P-777 Perinatal and neonatal outcomes, along with a long-term follow-up of children, following Capacitation In-vitro Maturation (CAPA-IVM) in women with predicted excessive ovarian response

Abstract

Study question What are the perinatal, neonatal outcomes and long-term development of children following CAPA-IVM in women with predicted excessive response to ovarian stimulation? Summary answer Cumulative live birth rate following CAPA-IVM was 37.8%. Perinatal, neonatal and long-term developmental outcomes of children born after CAPA-IVM were within the expected normal range. What is known already CAPA-IVM may be considered a viable alternative to In-vitro Fertilization (IVF) in women with predicted excessive ovarian stimulation. Results from a randomized controlled trial comparing CAPA-IVM and IVF did not demonstrate the inferiority of CAPA-IVM following the first transfer. Existing evidence on perinatal and neonatal outcomes following CAPA-IVM indicated that CAPA-IVM yields outcomes comparable to those of IVF. However, there is a paucity of data regarding the cumulative live birth rate and long-term follow-up of children born from CAPA-IVM. Study design, size, duration We have documented the perinatal and neonatal outcomes of 1,563 CAPA-IVM cycles performed at a tertiary IVF centerfrom January 2016 to December 2023. Additionally, a long-term follow-up study was conducted on children born from a randomized controlled trial (RCT) comparing CAPA-IVM and IVF, initiated in 2018. The follow-up assessments were carried out when the children were at the ages of 6 months, 12 months, 24 months, and 60 months. Participants/materials, setting, methods Cumulative live birth rate was calculated after utilizing all embryos generated from a single CAPA-IVM cycle. Low birth weight was defined as less than 2,500 grams, while high birth weight was defined as greater than 4,000 grams. Congenital anomalies was reported according to the ICD-10 system. Children were followed up to 60 months of age and assessed for weight, height, BMI, and psychomotor development using the Ages and Stages Questionnaires (ASQ-3) and Red Flag signs. Main results and the role of chance The analysis encompassed a total of 1,563 CAPA-IVM cycles, which included 2,016 embryo transfer cycles, culminating in the birth of 658 children. Among these children, 432 were singletons and 226 were twins. The cumulative live birth rate was 37.8%. The rates of hypertension, gestational diabetes mellitus, and preterm birth were 3.5%, 15%, and 24%, respectively. Mean birth weight for singletons was 3,084.1±620.7g, while for twins was 2,458.9±679.8g. The low birth weight rate was 15%, and high birth weight was 2.5%. Congenital anomalies were observed in 1.5% of the children. In a RCT comparing CAPA-IVM and IVF, 94 children born from CAPA-IVM were compared with 104 children born from IVF at 6 months, 12 months, and 24 months of age. The two groups were comparable in terms of ASQ-3 scores. At 60 months, 36 children born after CAPA-IVM were compared with 52 children born after IVF. There were no significant differences in weightand BMI between two groups, but children born from CAPA-IVM was significantly shorter than those born from IVF (112.0 [Q1-Q3: 110.0; 115.0] vs. 115.5 [Q1-Q3: 110.0; 120.0] cm, p = 0.02). Additionally, there were no differences in ASQ-3 scores and the rates of Red Flag signs. Limitations, reasons for caution The comparison of ASQ-3 scores is underpowered and a small sample size of children followed up to 60 months. Additionally, there is no comparison to children conceived through spontaneous conception. Wider implications of the findings CAPA-IVM demonstrates favorable live birth outcomes. Longitudinal data indicate that the developmental trajectories of children conceived through CAPA-IVM are comparable to those of children born following IVF. CAPA-IVM may be considered as an alternative for managing infertility in women predicted an excessive ovarian response. Trial registration number No