Withholding antibiotics does not reduce clinical pregnancy outcomes of natural cycle frozen embryo transfers

To assess the impact of withholding doxycycline on the success rate of natural cycle frozen embryo transfers (NC-FET). Retrospective cohort study. Single academic institution. Women undergoing 250 NC-FET with euploid blastocysts performed by a single provider. One hundred and twenty-five NC-FET cycl...

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Veröffentlicht in:Fertility and sterility 2021-05, Vol.115 (5), p.1225-1231
Hauptverfasser: Beshar, Isabel, Johal, Jasmyn K., Bavan, Brindha, Milki, Amin A.
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container_issue 5
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container_title Fertility and sterility
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creator Beshar, Isabel
Johal, Jasmyn K.
Bavan, Brindha
Milki, Amin A.
description To assess the impact of withholding doxycycline on the success rate of natural cycle frozen embryo transfers (NC-FET). Retrospective cohort study. Single academic institution. Women undergoing 250 NC-FET with euploid blastocysts performed by a single provider. One hundred and twenty-five NC-FET cycles performed after January 2019 without antibiotic administration compared with 125 NC-FET cycles before January 2019 with doxycycline administration. Primary outcome: live birth (LB) or ongoing pregnancy rate (OPR, defined as pregnancies ≥13 weeks); secondary outcomes included positive β-human chorionic gonadotropin (β-hCG) level and clinical pregnancy rate (CPR, defined as the presence of fetal cardiac activity on ultrasound). Each group of women comprised 125 NC-FET during the study period of March 2017 to March 2020. The women’s mean age was 36.3 years and mean body mass index was 24 kg/m2. Between the two groups, the baseline characteristics were similar, including age, body mass index, race, smoking status, parity, endometrial thickness, Society of Assisted Reproductive Technology diagnosis, and number of prior failed transfers. Comparing NC-FET with doxycycline administration versus without, we found no statistically significant difference in LB-OPR (64% vs. 62.6%), positive β-hCG (72.8% vs. 74.0%), or CPR (68% vs. 65.9%). After controlling for all variables in a logistic regression, doxycycline still had no effect on LB-OPR. In this analysis of similar patients undergoing NC-FET by a single provider, withholding doxycycline does not reduce success rates. Given the risks of antibiotics, our findings support withholding their use in NC-FET. La suspensión de los antibióticos no reduce los resultados clínicos de embarazo de las transferencias de embriones congelados en ciclo natural. Evaluar el impacto de la suspensión de doxiciclina en la tasa de éxito de las transferencias de embriones congelados en ciclo natural (NC-FET). Estudio retrospectivo de cohortes. Institución académica única. Mujeres que realizaron 250 NC-FET con blastocistos euploides realizados por un solo proveedor. Ciento veinticinco ciclos de NC-FET realizados después de enero de 2019 sin administración de antibióticos en comparación con 125 ciclos de NC-FET antes de enero de 2019 con administración de doxiciclina. Resultado primario: nacidos vivos (LB) o tasa de embarazos en curso (CPR), definido como embarazos ≥13 semanas); Los resultados secundarios incluyeron un nivel positivo de gonadot
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Retrospective cohort study. Single academic institution. Women undergoing 250 NC-FET with euploid blastocysts performed by a single provider. One hundred and twenty-five NC-FET cycles performed after January 2019 without antibiotic administration compared with 125 NC-FET cycles before January 2019 with doxycycline administration. Primary outcome: live birth (LB) or ongoing pregnancy rate (OPR, defined as pregnancies ≥13 weeks); secondary outcomes included positive β-human chorionic gonadotropin (β-hCG) level and clinical pregnancy rate (CPR, defined as the presence of fetal cardiac activity on ultrasound). Each group of women comprised 125 NC-FET during the study period of March 2017 to March 2020. The women’s mean age was 36.3 years and mean body mass index was 24 kg/m2. Between the two groups, the baseline characteristics were similar, including age, body mass index, race, smoking status, parity, endometrial thickness, Society of Assisted Reproductive Technology diagnosis, and number of prior failed transfers. Comparing NC-FET with doxycycline administration versus without, we found no statistically significant difference in LB-OPR (64% vs. 62.6%), positive β-hCG (72.8% vs. 74.0%), or CPR (68% vs. 65.9%). After controlling for all variables in a logistic regression, doxycycline still had no effect on LB-OPR. In this analysis of similar patients undergoing NC-FET by a single provider, withholding doxycycline does not reduce success rates. Given the risks of antibiotics, our findings support withholding their use in NC-FET. La suspensión de los antibióticos no reduce los resultados clínicos de embarazo de las transferencias de embriones congelados en ciclo natural. Evaluar el impacto de la suspensión de doxiciclina en la tasa de éxito de las transferencias de embriones congelados en ciclo natural (NC-FET). Estudio retrospectivo de cohortes. Institución académica única. Mujeres que realizaron 250 NC-FET con blastocistos euploides realizados por un solo proveedor. Ciento veinticinco ciclos de NC-FET realizados después de enero de 2019 sin administración de antibióticos en comparación con 125 ciclos de NC-FET antes de enero de 2019 con administración de doxiciclina. Resultado primario: nacidos vivos (LB) o tasa de embarazos en curso (CPR), definido como embarazos ≥13 semanas); Los resultados secundarios incluyeron un nivel positivo de gonadotropina coriónica humana β (β-hCG) y la tasa de embarazo clínico (CPR, definida como la presencia de actividad cardíaca fetal en la ecografía). Cada grupo de mujeres comprendía 125 NC-FET durante el período de estudio de marzo de 2017 a marzo de 2020. La edad media de las mujeres era de 36,3 años y el índice de masa corporal medio era de 24 kg / m2. Entre los dos grupos, las características iniciales fueron similares, incluida la edad, el índice de masa corporal, la raza, el tabaquismo, la paridad, el grosor del endometrio, el diagnóstico según la Society of Assisted Reproductive Technology y el número de transferencias fallidas anteriores. Al comparar NC-FET con la administración de doxiciclina versus sin ella, no encontramos diferencias estadísticamente significativas en LB-CPR (64% frente a 62,6%), β-hCG positiva (72,8% frente a 74,0%) o CPR (68% frente a 65,9%). Después de controlar todas las variables en una regresión logística, la doxiciclina aún no tuvo efecto sobre LB-OPR. En este análisis de pacientes similares sometidas a NC-FET por un solo proveedor, la suspensión de la doxiciclina no reduce las tasas de éxito. Dados los riesgos de los antibióticos, nuestros hallazgos apoyan la suspensión de su uso en NC-FET.</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2020.11.038</identifier><identifier>PMID: 33423784</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Antibiotics ; clinical pregnancy rate ; embryo transfer ; live-birth rate</subject><ispartof>Fertility and sterility, 2021-05, Vol.115 (5), p.1225-1231</ispartof><rights>2020 American Society for Reproductive Medicine</rights><rights>Copyright © 2020 American Society for Reproductive Medicine. Published by Elsevier Inc. 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Retrospective cohort study. Single academic institution. Women undergoing 250 NC-FET with euploid blastocysts performed by a single provider. One hundred and twenty-five NC-FET cycles performed after January 2019 without antibiotic administration compared with 125 NC-FET cycles before January 2019 with doxycycline administration. Primary outcome: live birth (LB) or ongoing pregnancy rate (OPR, defined as pregnancies ≥13 weeks); secondary outcomes included positive β-human chorionic gonadotropin (β-hCG) level and clinical pregnancy rate (CPR, defined as the presence of fetal cardiac activity on ultrasound). Each group of women comprised 125 NC-FET during the study period of March 2017 to March 2020. The women’s mean age was 36.3 years and mean body mass index was 24 kg/m2. Between the two groups, the baseline characteristics were similar, including age, body mass index, race, smoking status, parity, endometrial thickness, Society of Assisted Reproductive Technology diagnosis, and number of prior failed transfers. Comparing NC-FET with doxycycline administration versus without, we found no statistically significant difference in LB-OPR (64% vs. 62.6%), positive β-hCG (72.8% vs. 74.0%), or CPR (68% vs. 65.9%). After controlling for all variables in a logistic regression, doxycycline still had no effect on LB-OPR. In this analysis of similar patients undergoing NC-FET by a single provider, withholding doxycycline does not reduce success rates. Given the risks of antibiotics, our findings support withholding their use in NC-FET. La suspensión de los antibióticos no reduce los resultados clínicos de embarazo de las transferencias de embriones congelados en ciclo natural. Evaluar el impacto de la suspensión de doxiciclina en la tasa de éxito de las transferencias de embriones congelados en ciclo natural (NC-FET). Estudio retrospectivo de cohortes. Institución académica única. Mujeres que realizaron 250 NC-FET con blastocistos euploides realizados por un solo proveedor. Ciento veinticinco ciclos de NC-FET realizados después de enero de 2019 sin administración de antibióticos en comparación con 125 ciclos de NC-FET antes de enero de 2019 con administración de doxiciclina. Resultado primario: nacidos vivos (LB) o tasa de embarazos en curso (CPR), definido como embarazos ≥13 semanas); Los resultados secundarios incluyeron un nivel positivo de gonadotropina coriónica humana β (β-hCG) y la tasa de embarazo clínico (CPR, definida como la presencia de actividad cardíaca fetal en la ecografía). Cada grupo de mujeres comprendía 125 NC-FET durante el período de estudio de marzo de 2017 a marzo de 2020. La edad media de las mujeres era de 36,3 años y el índice de masa corporal medio era de 24 kg / m2. Entre los dos grupos, las características iniciales fueron similares, incluida la edad, el índice de masa corporal, la raza, el tabaquismo, la paridad, el grosor del endometrio, el diagnóstico según la Society of Assisted Reproductive Technology y el número de transferencias fallidas anteriores. Al comparar NC-FET con la administración de doxiciclina versus sin ella, no encontramos diferencias estadísticamente significativas en LB-CPR (64% frente a 62,6%), β-hCG positiva (72,8% frente a 74,0%) o CPR (68% frente a 65,9%). Después de controlar todas las variables en una regresión logística, la doxiciclina aún no tuvo efecto sobre LB-OPR. En este análisis de pacientes similares sometidas a NC-FET por un solo proveedor, la suspensión de la doxiciclina no reduce las tasas de éxito. Dados los riesgos de los antibióticos, nuestros hallazgos apoyan la suspensión de su uso en NC-FET.</description><subject>Antibiotics</subject><subject>clinical pregnancy rate</subject><subject>embryo transfer</subject><subject>live-birth rate</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqFkE1P3DAQQC1EBQvtX0A-csniryTOsUXQIiFxQeJoeccT8CqxF9uptP31NVpoj1xmpPGbGc8jhHK25ox3V9v1iKmEXGpcCyZqma-Z1Edkxdu2a9qulcdkxRhvGya0OCVnOW8ZYx3vxQk5lVIJ2Wu1ItOTLy8vcXI-PFMbit_4WDxk6iJmGmKhCd0CSGHywYOd6C7hc7AB9jQuBeJcsTjSYMuS6ivsYUI6pvgHA8V5k_aRlmRDrh_OX8mX0U4Zv73nc_J4e_N4_au5f_h5d_39vgElVGmkGtBJprjSm76zCsAJ1bqhHjU4B0Ja2QtmmWoHPQxWcTl2rXZ8cNophfKcXB7G7lJ8XTAXM_sMOE02YFyyEarvtOql4BXVBxRSzDnhaHbJzzbtDWfmTbXZmv-qzZtqw7mpqmvrxfuWZTOj-9f44bYCPw4A1lN_e0wmg8cA6HxCKMZF__mWv7mNlyc</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Beshar, Isabel</creator><creator>Johal, Jasmyn K.</creator><creator>Bavan, Brindha</creator><creator>Milki, Amin A.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4367-836X</orcidid></search><sort><creationdate>202105</creationdate><title>Withholding antibiotics does not reduce clinical pregnancy outcomes of natural cycle frozen embryo transfers</title><author>Beshar, Isabel ; Johal, Jasmyn K. ; Bavan, Brindha ; Milki, Amin A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-349ed304148b76a4ccd245d96539ddc23a3720a0459899a413f658d19d8d44e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antibiotics</topic><topic>clinical pregnancy rate</topic><topic>embryo transfer</topic><topic>live-birth rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beshar, Isabel</creatorcontrib><creatorcontrib>Johal, Jasmyn K.</creatorcontrib><creatorcontrib>Bavan, Brindha</creatorcontrib><creatorcontrib>Milki, Amin A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beshar, Isabel</au><au>Johal, Jasmyn K.</au><au>Bavan, Brindha</au><au>Milki, Amin A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Withholding antibiotics does not reduce clinical pregnancy outcomes of natural cycle frozen embryo transfers</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2021-05</date><risdate>2021</risdate><volume>115</volume><issue>5</issue><spage>1225</spage><epage>1231</epage><pages>1225-1231</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><abstract>To assess the impact of withholding doxycycline on the success rate of natural cycle frozen embryo transfers (NC-FET). Retrospective cohort study. Single academic institution. Women undergoing 250 NC-FET with euploid blastocysts performed by a single provider. One hundred and twenty-five NC-FET cycles performed after January 2019 without antibiotic administration compared with 125 NC-FET cycles before January 2019 with doxycycline administration. Primary outcome: live birth (LB) or ongoing pregnancy rate (OPR, defined as pregnancies ≥13 weeks); secondary outcomes included positive β-human chorionic gonadotropin (β-hCG) level and clinical pregnancy rate (CPR, defined as the presence of fetal cardiac activity on ultrasound). Each group of women comprised 125 NC-FET during the study period of March 2017 to March 2020. The women’s mean age was 36.3 years and mean body mass index was 24 kg/m2. Between the two groups, the baseline characteristics were similar, including age, body mass index, race, smoking status, parity, endometrial thickness, Society of Assisted Reproductive Technology diagnosis, and number of prior failed transfers. Comparing NC-FET with doxycycline administration versus without, we found no statistically significant difference in LB-OPR (64% vs. 62.6%), positive β-hCG (72.8% vs. 74.0%), or CPR (68% vs. 65.9%). After controlling for all variables in a logistic regression, doxycycline still had no effect on LB-OPR. In this analysis of similar patients undergoing NC-FET by a single provider, withholding doxycycline does not reduce success rates. Given the risks of antibiotics, our findings support withholding their use in NC-FET. La suspensión de los antibióticos no reduce los resultados clínicos de embarazo de las transferencias de embriones congelados en ciclo natural. Evaluar el impacto de la suspensión de doxiciclina en la tasa de éxito de las transferencias de embriones congelados en ciclo natural (NC-FET). Estudio retrospectivo de cohortes. Institución académica única. Mujeres que realizaron 250 NC-FET con blastocistos euploides realizados por un solo proveedor. Ciento veinticinco ciclos de NC-FET realizados después de enero de 2019 sin administración de antibióticos en comparación con 125 ciclos de NC-FET antes de enero de 2019 con administración de doxiciclina. Resultado primario: nacidos vivos (LB) o tasa de embarazos en curso (CPR), definido como embarazos ≥13 semanas); Los resultados secundarios incluyeron un nivel positivo de gonadotropina coriónica humana β (β-hCG) y la tasa de embarazo clínico (CPR, definida como la presencia de actividad cardíaca fetal en la ecografía). Cada grupo de mujeres comprendía 125 NC-FET durante el período de estudio de marzo de 2017 a marzo de 2020. La edad media de las mujeres era de 36,3 años y el índice de masa corporal medio era de 24 kg / m2. Entre los dos grupos, las características iniciales fueron similares, incluida la edad, el índice de masa corporal, la raza, el tabaquismo, la paridad, el grosor del endometrio, el diagnóstico según la Society of Assisted Reproductive Technology y el número de transferencias fallidas anteriores. Al comparar NC-FET con la administración de doxiciclina versus sin ella, no encontramos diferencias estadísticamente significativas en LB-CPR (64% frente a 62,6%), β-hCG positiva (72,8% frente a 74,0%) o CPR (68% frente a 65,9%). Después de controlar todas las variables en una regresión logística, la doxiciclina aún no tuvo efecto sobre LB-OPR. En este análisis de pacientes similares sometidas a NC-FET por un solo proveedor, la suspensión de la doxiciclina no reduce las tasas de éxito. Dados los riesgos de los antibióticos, nuestros hallazgos apoyan la suspensión de su uso en NC-FET.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33423784</pmid><doi>10.1016/j.fertnstert.2020.11.038</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-4367-836X</orcidid><oa>free_for_read</oa></addata></record>
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subjects Antibiotics
clinical pregnancy rate
embryo transfer
live-birth rate
title Withholding antibiotics does not reduce clinical pregnancy outcomes of natural cycle frozen embryo transfers
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