Our results are in line with the best European centers. The data reported refers to the period between 2010-2015.
The success rates of the different assisted reproduction treatments (IVF and ICSI) depend upon the woman age, the cause of infertility and may vary considerably from couple to couple and from cycle to cycle. Our team of expert tailors a customized protocol for each couple to optimize the results in each single cycle. In our center, the most sophisticated assisted reproductive techniques are adopted and the clinical data carefully interpreted.
IVF/ICSI CYCLES FOLLOWING OVARIAN STIMULATION
In the period between 2010-2015, 6.474 cycles of oocyte pick-up (OPU) for assisted fertilization (IVF/ICSI) were carried out at the GENERA center, and 6.170 underwent the embryo transfer (ET) of fresh and/or frozen embryos.
The average number of mature oocytes obtained was 5.5 per ovarian stimulation. This number varies considerably according to woman age, ovarian reserve and the controlled ovarian stimulation protocol (COS) adopted. In women younger than 35, on average 8 mature oocytes are obtained.
There is no predetermined number of oocytes to be inseminated, instead it is determined by the gynecologist responsible for the treatment in order to optimize it for each specific case (Constitutional Court Ruling 151/2009).
The oocyte fertilization rate was around 70% with both fresh and frozen oocytes.
The blastocyst development rate was 56% after fertilization of fresh oocytes, 44% after fertilization of frozen oocytes and over 70% with donated oocytes.
The delivery rate is shown as percentage per oocyte pick-up (OPU) and per embryo transfer (ET). The success rates for the period under consideration are shown hereafter. These data refer to transfers of both fresh and frozen embryos.
When the results are displayed according to woman age, it becomes evident that this factor is the most important predictor of pregnancy. A pregnancy is defined as the presences of at least one gestational sac observed by ultrasound scan; delivery means a pregnancy, which resulted in a livebirth.
Not all cycles result in an ET that may be cancelled for the following reasons:
- No oocytes retrieved
- Absence of fertilization
- Failure of embryo development or absence of embryos that are compatible with implantation
The cancellation of a fresh ET can also be a medical decision taken to preserve woman’s health and/or to optimize the evaluation of the embryo and/or to better synchronize the endometrium with the embryo. In any case, mature oocytes and/or viable embryos are cryopreserved.
From 2013, in the light of our results also published on Human Reproduction (Ubaldi et al., 2015), of international scientific literature and in the absence of other specific indications, single embryo transfer is recommended in women aged under 35 years or a single euploid blastocyst in cases of Preimplantation genetic diagnosis in all age groups.
The multiple pregnancy rates obtained at our center are listed below and were found to be highly dependent on the policy of the center with a significant reduction in twin pregnancy rate and none triplet pregnancy from 2013. Importantly the efficacy of the treatment, namely the pregnancy rate per started cycles was kept unchanged.
The average number of embryos transferred was 2.2 in 2010, 1.9 in 2011, 1.8 in 2012, 1.4 in 2013 and finally 1.1 in 2014 and 2015. This policy has led to a significant improvement of the obstetrical outcomes, with a reduction of pre-term deliveries and low weight after birth.
CYCLES WITH WARMED EMBRYOS AND OOCYTES
During 2015, 764 warming cycles (after vitrification) were carried out and 742 reached the ET (97.1%). Overall, 308 clinical pregnancies (41.5% per embryo transfer) were obtained, of which 244 delivered (32.8%). The results are therefore similar to those obtained in fresh cycles.
RESULTS OBTAINED IN PRE-IMPLANTATION DIAGNOSIS CYCLES FOR SCREENING OF CHROMOSOMAL ABNORMALITIES – PGS.
Preimplantation genetic testing for aneuploidies (PGS) of embryos at the blastocyst stage was introduced in 2010 at our center.
From 2010 to 2015, 1382 couples were treated, 1076 of which obtained at least one analyzable blastocyst (77.9%). The average age of the women at the time of OPU was 39.3 years. From 1276 PGS cycles in which at least a blastocyst was obtained, 3829 blastocysts (on average 2.9 per cycle) were screened, 2096 of which were diagnosed as affected by one or more chromosomal abnormalities (for an overall aneuploidy rate of 54.7%).
In 836 cycles (65.5%) at least one blastocyst with no chromosomal abnormality was identified.
Overall 849 ETs of 868 euploid blastocysts identified by PGS were carried out, which resulted in 375 term pregnancies and 382 children born (years 2011-2014). The term pregnancy rate per ET following PGS was 44.1%, while the implantation rate of chromosomally-normal blastocysts was 44.0%. It is important to underline here that almost all the post-PGS pregnancies were originated from the transfer of a single chromosomally-normal blastocyst, thus minimizing the incidence of multiple pregnancies and their gestational risks.
Overall, 37 miscarriages were reported, which translate into a miscarriage rate of about 9%, a percentage which is considerably lower than what is generally recorded in women with a mean maternal age of 39.3 years who conceive after IVF.