ΟΜΙΛΙΕΣ ΕΛΛΗΝΙΚΑ

 

1. Γ.Λαϊνάς. Can OHHS be completely prevented?
   Προσκεκλημένος Ομιλητής: Παγκόσμιο Συνέδριο IFFS στην Αθήνα, 10 - 13 Σεπτεμβρίου 2023
   
   
2. Γ.Λαϊνάς. Automated volumetric follicle measurements on the day of triggering final oocyte maturation predict the number of oocytes collected more accurately than manual-2D assessment. An observational cohort study
   Παγκόσμιο Συνέδριο IFFS στην Αθήνα, 10 - 13 Σεπτεμβρίου 2023
   
   
3. Γ.Λαϊνάς. . Follicular flushing increases the number of cumulus oocyte complexes retrieved. A Randomized Controlled Trial
   ESHRE 39η ετήσια συνάντηση Κοπεγχάγη, Δανία 25-28 Ιουνίου 2023
   
   
4. Γ.Λαϊνάς. Time-lapse in the modern IVF lab:A luxury or necessity? Debate Προσκεκλημένος ομιλητής: ESHRE 39th Annual Meeting Κοπεγχάγη, Δανία 25-28 Ιουνίου 2023
   
   
5. Γ.Λαϊνάς. Is Follicular flushing still alive? Debate
   Προσκεκλημένος Ομιλητής: ESHRE 39η ετήσια συνάντηση Κοπεγχάγη, Δανία 25-28 Ιουνίου 2023
   
   
6. Γ.Λαϊνάς. RIF - Is PGT-A and hCG all that ESHRE proposes?
   Προσκεκλημένος Ομιλητής: University College Hospital (UCLH) University of Glasgow London Μάιος 2023
   
   
7. Γ.Λαϊνάς. “Troubleshooting in the IVF clinic and lab”
   Προσκεκλημένος ομιλητής: Μάθημα διαδικτυακού σεμιναρίου ESHRE από την SIG Safety and Quality in ART (SQART) Webinar Απρίλιος 2023
   
   
8. Γ.Λαϊνάς. LH in COS: Pros VS Cons Debate
   Προσκεκλημένος Ομιλητής: Εκδήλωση Organon, Καστρί, Μάρτιος 2023
   
   
9. Γ.Λαϊνάς. Ενδομήτριο σε RIF
   Προσκεκλημένος Ομιλητής: Μεταπτυχιακό στο Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης, 6-7 Μαρτίου 2023
   
   
10. Γ.Λαϊνάς. Ανεξήγητη υπογονιμότητα
    Προσκεκλημένος Ομιλητής: Μεταπτυχιακό στο Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης, 6-7 Μαρτίου 2023
    
    
11. Γ. Λαϊνάς . Πανδημία Covid 19 σε μονάδες υποβοηθούμενης αναπαραγωγής. Προσκεκλημένος ομιλητής: ΕΕΕ 25-27 Νοεμβρίου 2022
    
    
12. Γ. Λαϊνάς. Outcome of children born after PGT.
    Προσκεκλημένος ομιλητής: ΕΕΓΣ : Εξελίξεις στην Ιατρικά Υποβοηθούμενη Αναπαραγωγή 10 Δεκεμβρίου 2022
    
    
13. Γ. Λαϊνάς. Controversies in Human Reproduction - Cost Effectiveness of Recombinant FSH.
    Προσκεκλημένος ομιλητής: 6η Συνάντηση SSHR. 14-16 Οκτωβρίου 2022
    
    
14. Γ.Λαϊνάς . Is flushing during oocyte retrieval unnecessary?
    Προσκεκλημένος ομιλητής: 38th Hybrid Annual Meeting of the ESHRE, Μιλάνο Ιταλία, 3–6 Ιουλίου
    
    
15. Γ.Λαϊνάς . Ορισμός και πρόβλεψη της ανθρώπινης υπογονιμότητας .
    Προσκεκλημένος ομιλητής: 5ο Συνέδριο ΕΛΕΙΥΑ, 16-18 Ιουλίου 2022

 

16. Γ.Λαϊνάς . Chronic endometritis: when to search for, how to diagnose and how to treat
    Προσκεκλημένος ομιλητής: ECW από SIG RE, 5-7 Μαΐου 2022

 

17. G. Lainas. “Individualisation of Ovarian Stimulation via A.I. – Guided FSH Dose Regimen.”
    Invited speaker: The Annual Congress of the Chinese Society of Reproductive Medicine 16 April 2022 (Virtual)
    
    
18. Γ. Λαϊνάς. “AI in fertility treatment”
    Προσκεκλημένος ομιλητής: Darmstadt Γερμανία, 12 Μαρτίου 2022

 

19. Γ. Λαϊνάς . «Σ.Υ.Ω. – Μία Τεκμηριωμένη Προσέγγιση»
    Προσκεκλημένος ομιλητής: Δημοκρίτειο Πανεπιστήμιο Θράκης
    Αλεξανδρούπολη , Ελλάδα, Σεπτέμβριος 2021
    
    
20. Γ. Λαϊνάς. ''Πρόκληση τελικής ωρίμανσης ωοθυλακίων. Ποιά είναι η καλύτερη επιλογή;»
    6ο Πανελλήνιο Συνέδριο Γονιμότητας και Στειρότητας
    Θεσσαλονίκη, Ελλάδα, Μάιος 2021
    
    
21. Γ. Λαϊνάς . "Ανάλογα GnRH - Εξέλιξη και τρέχουσα χρήση"
    Βελτιστοποίηση πρωτοκόλλων διέγερσης ωοθηκών
    Θεσσαλονίκη, Ελλάδα, Απρίλιος 2021

22. G. Lainas. “High gonadotropin dose or natural cycle?”
    The highs and lows of IVF
    34th Annual Meeting of ESHRE (Virtual)
    June 2021

23. G. Lainas. “The golden trigger for final oocyte maturation”
    Success in ART: New concepts, new strategies
    ESHRE Campus Workshop (Virtual)
    January 2021

24. G. Lainas. ‘’Uterine polyps, adenomyosis, leiomyomas - Effect on endometrial
    The endometrium in ART – Truth and Fallacies of the black box of embryo implantation
    ESHRE Campus Workshop (Virtual)
    October 2020

25. G. Lainas. “The real place of IVF in PCOS”
    Invited speaker at the 36th Annual Meeting of ESHRE (Virtual)
    July 2020

26. Γ. Λαϊνάς. «Φυσικός κύκλος και εξωσωματική γονιμοποίηση: Πλεονεκτήματα και μειονεκτήματα»
    Διαγνωστική και Θεραπευτική προσέγγιση υπογόνιμων ζευγαριών
    Ελληνική Εταιρεία Γονιμότητας και Στειρότητας
    Μάρτιος 2020

27. Γ. Λαϊνάς . «Εφαρμογή κατευθυντήριων οδηγιών και στοιχείων στην κλινική πρακτική της Ι.Υ.Α.»
    4ο συνέδριο Ελληνικής Εταιρείας Ιατρών Υποβοηθούμενης Αναπαραγωγής.
    Αθήνα, Ελλάδα, Φεβρουάριος 2020

28. G. Lainas. ‘’The Pharmacogenomis of Ovarian Stimulation’’
    Addressing the "extremes" in ovarian stimulation: New tools for poor and hyper responders
    ESHRE Campus symposium

29. G. Lainas. “Which is the preferred drug and dosage for Ovulation Triggering?”
    The ESHRE Guideline on Ovarian Stimulation: Do we have an agreement?
    ESHRE Campus symposium
    Barcelona, Spain, October 2019

30. G. Lainas. “Definition and Prognosis of Unexplained Infertility”
    Infertility: Tales of the unexplained
    35th Annual Meeting of ESHRE
    Vienna, Austria, June 2019

31. Γ. Λαϊνάς. «Φυσικός κύκλος και εξωσωματική γονιμοποίηση: Πλεονεκτήματα και μειονεκτήματα».
    2ο Συνέδριο Ελληνικής Αναπαραγωγικής Ιατρικής
    Πάτρα, Ελλάδα, Δεκέμβριος 2018

32. Γ. Λαϊνάς . «Απόξεση ενδομητρίου και υστεροσκόπηση στην εξωσωματική γονιμοποίηση»
    Νέα δεδομένα στη Στειρότητα και τη Στειρότητα
    Λάρισα, Ελλάδα, Σεπτέμβριος 2018

33. G.  Lainas. “Hysterscopy and Endometrial Scratching: Facts and Fictions’’
    The luteal phase: the neglected part of assisted reproduction?
    ESHRE Campus symposium
    Hamburg, Germany, May 2018

34. G. Lainas. ‘’Beyond FSH - Which other tools matter in stimulation phase?’’
    Ovarian Stimulation for IVF: individualization and beyond?
    Pre-congress Course ESHRE
    Geneva, Switzerland 2017

35. G. Lainas, J.K. Bosdou, C.A. Venetis, I.A. Sfontouris, K. Chatzimeletiou, L. Zepiridis, A.     Makedos, A. Daniilidis, A. Mitsoli, D. Savvaidou, T.G. Lainas, B.C. Tarlatzis,E.M. Kolibianakis
    ‘‘The optimal dose of triptorelin for triggering final oocyte maturation in patients at high-risk for OHSS: A randomized clinical trial’’
    32nd Annual Congress of ESHRE
    Lisbon, Portugal, June 2015

36. G. Lainas GT, Navaratnarajah R, Sfontouris IA, Venetis C, Zorzovilis IZ, Lainas TG
    ‘’Are pregnancy outcomes affected by the presence of hysteroscopic findings in asymptomatic women undergoing in vitro fertilization treatment?’’
    European Society of Gynecological Endoscopy (ESGE)
    Brussels, Belgium 2014

37. G. Lainas, - Effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on pregnancy rates in patients with multiple unsuccessful IVF attemptsOral Presentation - Effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on pregnancy rates in patients with multiple unsuccessful IVF attempts
    Jun 2013 Issued by Human Reproduction · Jun 2013
    
    
38. G. Lainas - Επαγωγή της τελικής ωρίμανσης των ωοθυλακίων με χορήγηση αγωνιστή GnRH σε γυναίκες με πολυκυστικές ωοθήκες που υποβάλλονται σε εξωσωματική γονιμοποίηση.
    12ο Πανελλήνιο Συνέδριο Μαιευτικής και Γυναικολογίας, Θεσσαλονίκη, 17-20 Μαΐου 2012
    
    
39. G. Lainas - Assessment of embryo selection using non-invasive metabolomic analysis as an adjunct to morphology indicates improvement in implantation and fetal cardiac activity ratesOral Presentation - Assessment of embryo selection using non-invasive metabolomic analysis as an adjunct to morphology indicates improvement in implantation and fetal cardiac activity rates
    Issued by Human reproduction · Jul 2011

 

ΟΜΙΛΙΕΣ ΑΓΓΛΙΚΑ

1. G. Lainas. Can OHHS be completely prevented?
   Invited Speaker: IFFS World Congress in Athens, 10 - 13 September, 2023
   
   
2. G. Lainas.Automated volumetric follicle measurements on the day of triggering final oocyte maturation predict the number of oocytes collected more accurately than manual-2D assessment. An observational cohort study
   IFFS World Congress in Athens, 10 - 13 September, 2023
   
   
3. G. Lainas. Follicular flushing increases the number of cumulus oocyte complexes retrieved. A Randomized Controlled Trial
   ESHRE 39th Annual Meeting Copenhagen, Denmark 25-28 June 2023
   
   
4. G. Lainas. Time-lapse in the modern IVF lab:A luxury or necessity? Debate
   Invited speaker: ESHRE 39th Annual Meeting Copenhagen, Denmark 25-28 June 2023
   
   
5. G. Lainas. Is Follicular flushing still alive? Debate
   Invited Speaker: ESHRE 39th Annual Meeting Copenhagen, Denmark 25-28 June 2023
   
   
6. G. Lainas. RIF - Is PGT-A and hCG all that ESHRE proposes?
   Invited Speaker: University College Hospital (UCLH) University of Glasgow London May 2023
   
   
7. G. Lainas. “Troubleshooting in the IVF clinic and lab”
   Invited Speaker: ESHRE webinar course by SIG Safety and Quality in ART (SQART) Webinar April 2023
   
   
8. G. Lainas. LH in COS: Pros VS Cons Debate
   Invited Speaker: Organon event, Kastri, March 2023
   
   
9. G. Lainas. Endometrium in RIF
   Invited Speaker: Master’s in Aristotle university of Thessaloniki, 6-7 Μαρτίου 2023
   
   
10. G. Lainas. Unexplained infertility
    Invited Speaker: Master’s in Aristotle university of Thessaloniki, 6-7 Μαρτίου 2023
    
    
11. G. Lainas. Covid 19 pandemic in assisted reproduction units.
    Invited speaker: EEE 25-27 November 2022
    
    
12. G. Lainas. Outcome of children born after PGT.
    Invited speaker: ΕΕΓΣ: Developments in Medically Assisted Reproduction 10 December 2022
    
    
13. G. Lainas. Controversies in Human Reproduction - Cost Effectiveness of Recombinant FSH.
    Invited speaker: 6th SSHR Meeting. 14-16 October 2022

14. G. Lainas. Is flushing during oocyte retrieval unnecessary?
    Invited speaker: 38th Hybrid Annual Meeting of the ESHRE, Milan Italy, 3–6 July 2022
    
    
15. G. Lainas. Definition and prediction of human infertility.
    Invited speaker: : 5th Conference ΕΛΕΙΥΑ, 16-18 July 2022
    
    
16. G. Lainas. Chronic endometritis: when to search for, how to diagnose and how to treat
    Invited speaker: ECW by SIG RE, 5-7 Μαΐου 2022
    
    
17. G. Lainas. “Individualisation of Ovarian Stimulation via A.I. – Guided FSH Dose Regimen.”
    Invited speaker: The Annual Congress of the Chinese Society of Reproductive Medicine 16 April 2022 (Virtual)
    
    
18. G. Lainas. “AI in fertility treatment”
    Invited speaker: Darmstadt Germany, 12 March 2022
    
    
19. G. Lainas. “OHSS – Evidence based approach”
    Invited lecture for Human Reproduction Democritus University of Thrace
    Alexandroupoli, Greece, September 2021

 

20. G. Lainas. ‘’Induction of final follicular maturation. Which is the best option?”
    6th Hellenic congress of fertility and sterility
    Thessaloniki, Greece, May 2021

 

21. G. Lainas. “GnRH Analogues – Evolution and current use’’
    Optimization of Ovarian Stimulation protocols
    Thessaloniki, Greece, April 2021

 

22. G. Lainas. “High gonadotropin dose or natural cycle?”
    The highs and lows of IVF
    34th Annual Meeting of ESHRE (Virtual)
    June 2021

 

23. G. Lainas. “The golden trigger for final oocyte maturation”
    Success in ART: New concepts, new strategies
    ESHRE Campus Workshop (Virtual)
    January 2021

 

24. G. Lainas. ‘’Uterine polyps, adenomyosis, leiomyomas - Effect on endometrial
    The endometrium in ART – Truth and Fallacies of the black box of embryo implantation
    ESHRE Campus Workshop (Virtual)
    October 2020

 

25. G. Lainas. “The real place of IVF in PCOS”
    Invited speaker at the 36th Annual Meeting of ESHRE (Virtual)
    July 2020

26. G. Lainas. “Natural cycle and IVF: Pros and Cons”
    Diagnostic and Therapeutic approach of infertile couples
    Hellenic company of Fertility and Sterility
    March 2020

 

27. G. Lainas. “Implementing guidelines and evidence in ART clinical practice’’
    4th conference of Hellenic company of Assisted Reproduction Physicians.
    Athens, Greece, February 2020

 

28. G. Lainas. ‘’The Pharmacogenomis of Ovarian Stimulation’’
    Addressing the "extremes" in ovarian stimulation: New tools for poor and hyper responders
    ESHRE Campus symposium
    Bucharest, Romania, December 2019

 

29. G. Lainas. “Which is the preferred drug and dosage for Ovulation Triggering?”
    The ESHRE Guideline on Ovarian Stimulation: Do we have an agreement?
    ESHRE Campus symposium
    Barcelona, Spain, October 2019

 

30. G. Lainas. “Definition and Prognosis of Unexplained Infertility”
    Infertility: Tales of the unexplained
    35th Annual Meeting of ESHRE
    Vienna, Austria, June 2019

 

31. G. Lainas. “Natural Cycle and IVF: Pros and Cons”.
    2nd Conference of the Greek Reproductive medicine
    Patras, Greece, December 2018

 

32. G. Lainas. “Endometrial Scratching and Hysteroscopy in IVF”
    New data in Infertility and Sterility
    Larissa, Greece, September 2018

33. G. Lainas. “Hysterscopy and Endometrial Scratching: Facts and Fictions’
    The luteal phase: the neglected part of assisted reproduction?
    ESHRE Campus symposium.
    Hamburg, Germany, May 2018

                                

34. G. Lainas. ‘’Beyond FSH - Which other tools matter in stimulation phase?’’
    Ovarian Stimulation for IVF: individualization and beyond?
    Pre-congress Course ESHRE
    Geneva, Switzerland 2017

 

35. G. Lainas, J.K. Bosdou, C.A. Venetis, I.A. Sfontouris, K. Chatzimeletiou, L. Zepiridis, A.     Makedos, A. Daniilidis, A. Mitsoli, D. Savvaidou, T.G. Lainas, B.C. Tarlatzis,E.M. Kolibianakis
    ‘‘The optimal dose of triptorelin for triggering final oocyte maturation in patients at high-risk for OHSS: A randomized clinical trial’’
    32^nd Annual Congress of ESHRE
    Lisbon, Portugal, June 2015

 

36. Lainas GT, Navaratnarajah R, Sfontouris IA, Venetis C, Zorzovilis IZ, Lainas TG
    ‘’Are pregnancy outcomes affected by the presence of hysteroscopic findings in asymptomatic women undergoing in vitro fertilization treatment?’’
    European Society of Gynecological Endoscopy (ESGE)
    Brussels, Belgium 2014

37. Effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on pregnancy rates in patients with multiple unsuccessful IVF attemptsOral Presentation - Effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on pregnancy rates in patients with multiple unsuccessful IVF attempts
    Issued by Human Reproduction · Jun 2013

38. Induction of final follicular maturation by GnRH agonist administration in women with polycystic ovaries undergoing IVF.
    Issued by Human Reproduction · May 2012
    Oral Presentation: 12th Panhellenic Conference on Obstetrics and Gynecology, Thessaloniki, May 17-20, 2012
    
    
39. Assessment of embryo selection using non-invasive metabolomic analysis as an adjunct to morphology indicates improvement in implantation and fetal cardiac activity rates
    Issued by Human reproduction · Jul 2011

ΔΗΜΟΣΙΕΥΣΕΙΣ ΑΓΓΛΙΚΑ

Complex chromosomal aberrations in a fetus originating from oocytes with smooth endoplasmic reticulum (SER) aggregates Systems Biology in Reproductive Medicine · Feb 5, 2018

The presence of smooth endoplasmic reticulum aggregates (SERa) in the ooplasm is considered as the most severe oocyte dysmorphism due to its serious and potentially lethal outcomes in offspring. In the present case report, a couple underwent their first intracytoplasmic sperm injection (ICSI) cycle using a gonadotrophin releasing hormone (GnRH) antagonist protocol, followed by fetal ultrasound scanning and amniocentesis. SERa were observed in all oocytes retrieved. A singleton pregnancy was established. The second trimester fetal ultrasound scan revealed a female fetus with overlapping fingers in both hands, and amniocentesis was performed for the detection of chromosomal abnormalities. Comprehensive genetic analysis with the combined use of array-comparative genomic hybridization (CGH), fluoresence in situ hybridization (FISH) and conventional cytogenetics revealed a complex chromosome rearrangement (CCR) involving three break points on two chromosomes, resulting in a reciprocal translocation with a cryptic 2q31 deletion. A week following amniocentesis, there was rupture of amniotic membranes and a stillborn was delivered. This is the first case in the literature to report a CCR with concomitant 2q31 deletion resulting in a well-defined and clinically recognizable contiguous gene syndrome with an abnormal phenotype in a fetus arising from a cohort of oocytes affected by SERa. It is suggested that fertilization and transfer of oocytes with SERa should be avoided, until further research establishes whether there is a causal relationship between the presence of SERa and chromosomal abnormalities in the resulting fetus.

Outcomes after open and laparoscopic appendectomy during pregnancy: A meta-analysis

European Journal of Obstetrics & Gynecology and Reproductive Biology · Jun 1, 2018

The study aimed to assess surgical and obstetrical outcomes of laparoscopic (LA) and open approach (OA) in pregnant patients with acute appendicitis, a common non-obstetrical surgical issue during pregnancy. The researchers conducted a meta-analysis of twenty studies involving 6,210 pregnant women. They found that laparoscopic appendectomy was associated with lower overall complication rates and shorter hospital stays compared to open appendectomy. However, laparoscopic appendectomy patients had higher rates of fetal loss, while the open appendectomy group had a prolongation of gestational age for term deliveries. The study concludes that the optimal approach for appendectomy in pregnant women remains inconclusive, and further larger studies are needed to clarify the impact of laparoscopic appendectomy on fetal loss rates during pregnancy.

Is oocyte maturation rate associated with triptorelin dose used for triggering final oocyte maturation in patients at high risk for severe ovarian hyperstimulation syndrome?

Human Reproduction · Aug 6, 2019

The GnRH agonist triptorelin is widely used instead of hCG for triggering final oocyte maturation, in order to eliminate the risk of severe OHSS in patients undergoing ovarian stimulation for IVF/ICSI. However, limited data are currently available regarding its optimal dose use for this purpose in patients at high risk for OHSS.
This study looked to answer if oocyte maturation rates are different among 0.1, 0.2 and 0.4 mg triptorelin used for triggering final oocyte maturation in patients at high risk for ovarian hyperstimulation syndrome (OHSS) undergoing ICSI.
A retrospective study was performed between November 2015 and July 2017 in 131 infertile patients at high risk for severe OHSS undergoing ovarian stimulation for ICSI. High risk for severe OHSS was defined as the presence of at least 19 follicles ≥11 mm in diameter on the day of triggering final oocyte maturation.

Female Infertility and Cardiovascular Risk - A Hype or an Underestimated Reality?

 Current pharmaceutical design · Jan 1, 2020

Infertility may be an early indicator of later-life health risk development, such as cardiovascular disease (CVD), the leading cause of death globally. Various infertility-associated factors such as female age, polycystic ovarian syndrome, endometriosis and metabolic syndrome are also risk factors for CVD. Whether there is a real association between female infertility and CVD, given that common pathways lead to both entities, or since both female infertility and CVD share a common basis, needs to be further investigated. If such an association is confirmed, infertile women might benefit from the initiation of preventive strategies aiming to control CVD risk factors. Thus, female infertility may represent an early indicator of future CVD and concomitantly a unique opportunity to identify women at increased risk for developing CVD. It is therefore imperative that large population- based studies are performed to elucidate this issue further and promote public awareness, if necessary.

Association between body mass index and oocyte maturation in patients triggered with GnRH agonist who are at high risk for severe ovarian hyperstimulation syndrome: an observational cohort study.

Reproductive Biomedicine Online · Jan 1, 2020

 This study looked to answer whether body-mass index (BMI) is associated with oocyte maturation in women at high risk for developing severe ovarian hyperstimulation syndrome (OHSS) who are triggered with gonadotrophin releasing hormone (GnRH) agonist.
Prospective observational cohort study. A total of 113 patients at high risk for severe OHSS (presence of at least 19 follicles ≥11 mm) pre-treated with gonadotrophin releasing hormone (GnRH) antagonists and recombinant FSH were administered 0.2 mg triptorelin to trigger final oocyte maturation. Patients were classified in two groups depending on their BMI: ΒΜΙ less than 25 kg/m2 (n = 72) and ΒΜΙ 25 kg/m2 or over (n = 41). Baseline, ovarian stimulation and embryological characteristics, as well as luteal-phase hormone profiles, were compared in patients classified into the two BMI groups. The main outcome measure was the number of mature oocytes.

Risk of gestational diabetes mellitus in women achieving singleton pregnancy spontaneously or after ART: a systematic review and meta-analysis.

Human Reproduction Update · May 22, 2020

The purpose of this systematic review and meta-analysis was to synthesize the best available evidence regarding the association between ART and gestational diabetes mellitus (GDM) in women with singleton pregnancies. The research question asked was whether the risk of GDM is higher in women achieving singleton pregnancy by ART compared with those achieving singleton pregnancy spontaneously.
The present systematic review and meta-analysis, by analysing 1 893 599 women, showed a higher risk of GDM in women achieving singleton pregnancy by ART compared with those achieving singleton pregnancy spontaneously. This finding highlights the importance of early detection of GDM in women treated by ART that could lead to timely and effective interventions, prior to ART as well as during early pregnancy.


Is the probability of pregnancy after ovarian stimulation for IVF associated with serum estradiol levels on the day of triggering final oocyte maturation with hCG? A systematic review and meta-analysis.
Journal of Assisted Reproduction and Genetics · May 29, 2020

The systematic review and meta-analysis aimed to investigate the relationship between serum estradiol levels (Ε2) on the day of triggering final oocyte maturation with human chorionic gonadotrophin (hCG) and the probability of pregnancy in women undergoing ovarian stimulation for in vitro fertilization (IVF). The study included 21 eligible studies with a total of 19,598 IVF cycles and found that there was insufficient evidence to establish a clear association between Ε2 levels and the likelihood of clinical or ongoing pregnancy, as indicated by various Ε2 threshold groups analyzed in the meta-analysis.

A decision-making algorithm for performing or cancelling embryo transfer in patients at high risk for ovarian hyperstimulation syndrome after triggering final oocyte maturation with hCG

Human Reproduction Open · Jun 6, 2020

Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially life-threatening complication of ovarian stimulation that affects up to 2 out of 100 women having IVF/ICSI treatment. It can be mild, moderate or severe. The severe form of OHSS usually requires long hospital treatment, with a considerable cost for both the patient and national health systems. OHSS causes deaths of mothers, and three deaths per 100 000 women undergoing ovarian stimulation have been reported worldwide.
According to ESHRE, 2040 cases of OHSS were reported from European countries for the year 2014. More importantly, it seems that OHSS is not always reported by clinics, since there is a big difference between the number of cases reported to the UK regulator Human Fertilisation and Embryology Authority (HFEA) and the number of hospital admissions due to OHSS reported to NHS Digital. Sixty cases of serious or critical OHSS were reported to the HFEA in 2015 and 38 cases in 2016 compared with the actual 865 admissions to hospital for OHSS in England during the same period, 836 of which were emergency admissions.
The authors therefore want OHSS to be more accurately predicted so it can be prevented.
In this paper, the authors develop a decision-making tool for doctors that predict severe OHSS in women undergoing IVF/ICSI treatment. This tool is very accurate at predicting severe OHSS and can do so early in the IVF/ICSI process.
The tool is useful for telling doctors when severe OHSS is likely to happen to women who are having IVF. This would then help them give these women advice early on in their treatment and therefore allow decisions about treatment to be made at an early stage.


Risk of gestational diabetes mellitus in women achieving singleton pregnancy spontaneously or after ART: a systematic review and meta-analysis.

Human Reproduction Update · Jun 18, 2020

The present systematic review and meta-analysis, by analysing 1 893 599 women, showed a higher risk of GDM in women achieving singleton pregnancy by ART compared with those achieving singleton pregnancy spontaneously. This finding highlights the importance of early detection of GDM in women treated by ART that could lead to timely and effective interventions, prior to ART as well as during early pregnancy.


ESHRE guideline: ovarian stimulation for IVF/ICSI

 Human Reproduction Open · Dec 29, 2020

 Ovarian stimulation is an important first step in many fertility treatments. During ovarian stimulation, doctors prescribe different medications that stimulate the ovaries into producing 5 to 10 mature eggs, instead of one egg in a normal menstrual cycle. These eggs are then removed from the ovaries during egg pickup and later fertilized with sperm in the lab. The resulting fertilized eggs (now embryos) are transferred to the women’s womb resulting in a pregnancy, if all goes well.
There are several options for ovarian stimulation, but they all include a series of different medications taken over several days/weeks, called a stimulation protocol. There is no one treatment scheme that works for each woman undergoing fertility treatment. Some patients may develop only very few eggs (and the stimulation will have to be repeated), while others may over-react with a risk of a serious complication (called ovarian hyperstimulation syndrome).
The current guideline aims to give advice to fertility doctors on which stimulation protocols are safe and effective. The guideline further provides advice on whether clinicians can predict how patients will react and how to adapt the stimulation protocol, for example for patients expected to be at risk of ovarian hyperstimulation syndrome. Finally, there is some advice on ‘add-on’ treatments (growth hormone, aspirin) in ovarian stimulation and whether these are recommended.

How frequent is severe ovarian hyperstimulation syndrome after GnRH agonist triggering in high-risk women? A systematic review and meta-analysis.

Reproductive Biomedicine Online · Jan 3, 2021

Although the incidence of severe OHSS after GnRH agonist triggering of final oocyte maturation in high risk women was low in all strategies examined, its elimination (upper 95% CI=0) was only present in studies where no form of luteal phase support was added.
The current study, sets the discussion about the best method to manage high risk women for OHSS undergoing ovarian stimulation for IVF on a new basis, since it shows that it is possible to eliminate sever OHSS. Apparently, if safety of an ART procedure, regarding severe OHSS incidence, is compromised, this represents a rate-limiting step in offering such a treatment, if an alternative method that will not lead to severe OHSS is present.

The Maribor consensus: report of an expert meeting on the development of performance indicators for clinical practice in ART

Human Reproduction Open · Jul 3, 2021

Performance indicators (PIs) are seen as a valid way to check that the healthcare provided is high in quality and operates within acceptable limits. Although there already is a list of PIs for the laboratories working on infertility and ART (such as IVF, ICSI), a list of PIs for the ART clinical work is lacking. This paper looks at PIs for ART clinical work for different steps of the ART process, starting from fertility workup and diagnosis, extending to ovarian stimulation and oocyte pick-up (OPU), and ending with embryo transfer and the birth of a healthy baby. After consensus was reached in the working group, the PIs were sent through an online survey to find agreement within a group of medical experts. Finally, six PIs were defined: cycle cancellation rate (before OPU), rate of cycles with moderate/severe ovarian hyperstimulation syndrome, the proportion of mature oocytes at ICSI, complication rate after OPU, clinical pregnancy rate, and multiple pregnancy rate.

The working group concluded that it was important for each clinic and/or individual doctor to monitor and check their own performance regularly using these PIs. The PIs are an important step towards improving the outcomes of ART and achieving high-quality ART services.

Chorionic gonadotropin: Ovarian hyperstimulation syndrome and respiratory problems: case report
Reactions Weekly · Jan 26, 2023

 An observational cohort study identified a female patient [age not stated] who developed ovarian hyperstimulation syndrome (OHSS) and respiratory problems after receiving human chorionic gonadotropin (hCG). The woman underwent
ovarian stimulation for in vitro fertilisation. Following final oocyte maturation, she received an IM injection of 5000IU chorionic gonadatropin [Pregnyl], and transvaginal oocyte retrieval was performed 36 hours later. She developed severe
early OHSS, defined as the presence of moderate/marked ascites and at least two of the following: large ovaries, haematocrit >45%, WBC count >15 000/mm3, hydrothorax, dyspnoea, oliguria or abnormal liver function tests [time to reaction onset and outcome not stated]. On day 5 post oocyte retrieval, she developed mild respiratory problems, which resolved spontaneously within 24 hours.

The importance of follicular flushing in optimizing oocyte retrieval.The importance of follicular flushing in optimizing oocyte retrieval.

Current Opinion in Obstetrics and Gynecology · Mar 17, 2023

The latest meta-analysis evaluating follicular flushing does not favour its use over single aspiration. The randomized controlled trials (RCTs) included, however, are characterized by significant heterogeneity regarding the population analysed, the needle type and lumen used, the aspiration pressure applied and the number of flushing attempts performed. More importantly, information regarding the flow rate used for aspiration is scarce. The only RCT employing a constant flow rate between single aspiration and follicular flushing in women with monofollicular development, suggests that a higher number of oocytes is retrieved after follicular flushing.
In order to eliminate clinical heterogeneity that might obscure the detection of the true effect of follicular flushing, randomization to single aspiration and follicular flushing should occur within the same patient. This can be achieved by randomly allocating each patient's ovary to either single aspiration or follicular flushing, maintaining similar flow rates between the groups compared.Given the importance of maximizing the number of oocytes retrieved from a given number of follicles developed, the conduction of properly designed RCTs evaluating follicular flushing is certainly required.

The HERA (Hyper-response Risk Assessment) Delphi consensus definition of hyper-responders for in-vitro fertilization.The HERA (Hyper-response Risk Assessment) Delphi consensus definition of hyper-responders for in-vitro fertilization.

Journal of Assisted Reproduction and Genetics · Mar 18, 2023
The study aimed to establish a consensus on the definition of hyper-response in women undergoing ovarian stimulation for assisted reproductive technology. A committee of experts conducted a Delphi consensus process involving 22 global experts, aiming to reach consensus with ≥66% agreement within ≤3 rounds. Key findings include defining hyper-response as the collection of ≥15 oocytes (72.7% agreement), irrespective of ovarian hyperstimulation syndrome (OHSS) when oocyte count exceeds this threshold (77.3% agreement). The number of follicles ≥10 mm in mean diameter was identified as a critical factor in defining hyper-response (86.4% agreement). Risk factors for hyper-response include AMH values (95.5% agreement), AFC (95.5% agreement), and patient age (77.3% agreement). In patients without prior ovarian stimulation, AFC was considered a more reliable marker when discordant with AMH values (68.2% agreement). The lowest serum AMH level indicating risk for hyper-response was ≥2 ng/ml (72.7% agreement), and the lowest AFC was ≥18 (81.8% agreement). Women with polycystic ovarian syndrome (PCOS) according to Rotterdam criteria were deemed at higher risk for hyper-response (86.4% agreement). However, consensus was not achieved regarding the specific number of growing follicles ≥10 mm defining hyper-response. These findings provide a valuable framework for standardizing research and clinical approaches in managing hyper-response during ovarian stimulation for assisted reproduction.

Non-invasive metabolomic analysis using a commercial NIR instrument for embryo selection.
 Journal of Human Reproductive Sciences · Apr 1, 2023

Metabolomics was introduced in human in vitro fertilization (IVF) for noninvasive identification of viable embryos with the highest developmental competence.
The aim of this study was to determine whether embryo selection using a commercial version of metabolomic analysis leads to increased implantation rates (IRs) with fetal cardiac activity (FCA) compared with morphology evaluation alone.
Metabolomic analysis using the commercial near-infrared (NIR) instrument does not appear to have a beneficial effect on pregnancy and live births, with improvement in IR with FCA for Day 5 transfers. However, no solid conclusions can be reached due to the lack of adequate study power.

 ESHRE Good Practice Recommendations on Recurrent Implantation Failure (RIF)ESHRE Good Practice Recommendations on Recurrent Implantation Failure (RIF)

Human Reproduction Open · Jun 15, 2023

The fertility treatment journey, from the fertility workup to the actual treatments and pregnancy, is a challenge for patients, especially if several transfers of good-quality embryos do not result in a pregnancy. When more than two embryo transfers fail to result in a pregnancy, the term ‘recurrent implantation failure' (or RIF) is often used. Much is still unknown regarding the causes of implantation failure, and whether these causes are linked to the mother, the father, the embryo, or all three. With so many unknowns, healthcare professionals may offer several tests and treatments to patients diagnosed with RIF, often without clear evidence from studies that the tests or treatments are helpful to achieve a pregnancy in a next attempt.
This article challenges the concept of RIF as currently accepted and provides a means of individualizing its recognition to each specific patient context. Evidence supporting the different tests and treatments available is summarized with a recommendation on which tests/treatment could be recommended for use in ART clinics, which can be considered, and those which are not recommended until further research in high-quality studies verifies their usefulness and safety. These recommendations aim to support the management of RIF in clinical practice and stimulate research on the topic.

Two-dimensional ultrasound results in underestimation of the ovarian follicle size compared to automated three-dimensional imaging in women undergoing IVFTwo-dimensional ultrasound results in underestimation of the ovarian follicle size compared to automated three-dimensional imaging in women undergoing IVF

Journal of Ultrasound · Jun 23, 2023
This prospective observational cohort study aimed to compare follicular sizes measured using two-dimensional (2D) and three-dimensional (3D) ultrasound imaging on the final day of controlled ovarian stimulation (COS) in women undergoing in vitro fertilization (IVF). The study included 121 women, and the results showed significant differences between 2D and 3D ultrasound measurements of follicular dimensions. In particular, the x- and y-dimensions were consistently larger in 3D measurements. These discrepancies could have implications for IVF outcomes, as they are used to determine the timing of final oocyte maturation triggering, which in turn affects the yield of mature oocytes and the chances of a successful live birth.

Follicular flushing increases the number of oocytes retrieved: a randomized controlled trial
Human Reproduction · Aug 25, 2023

This is the first RCT to suggest that follicular flushing increases the number of COCs retrieved compared to single aspiration, independently of ovarian response. This implies that follicular flushing plays an important role in the optimization of oocyte retrieval. These results, however, need to be confirmed in future studies, in which an equal flow rate should be used during oocyte retrieval.