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Purpose: To assess effects on fertilization rate, embryo quality, pregnancy, and live birth rates of vitrification and warming of oocytes that matured in vitro (vIVM) compared to fresh in vitro maturation (fIVM) cycles.Methods: A retrospective cohort study conducted at a university hospital-affiliated IVF unit. Fifty-six cycles of vIVM cycles and 263 fIVM in women diagnosed with polycystic ovarian syndrome (PCOS) ovaries were included in the analysis. The study group included PCOS patients who failed ovulation induction with intrauterine insemination and were offered IVM cycle followed by oocyte vitrification and warming. The embryological aspects and clinical outcomes were compared to those of controls undergoing fresh IVM cycles during the same period. The main outcome measure was live birth rate.Results: One thousand seventy oocytes were collected from 56 patients and underwent vitrification and warming. In the control group, 4781 oocytes were collected from 219 patients who had undergone a fresh IVM cycle. Oocyte maturation rates were similar between the groups (mean ± SD: 0.7 ± 0.2 vs. 0.6 ± 0.2, for vIVM and fIVM, respectively). Survival rate after warming was 59.8%. Fertilization and embryo cleavage rates per oocyte were significantly lower in the vIVM group. Clinical pregnancy (10.7 vs. 36.1%) and live birth rates (8.9 vs. 25.9%) per cycle were significantly lower in the vIVM group than those in the fIVM group (P = 0.005 and P < 0.001, respectively). Five healthy babies were born in the vIVM group.Conclusions: The reproductive potential of vitrified IVM oocytes is impaired. This injury likely occurs through vitrification and warming. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate reproductive outcomes following elective single blastocyst transfer (eSBT) compared with those of double blastocyst transfer (DBT) in advanced maternal age. Methods: This was a retrospective cohort study performed at an academic fertility center. All women aged 40 and over for whom in vitro fertilization (IVF) cycles were performed and in whom embryo culture was extended to the blastocyst stage were reviewed for possible inclusion. Exclusion criteria included the following: women with >3 previous IVF cycles, the use of donor or frozen oocytes, preimplantation genetic diagnosis/preimplantation genetic screening cycles, and cycles in which embryos did not reach the blastocyst stage on day 5. The study included 310 women; 148 were included in the eSBT group and 162 were included in the DBT group. Live birth rate (LBR) was the main outcome. Outcomes were analyzed using logistic regression, controlling for confounders. These confounders were embryo expansion, embryo quality, and the number of previous IVF cycles. Results: The mean age of the whole group was 41 ± 0.91 years, and the LBR was 21.6%. The eSBT group and the DBT group achieved similar clinical pregnancy rates (33 vs. 33%) (OR 1.04; 95%CI, 0.62-1.75) and LBRs (20 vs. 22.8%) (OR 1.43; 95% CI, 0.78-2.64). The multiple birth rate was lower in the eSBT group (0 vs. 16%, p = 0.02). The subgroup of women who had elective DBT (eDBT) achieved a higher LBR (20 vs. 30.6%) (OR 2.32; 95% CI, 1.16-4.68) and a higher multiple birth rate (0 vs. 22%, p = 0.001). Cycles with early blastocyst transfers were associated with lower LBRs compared with cycles with fully expanded blastocyst transfers (11 vs. 24%, p = 0.02). Conclusion: The results of this study indicate that eSBT is associated with similar LBRs compared to the entire DBT cohort; however, when supernumerary blastocysts are available for cryopreservation, eDBT is associated with both higher LBRs and a higher number of multiple births. Studies assessing the cumulative LBR in advanced maternal age after single blastocyst transfer and subsequent frozen-thawed blastocyst transfers are needed. [ABSTRACT FROM AUTHOR]