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| CONFERENCE ABSTRACT |
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| Year : 2016 | Volume
: 1
| Issue : 2 | Page : 39-44 |
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AFRH Conference 2016 Abstracts
| Date of Web Publication | 20-Sep-2017 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2468-8452.215112
How to cite this article:
. AFRH Conference 2016 Abstracts. Afr J Infertil Assist Concept 2016;1:39-44 |
| Using empirical bioethics to define ethical standards for Assisted Reproductive Technology in Nigeria | |  |
Patrick I. Okonta
Department of Obstetrics and Gynaecology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
E-mail: patrickokonta@yahoo.com
The study described how empirical bioethics can be utilized in defining ethical standards for assisted reproductive technology (ART) in Nigeria; a synthesis of the literature and a discourse on empirical bioethics were carried out.
Over the past two decades, the practice of ARTs has expanded in Nigeria with over 40 fertility centers. Globally, the practice of ARTs is fraught with ethical and legal challenges and controversies. Many developed countries have set up legal framework for the practice of assisted conception in their respective domains. Practice guidelines have also been developed to guide the practice and to address ethical issues that emerge. Nigeria is yet to develop a regulatory framework to guide the practice of ART although the Association for Fertility and Reproductive Health is at the forefront of driving this process. A methodology for resolution of ethical dilemma and production of appropriate practice guidelines that is relevant to our circumstance is highly desired. Empirical bioethics is a strategic approach that is very relevant in achieving this desired goal.
Empirical research into ethical issues in the context of Nigeria is a prerequisite in utilizing empirical bioethics to define ethical standards of practice for ART in Nigeria.
| The effect of modern Mayr therapy type of detoxification on oocyte yield, pregnancy rate, and live birth rate in infertile women undergoing art | | |
Oladapo Adenrele Ashiru, Tinuke Adeyi, Tope Fashina, Kenny Osewa, Ijeoma Uzodinma, Ebele Iloabachie, Akemini Umana
Mart Life Detox Clinic, Lagos, Nigeria
The aim of the study was to determine whether modern Mayr type of detoxification improves fertility and pregnancy outcome. This study was a retrospective study design of 111 patients attending Medical Assisted Reproductive Technology Center for infertility treatment from 2014 to 2016 who were referred to the Mart Life Detox Clinic for a supervised modern Mayr type of detoxification before further assisted reproductive technology (ART) treatment. Sixty-seven patients had a history of repeated in vitro fertilization (IVF) failures (60.4%), 89 had body mass index (BMI) ≥27 mg/kg (80%), and nine were poor responders (8.1%). Twelve patients had never attempted IVF before the program (11%). Improvement in their fertility outcomes and other laboratory parameters was assessed in subsequent cycles after detoxification.
More than 80% of patients achieved a significant weight reduction and improvement in BMI. Uniform increase in oocyte yield was noted across board, but this was particularly significant in previous poor responders (threefold increase). Thirty-eight percent of the patients tested positive for beta-human chorionic gonadotropin (hCG) following detoxification while 51.6% of the subset of patients who had a history of repeated IVF failure tested positive for beta-hCG after detoxification. Approximately 50% either have on-going pregnancies or have carried babies to term.
Increase in oocyte yield was found to have a direct relationship with fertilization and pregnancy rate, following the detoxification program. This was also observed in previous poor responders. The data suggest that supervised modern Mayr type of detoxification may positively impact fertility indices in infertile couples who undergo ART; however, there is need for further studies on larger populations to further establish pattern of response.
| Pregnancy and live birth after testicular sperm extraction and intracytoplasmic sperm injection with immotile spermatozoa | | |
M. U. Agioh, L. C. Okorie, J. C. Onyeike
IVF Department, The Bridge Clinic Ltd., Ikeja GRA, Lagos, Nigeria
E-mail: magioh@thebridgeclinic.com
The pregnancy and live birth rate in couples who had testicular sperm extraction (TESE) followed by intracytoplasmic sperm injection (ICSI) with immotile spermatozoa were analyzed.
Thirty ICSI cycles were carried out in 30 couples with determinant male factor infertility. TESE was performed in all the cases, and only immotile spermatozoa were retrieved. The outcome measures were fertilization, clinical pregnancy, and live birth rate.
A total of 426 metaphase II oocytes were microinjected with immotile testicular spermatozoa. Immotile testicular spermatozoa were selected for ICSI based on their physical characteristics. Fertilization and cleavage rates were 40% and 98%, respectively. Ten clients had positive pregnancy test with implantation rate of about 13%. Clinical pregnancy rate per transfer was 25.8%, resulting in six live births, two on-going pregnancies, and two early pregnancies loses.
Pregnancy and live birth can be achieved with immotile testicular spermatozoa in men with azoospermia; however, there is need to further investigate the genetic implication in light of the potential risks of transmission of underlying genetic disorders to the male offspring.
| Advanced paternal age and semen parameters of an indigenous Black African population – Nigerians | | |
Ajayi V, A. Ajayi, I. Oyetunji, O. Biobaku, H. Aikhuele, A. Atiba, B. Afolabi
Nordica Fertility Centre, Ikoyi, Lagos, Nigeria
E-mail: victor.ajayi@nordicalagos.org
The main objective of the study was to analyze the influence of advanced paternal age on semen volume, liquefaction, sperm concentration, motility, mean progressive motility, and sperm morphology among an indigenous Black African population – Nigerians.
This was a descriptive, analytic, cross-sectional study carried out between 2010 and 2015 on a sample of 505 apparently healthy adult males who presented for assisted conception at Nordica Fertility Center in Nigeria. Paternal age (years) was categorized into <40, 40–44.9, 45–49.9, 50–54.9, 55–59.9, and ≥60. Sperm was collected by masturbation and examined within 60 min of collection. Analysis was done using STATA version 13 (StataCorp LLC, Texas, USA), and the level of significance was set at P < 0.05.
Overall, mean (±standard deviation) of age (years) and body mass index were 42.5 (7.2) and 27.4 (4.5), respectively. Mean seminal fluid volume (SFV) at age < 40 (2.3 ± 1.4 ml) was significantly higher (t = 2.7, P = 0.006; t = 2.7, P = 0.01, respectively) than that at age 55–59 (1.5 ± 1.2 ml) and at age ≥ 60 (1.4 ± 0.8 ml). Mean sperm motility at age < 40 (39.9 ± 22.4) was significantly higher (t = 2.1, P = 0.02) than at age 55–59 (28.7 ± 22.9). There was no significant statistical change in sperm cell morphology regardless of age difference. Multivariate regression analysis indicated that paternal age significantly correlated with liquefaction time (r = 0.61, P = 0.013), SFV (r = −0.14, P = 0.007), and motility (r = −1.57, P = 0.041).
The study showed that paternal age may influence semen parameters such as volume, liquefaction time, and sperm motility. These may serve as useful points of consideration in assisted reproductive practice in relation to increase in paternal age.
| Endometriosis and assisted reproductive technology: A review | | |
A. Ajayi, V. Ajayi, I. Oyetunji, O. Biobaku, H. Aikhuele, A. Atiba, B. Afolabi
Nordica Fertility Centre, Ikoyi, Lagos, Nigeria
E-mail: victor.ajayi@nordicalagos.org
The objective of this review is to share information and our experience on this poorly understood disease especially as it concerns endometriosis and assisted reproductive technology (ART).
A review of the literature through internet search mainly via PubMed and of our experience in managing infertile women with endometriosis was carried out, and relevant information to the topic was retrieved and reported. The setting of the study was Nordica Fertility Centre, Lagos, a private assisted conception and endoscopy center located in Lagos, Nigeria.
Results: We found that there are a variety of protocols advocated for assisted reproduction in infertile women with endometriosis. The long protocol with prolonged downregulation appears to be the preferred protocol especially in women with good ovarian reserve as it results in better metaphase II eggs and embryos. The presence of endometrioma does not affect the outcome of in vitro fertilization (IVF), and so, surgery must be indicated. Risk of disease progression is low. There is also no proof that IVF influences risk of cancer of the ovary in women with endometriosis undergoing controlled ovarian hyperstimulation.
The best approach to the management of endometriosis-related infertility using ART is still work in progress; however, some useful recommendations exist in the literature.
| Analysis of two-dimensional and three-dimensional ultrasound features of the endometrium: Implications for making embryo transfer decision | | |
I. Wada, T. Odeku, I. Destiny, S. S. Hati
Fertility and Genetics Center, Nisa Premier Hospital, Abuja, Nigeria E-mail: wada_dr@yahoo.com
The study aims to compare two-dimensional (2D) and 3D ultrasound features of the endometrium before embryo transfer (ET) in vitro fertilization (IVF) or frozen embryo transfer (FET) cycles.
This is a cohort study of women ≤34 years old undergoing IVF or FET cycles. Examinations were carried out by a single observer using 2D (Ultrasonix SXTCH3, Canada) and 3D (Voluson E8 Expert, GE Germany) equipped with vaginal multifrequency probe (from 3 to 12 MHz). The endometrial features monitored include endometrial thickness, endometrial pattern, Doppler uterine blood flow, and presence of fluid tracks, performed in consecutive patients on proposed ET day. Analyse-it® version 4.6 method validation statistical software approach was used to present data analysis results.
Of the total number of scans assessed, attaining the criteria for going ahead with ET is about 20% lower using 3D than 2D ultrasound technique. Improved sensitivity in the detection of tracks of fluid in the endometrium is a significant feature using 3D technique.
3D ultrasound assessment of the endometrium on the proposed ET day provides a more superior option to making ET decision. However, due to the higher likelihood of not proceeding with ET, using this technique posits the need for a functional embryo freezing infrastructure.
| Routine hysteroscopic examination of patients with infertility undergoing in vitro fertilization/intracytoplasmic sperm injection at Georges Memorial Medical Centre, Lagos: A 2-year review | | |
N. Okoh, F. Iketubosin
George's Memorial Medical Centre, Lekki, Lagos, Nigeria
E-mail: newton_walter@yahoo.com
The pathologic findings from hysteroscopic examination of infertile patients planned for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) were evaluated and to correlate with the number(s) of previous IVF failure (s) and evaluate the importance of subjecting patients to hysteroscopic examination before assisted reproductive techniques.
The study was a retrospective study. The electronic medical records of the patients who had hysteroscopic examination before IVF/ICSI between July 2014 and June 2016 were reviewed. Data collected were recorded on a preformed format sheet and analyzed using SPSS version 19 (IBM Corporation, New York, USA).
A total of 220 medical records were reviewed; 214 had successful procedures and 52 (24.3%) of them had previous assisted reproductive technology (ART) failure(s). Sixty-two percent of the patients had normal findings while abnormal hysteroscopic findings were observed in 38% of the patients. Submucous fibroids, endometrial polyps, and intrauterine adhesions were the most common pathologic findings accounting for 32%, 22%, and 16% of the abnormalities, respectively. There was no significant difference in abnormal hysteroscopic findings in patients with previous ARTs failure(s).
Conclusion: The prevalence of intrauterine abnormalities in patients with infertility is high. This may have implications for the success of IVF/ICSI. We therefore conclude that hysteroscopy should be part of routine infertility workup before IVF/ICSI.
| Comparative assessment of transvaginal ultrasonography and saline sonohysterography in the evaluation of endometrial factor infertility: A preliminary report | | |
O. D. Ray-Offor, E. Ray-Offor, E. N. Onwudiwe, T. K. Nyengidiki
Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
E-mail: erayoffor@yahoo.com
The diagnostic yield of transvaginal ultrasonography (TVS) and sonohysterography (SHG) in the evaluation of endometrial factor infertility was compared.
This is a cohort study of patients who presented for hysteroscopy with a history of infertility to an ambulatory care endoscopy center in Port Harcourt Metropolis. Twenty patients underwent SHG and twenty had TVS with diagnostic hysteroscopy as the final confirmatory test. Statistical analysis was with SPSS version 20 (IBM Corporation, New York, USA). Sensitivity, specificity, and predictive values were calculated for both investigations.
A total of 40 patients were evaluated with age range of 28–51 years; mean age of 41.8 ± 6.4 years. The sensitivity of TVS and SHG was 64% and 75%, respectively. TVS was better in assessing submucous myoma. A positive predictive value of 84% versus 68% and negative predictive value of 14.2% versus 25% were noted.
Hysteroscopy remains the mainstay for diagnosis of endometrial pathologies though SHG and TVS play a crucial complimentary role.
| The effect of transfer distance from the fundus on clinical pregnancy rates in intracytoplasmic sperm injection cycles | | |
Bamidele Babatunde, Ajayi Richardson, Abiara Tayo, Ugwu Nneka, Okorie Lauretta
IVF Department, The Bridge Clinic Ltd., Ikeja Lagos, Nigeria
E-mail: babatundeb@thebridgeclinic.com
The effect of the transfer distance from the fundus on clinical pregnancy rates in intracytoplasmic sperm injection cycles was assessed.
The study was conducted on 50 consecutive patients who underwent in vitro fertilization using long agonist protocol. Oocytes pick up was carried out within 36 h after human chorionic gonadotropin administration. Embryo transfer took place 5 days after oocyte retrieval. All the patients but one (who had one blastocyst) had two good grade blastocysts at transfer. The patients were grouped into four according to the distance between the tip of the catheter and the uterine fundus at transfer: Group 1: 0.5 cm; Group 2: 1 cm; Group 3: 1.5 cm; and Group 4: 2 cm.
Results: Groups 3 and 4 were just two patients (hence, they are excluded from the study); 96% of the patients are in Groups 1 and 2, 50% pregnancy rate in Group 1, and 60% pregnancy rate in Group 2.
Conclusion: The depth of embryo replacement in the uterine cavity may influence implantation rates and should be considered as an important factor to improve the success of implantation and pregnancy rates.
| Effect of endometrial thickness on success of intracytoplasmic sperm injection at The Bridge Clinic, Port Harcourt, Nigeria | | |
M. A. Udensi, T. O. Adakole, P. O. Fiebai
IVF Department, The Bridge Clinic, Port Harcourt, Rivers State, Nigeria E-mail: maduabuchia@thebridgeclinic.com
The study determined the effect of endometrial thickness on pregnancy rate in women after intracytoplasmic sperm injection (ICSI) treatment cycles at The Bridge Clinic, Port Harcourt, Nigeria. A retrospective case–control study of infertile women who underwent fresh ICSI cycles with blastocyst stage transfer of not more than two embryos on day 5 was conducted from January 2012 to December 2015 at The Bridge Clinic, Port Harcourt, Nigeria. Women who had positive pregnancy test were seen as cases and their ages were matched 1:1 with those of negative pregnancy outcome taken as controls. Long protocol of controlled ovarian hyperstimulation was used. Endometrial thickness at oocytes retrieval was estimated by transvaginal ultrasonography at its widest thickness in the midsagittal plane of the uterus. Both cases and controls were subclassified based on endometrial thickness into three groups: <8 mm; 8–14 mm; and >14 mm. Data analysis was done using SPSS version 15 (IBM Corporation, New York, USA) for Windows statistical software, and statistical significance was set at P < 0.05. A total of 210 fresh ICSI cycles were analyzed with 105 each in the pregnant cases and nonpregnant controls. The endometrial thickness in women with positive pregnancy test outcome was not significantly different from those of negative pregnancy outcome (13.19 ± 3.15 vs. 12.59 ± 3.93, P = 0.226).
Endometrial thickness does not seem to influence outcome of ICSI treatment cycles.
| The effect of fibroids on the outcome of assisted reproductive technology treatment in Port Harcourt | | |
I. Oyeleye, E. Okandeji, M. A. Udensi, P. Fiebai
IVF Department, The Bridge Clinic, Port Harcourt, Rivers State, Nigeria
E-mail: ifeomao@thebridgeclinic.com
The study evaluated the effect of fibroids on outcomes of infertility treatment by in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment in Nigerian women.
This was a retrospective case–controlled study from January 2013 to December 2014 of fresh IVF/ICSI cycles among forty women with either intramural or subserous fibroids or both and forty women without fibroids presenting at The Bridge Clinic, Port Harcourt.
The main outcome measures were biochemical pregnancy, clinical pregnancy, miscarriage, and live birth rates. Data analysis was done with Epi Info™ version 3.5.4 (CDC, Washington, USA). Comparisons were made by Student's t-test and Chi-square analysis. P < 0.05 was considered as statistically significant.
The two groups were similar in their baseline characteristics and ovarian stimulation outcomes. Biochemical pregnancy rate was significantly lower in women with fibroids 8 (20%) versus 17 (43%), P = 0.029. Clinical pregnancy 7 (18%) versus 12 (30%) (P = 0.189); live birth 5 (13%) and 11 (28%) (P = 0.09), and miscarriage rates 44% and 35% (P = 0.65) were not significantly different.
Intramural and subserous fibroids significantly reduced biochemical pregnancy rates in infertile women who received assisted reproductive technology treatment in Port Harcourt without significantly impacting on clinical pregnancy, miscarriage, and live birth rates. Prospective evaluation of the effects of fibroids on treatment outcome is recommended.
| Assisted conception at the Ahmadu Bello University Teaching Hospital, Shika-Zaria: A modest attempt amid challenges | | |
H. Umar Sulayman, F. Bakari, S. Avidime, U. S. Bawa, A. G. Adesiyun, A. Ameh
Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria
E-mail: hajaratuumar@gmail.com
We determined the pregnancy rate of assisted conception procedures at the Ahmadu Bello University Teaching Hospital, Shika-Zaria.
Patients with infertility who had assisted conception treatment were analyzed over a 4½-year period; the patients had ovulation induction and timed intercourse or intrauterine insemination. Ovulation induction was with clomiphene citrate and human menopausal gonadotropin.
A total of 126 patients were seen over this period and had assisted conception, of which 38 conceived giving a pregnancy rate of 30.2% of the 38 that got pregnant 15 (39.5%) of them were between the ages of 26 and 30 years. Primary infertility was diagnosed in 29 (76.3%) of the patients while 9 (23.7%) had secondary infertility. Ovulation induction with timed intercourse accounted for 92.1% of the procedures, while ovulation induction with intrauterine insemination was done in 7.9% of cases.
Within the constraints obtainable in most low-resource settings, timed intercourse and intrauterine insemination are still viable options in the management of infertility. However, a lot more patients would have benefitted from advanced assisted conception technique.
| Outcome and congenital anomalies in children born after assisted reproductive technology in Port Harcourt | | |
Ngozi Orazulike, Preye Fiebai, Petronilla Tabansi, Barbara Otaigbe, Richard Ajayi
Department of Obstetrics and Gynaecology, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
E-mail: ngorazulike@yahoo.com
We evaluated the outcome of children born following assisted reproductive technology (ART) in Port Harcourt, Nigeria. This was a case–control study involving 50 ART-conceived children (subjects) and 50 naturally conceived children (controls) between 2004 and 2013. The subjects were recruited from The Bridge Clinic, Port Harcourt. Those who gave consent were invited to the pediatric clinic at the University of Port Harcourt Teaching Hospital between January 2014 and June 2014 where they were interviewed with a structured questionnaire. Data collected were collated and analyzed with Epi Info™ version 6.0.4 (CDC, Washington, USA).
The gestational age at delivery and the mean birth weight of ART children were significantly lower than that of controls. There was a higher incidence of congenital anomalies in the ART babies 17 (34%) than in the controls 0 (0%), P < 0.05 (odd ratio [OR] 25.24, 95% confidence interval [CI]: 3.25–53.19). Admission to the Neonatal Intensive Care Unit (NICU) was significantly higher in the ART babies (OR 6.53, 95% CI: 6.23–30.90). ART children in Port Harcourt had more adverse outcomes than naturally conceived counterparts in terms of preterm birth, neonatal admission, and congenital anomalies. Patients should be adequately counseled on these outcomes before they embark on assisted conception.
| Blastocyst transfer: A 5-year review at The Bridge Clinic, Port Harcourt | | |
T. Adakole, L. Okorie, E. Okandeji, P. Fiebai
IVF Department, The Bridge Clinic, Port Harcourt, Rivers State, Nigeria
E-mail: taiyea@thebridgeclinic.com
The study reports on the treatment outcome following transfer of embryos at the blastocyst stage and to present experience with prolonged embryo culture in Port Harcourt, Nigeria.
A retrospective review of all embryo transfers at the blastocyst stage done at The Bridge Clinic, Port Harcourt, from January 2011 to December 2015 was carried out. Demographic, clinical, and laboratory data of clients who had blastocyst transfer were retrieved from the clinic's electronic database (DynaMed). Statistical analysis was carried out with SPSS 17.0 for Windows Statistical Software.
A total of 320 couples had extended culture for blastocyst transfer during the study period; three of this group did not have embryos for transfer. A total of 5460 oocytes were collected from 317 couples; 4031 matured oocytes were inseminated by intracytoplasmic sperm injection and 67 oocytes by conventional in vitro fertilization. Fertilization rate was 69.7%, cleavage rate was 98.9%, and blastocyst formation rate was 55.9%. Two embryos were transferred to 303 clients while 14 had only one blastocyst transferred. Clinical pregnancy rate was 32.2% and live birth rate was 34.7%. One client has an ongoing pregnancy.
Blastocyst transfer has resulted in successful treatment of infertility at the Bridge Clinic, Port Harcourt, with a live birth rate of 34.7%.
| Comparison of clinical efficacy of long-acting and short-acting gonadotropin-releasing hormone agonist in vitro fertilization and embryo transfer | | |
U. M. Umemmuo, O. C. Aghogoroma, E. Efetie, J. A. F. Momoh,
J. Ikechebelu
Department of Obstetrics and Gynaecology, National Hospital, Abuja, Nigeria
E-mail: jeseuandme@yahoo.com
We compared the efficacy and cost of a single administration of long-acting gonadotropin-releasing hormone agonist (GnRHa) with daily administration of short-acting GnRHa for downregulation during in vitro fertilization and embryo transfer (IVF-ET) cycles.
One hundred and fourteen IVF patients were consecutively allocated into either long-acting GnRHa, goserelin (Group A), or short-acting GnRHa, buserelin (Group B), all commenced on day 21 of the preceding IVF-ET cycle, and compared their effect on hormonal suppression and clinical outcome.
Time taken to achieve downregulation and mean number of human menopausal gonadotropins doses used were not significantly different in both groups. Although the number of oocytes retrieved and fertilized was significantly higher in Group A, there was no significant difference in the number of embryos (P = 0.850) and clinical pregnancy rate at 6 weeks (P = 0.578) in both groups. While Group B had significantly higher number of hospital visits (P = 0.0001) as well as higher number of injections (P = 0.0001), the mean cost of downregulation and ovarian stimulation was significantly higher in Group A (P = 0.043).
Single administration of long-acting GnRHa (goserelin) is as effective as daily injection of short-acting GnRHa (buserelin) for pituitary desensitization during controlled ovarian hyperstimulation in IVF-ET cycles.
| Comparison of treatment outcomes between frozen-thawed blastocyst transfers and fresh blastocyst transfers at the Bridge Clinic, Port Harcourt | | |
E. Okandeji, T. Adakole, P. Fiebai
IVF Department, The Bridge Clinic, Port Harcourt, Rivers State, Nigeria
E-mail: elozinoo@thebridgeclinic.com
The aim of the study was to determine if frozen-thawed embryo transfers (FETs) of blastocysts have comparable outcomes to fresh blastocyst transfers.
This was a retrospective case–controlled study of FET cycles at The Bridge Clinic, Port Harcourt, from January 2014 to July 2016. Couples (n = 41) who had their spare embryos vitrified on day 5, at the blastocyst stage, and subsequently had FET were compared with randomly selected controls matched for age and embryonic development, who had fresh day 5 blastocyst transfers. The main outcome measures were biochemical and clinical pregnancy rates and miscarriage rate. Data analysis was done using Epi Info™ version 6.0.4 (CDC, Washington, USA) statistical software version 3.5.4. Comparison was carried out with the Chi-square and Student's t-tests and significance set at P < 0.05.
There was no significant difference in the biochemical pregnancy rate (37% vs. 32%; P = 0.48), clinical pregnancy rate (24% vs. 20%; P = 0.59), and miscarriage rate (40% vs. 46%; P = 0.72) between the FET and fresh embryo transfer groups.
Treatment outcome with FET of vitrified blastocysts is comparable to that with fresh day 5 blastocyst transfers at The Bridge Clinic, Port Harcourt.
| Comparing day 3 and day 5/6 embryo biopsy for the preimplantation genetic diagnosis of sickle cell anemia in a developing country | | |
R. Ogbeche, E. Iloabachie, A. Umana, O. Osumah, O. Moruf, C. Okeke, K. Ailoje-Ibru, A. Adewusi, O. Ashiru
Medical Assisted Reproductive Technology Center, Lagos, Nigeria
E-mail: rose.ogbeche@medicalartcenter.com
The study compared the outcome of all preimplantation genetic diagnosis (PGD) cases for sickle cell anemia using cleavage and blastocyst stage biopsy in a private hospital set up in Nigeria.
All patients who underwent in vitro fertilization (IVF) and PGD for sickle cell anemia from April 2011 to April 2016 were included in the study. Embryos were biopsied either on day 3 (blastomere) or day 5/6 (trophectoderm). Day 5/6 embryos were vitrified within 1 h after biopsy with subsequent frozen embryo transfer after genetic analysis. Positive human chorionic gonadotropin (hCG), clinical pregnancy, implantation rate, and live birth rate for both stages were evaluated.
A total of 29 patients went through IVF-PGD for sickle cell anemia. Of the 29 patients, 18 had day 3 embryo biopsy (Group A) while 11 had day 5/6 embryo biopsy (Group B). The mean patient age was 34.4 years for both groups. A total of 131 embryos were biopsied in Group A and 68 in Group B. Group A and B had a percentage of 40.5 and 75.5 normal (HB AA and HB AS) embryos, respectively. In Groups A and B, positive hCG rate was 7.7% versus 30%, clinical pregnancy rate was 7.7% versus 30%, implantation rate was 3.7% versus 31.6%, and live birth rate was 3.7% versus 30%.
Trophectoderm biopsy may be more beneficial than blastomere biopsy for preimplantation genetic diagnosis.
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