the monozygotic (one embryo which splits to make two identical genetic embryos). We know the risk factors for dizygotic pregnancies, but the mechanism of monozygotic pregnancies remains unclear. Assisted reproduction treatment seems to increase the multiple monozygotic pregnancy rate to 3-times more than that in nature. Several possibilities could be suspected as responsible for these monozygotic multiple pregnancies - advanced maternal age, alterations of the zona pellucida, transfers at the blastocyst stage, prolonged culture and ovarian stimulation - but a absolute explanation is not yet defined. This article is a scientific review of the literature on monozygotic multiple pregnancies after IVF treatment and a description of nine cases following IVF treatment at the OVO Clinic in Montreal between January 2007 and August 2011. The bibliographic references were found in the Medline and Cochrane Database. © 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. Source


Bouet P.-E.,Ovo Clinic | Bouet P.-E.,University of Montreal | El Hachem H.,Ovo Clinic | El Hachem H.,University of Montreal | And 7 more authors.
Fertility and Sterility | Year: 2016

Objective To determine the prevalence of chronic endometritis (CE) in patients with recurrent implantation failure (RIF) after IVF and unexplained recurrent pregnancy loss (RPL). Design Prospective observational study between November 2012 and March 2015. Setting University-affiliated private IVF clinic. Patient(s) Women with RIF after IVF (group 1) and unexplained RPL (group 2). Intervention(s) Office hysteroscopy followed by an endometrial biopsy was performed as part of the workup for RIF and RPL. The diagnosis of CE was histologically confirmed using immunohistochemistry stains for syndecan-1 (CD138). Main Outcome Measure(s) The prevalence of CE in each group and the sensitivity/specificity of office hysteroscopy in the diagnosis of CE. Result(s) Ninety-nine patients were included (46 in group 1 and 53 in group 2). The mean age was 36.3 ± 4.9 years in group 1 and 34.5 ± 4.9 years in group 2. Five biopsies were uninterpretable (three in group 1 and two in group 2) because of insufficient specimen. The prevalence of CE was 14% (6/43) in group 1 and 27% (14/51) in group 2. The sensitivity and specificity of office hysteroscopy in the diagnosis of CE were 40% (8/20) and 80% (59/74), respectively. Conclusion(s) We found a high prevalence of immunohistochemically confirmed CE in women with RIF and RPL. Office hysteroscopy is a useful diagnostic tool but should be complemented by an endometrial biopsy for the diagnosis of CE. Clinical Trial Registration No. NCT01762098. © 2016 American Society for Reproductive Medicine. Source

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