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Abdala A, Elkhatib I, Bayram A, El-Damen A, Melado L, Lawrenz B, Fatemi HM, Nogueira D. Embryo Culture Medium Has No Impact on Mosaicism Rates: a Sibling Oocyte Study. Reprod Sci 2023; 30:3296-3304. [PMID: 37253937 DOI: 10.1007/s43032-023-01276-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/24/2023] [Indexed: 06/01/2023]
Abstract
Human embryos cultured in vitro can contain two or more cytogenetically distinct cell lineages known as "chromosomal mosaicism". Since mosaicism is produced by mitotic errors after fertilization occurs, culture conditions might contribute to mosaicism origins. Many studies demonstrated that euploidy rates are not affected by culture media; however, whether oocytes cultured under continuous culture media (CCM) or sequential culture media (SCM) has a higher risk of mosaicism occurring remains unsolved. Therefore, this study aims to determine whether mosaicism rates differ when sibling oocytes are cultured in CCM or SCM. A single center observational study was performed including 6072 sibling oocytes. Mature oocytes (MII) were inseminated and cultured in CCM (n = 3,194) or SCM (n = 2,359) until blastocyst stage for trophectoderm (TE) biopsy on day (D) 5, D6, or D7 for preimplantation genetic testing analysis with a semi-automated next-generation sequencing. Mosaicism was classified as low (30-50%) or high (50-80%) based on the percentage of abnormal cells constitution detected in TE samples. As a result, 426 women with a mean age of 34.7 ± 6.4 years were included in the study. Fertilization rates were comparable between CCM and SCM (74.0% vs 72.0%, p = 0.091). Although total blastulation rate and usable blastocyst rate (biopsied blastocysts) were significantly higher in CCM than SCM (75.3 % vs. 70.3%, p < 0.001 and 58.0% vs. 54.5%, p = 0.026), euploidy rates did not differ significantly (45.2% vs. 45.7%, p = 0.810, respectively). Mosaicism rate was not significantly different for blastocysts cultured in CCM or SCM (4.7% vs. 5.1%, p = 0.650), neither the proportion of low or high mosaic rates (3.7% vs. 4.4%, p = 0.353 and 1.0% vs. 0.7%, p = 0.355, respectively). Hence, it was concluded that CCM or SCM does not have an impact on mosaicism rate of embryos cultured until the blastocyst stage.
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Affiliation(s)
- Andrea Abdala
- ART Fertility Clinics, Abu Dhabi, United Arab Emirates.
| | | | - Aşina Bayram
- ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | | | - Laura Melado
- ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Barbara Lawrenz
- ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- Obstetrical Department, Women's University Hospital Tuebingen, Tuebingen, Germany
| | | | - Daniela Nogueira
- ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- Inovie Fertilité, Toulouse, France
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2
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Tao P, Zhou W, Yan X, Wu R, Cheng L, Ye Y, Wang Z, Li Y. Effect of sequential versus single-step culture medium on IVF treatments, including embryo and clinical outcomes: a prospective randomized study. Arch Gynecol Obstet 2021; 305:757-765. [PMID: 34510243 DOI: 10.1007/s00404-021-06219-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 08/25/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Sequential media G5 series (Vitrolife) and single-step medium Continuous Single Culture Complete (CSC-C) (Irvine Scientific) are two different culture media. We want to examine difference between culturing effects of the two media. METHODS To compare the fertilization and early embryo development, a prospective randomized controlled trial with sibling oocytes in infertile patients, aged ≤ 45 years with ≥ 8 oocytes (226 cycles) was conducted. Each half of the retrieved oocytes from the same patient were randomly allocated to two culture media separately. The remaining fresh cycles were randomly assigned to two culture media during the same period (179 cycles). We compared the clinical outcomes based on the total fresh ET cycles in this periods, in which the transferred embryos were only from one culture medium. RESULTS Embryo outcomes: 226 cycles, included 176 IVF and 50 ICSI cycles, were analyzed, which correspond to 3518 inseminated or micro-injected oocytes. Clinical outcomes: 71 (CSC-C) and 71 (G5 series) fresh ET cycles were compared. There were no significant differences in clinical outcomes and general fertilization rate. However, the fertilization rate was superior in the CSC-C when compared with G5 in ICSI cycles (76.51% vs. 67.25%, P = 0.008). In addition, the compacted embryo development rate was significantly higher in CSC-C on day 3. The cycles that had compacted embryos on day 3 demonstrated better outcomes both in embryos as well as clinically. CONCLUSIONS CSC-C had higher fertilization rates than G5 series in ICSI cycles. In addition, the compaction rates of day 3 embryos were significantly higher in CSC-C.
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Affiliation(s)
- Ping Tao
- Reproductive Medicine Centre, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China
| | - Weidong Zhou
- Reproductive Medicine Centre, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China
| | - Xiaohong Yan
- Reproductive Medicine Centre, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China
| | - Rongfeng Wu
- Reproductive Medicine Centre, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China
| | - Ling Cheng
- Reproductive Medicine Centre, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China
| | - Yuanyuan Ye
- Reproductive Medicine Centre, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China
| | - Zhanxiang Wang
- Department of Neurosurgery, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China.
| | - Youzhu Li
- Reproductive Medicine Centre, First Affiliated Hospital of Xiamen University, 55# Zhenhai Road, Xiamen, 361000, Fujian, People's Republic of China.
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3
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Ferré LB, Kjelland ME, Taiyeb AM, Campos-Chillon F, Ross PJ. Recent progress in bovine in vitro-derived embryo cryotolerance: Impact of in vitro culture systems, advances in cryopreservation and future considerations. Reprod Domest Anim 2020; 55:659-676. [PMID: 32144939 DOI: 10.1111/rda.13667] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/19/2020] [Indexed: 02/01/2023]
Abstract
Cryopreservation of in vitro-derived bovine embryos is a crucial step for the widespread reproduction and conservation of valuable high-merit animals. Given the current popularity of bovine in vitro embryo production (IVP), there is a demand for a highly efficient ultra-low temperature storage method in order to maximize donor ovum pickup (OPU) turn-over, recipient availability/utilization and domestic/overseas commercial trading opportunities. However, IVP bovine embryos are still very sensitive to chilling and cryopreservation, and despite recent progress, a convenient (simple and robust) protocol has not yet been developed. At the moment, there are two methods for bovine IVP embryo cryopreservation: slow programmable freezing and vitrification. Both of the aforementioned techniques have pros and cons. While controlled-rate slow cooling can easily be adapted for direct transfer (DT), ice crystal formation remains an issue. On the other hand, vitrification solved this problem but the possibility of successful DT commercial incorporation remains to be determined. Moreover, simplification of the vitrification protocol (including warming) through the use of an in-straw dilution without the use of a microscope is a prerequisite for its use under farm conditions. This review summarizes the bovine IVP embryo cryopreservation achievements, strengths and limitations of both freezing systems and prospective improvements to enhance cryosurvival, as well as perspectives on future directions of this assisted reproductive technology.
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Affiliation(s)
- Luis B Ferré
- National Institute of Agricultural Technology (INTA), Buenos Aires, Argentina
| | - Michael E Kjelland
- Conservation, Genetics & Biotech, LLC, Valley City, ND, USA.,Mayville State University, Mayville, ND, USA
| | - Ahmed M Taiyeb
- Conservation, Genetics & Biotech, LLC, Valley City, ND, USA.,Barz IVF Center for Embryo Research and Infertility Treatment, Kurdistan, Iraq
| | - Fernando Campos-Chillon
- Animal Science Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Pablo J Ross
- Department of Animal Science, University of California, Davis, CA, USA
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4
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Culture of Human Preimplantation Embryos in a Clinical ART Setting. Methods Mol Biol 2019. [PMID: 31230292 DOI: 10.1007/978-1-4939-9566-0_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
In vitro fertilization (IVF) and embryo culture in the human is a unique endeavor. Human assisted reproductive technology (ART) is practiced clinically to treat infertility. Due to the obvious ethical considerations of ART as applied to human medicine, only rarely is embryo culture undertaken for research purposes. As most IVF clinics are for profit businesses, a robust industry has developed to supply embryologists with quality control-tested media, equipment, and supplies necessary to support human IVF laboratory operation. Moreover, commercial items are preferred for efficiency and consistency, and strict quality control is required by accrediting organizations. As such, very little manual formulation or preparation of culture medium is typically required. Although human embryo culture is performed clinically, there is a surprising degree of variability in the details of the techniques used. In this chapter, we describe state-of-the-art procedures for gamete collection, in vitro fertilization, embryo culture, and embryo transfer that result in excellent blastocyst development and pregnancy rates for patients seeking treatment for infertility.
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5
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Petersen CG, Mauri AL, Vagnini LD, Renzi A, Petersen B, Matilla MC, Comar VA, Ricci J, Dieamant F, Oliveira JBA, Baruffi RLR, Franco JG. Randomized comparison of two commercial culture media (Cook and Vitrolife) for embryo culture after IMSI. JBRA Assist Reprod 2019; 23:33-36. [PMID: 30500133 PMCID: PMC6364275 DOI: 10.5935/1518-0557.20180058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE A variety of studies randomizing women/cycles or oocytes/embryos has been carried out to compare different culture media for culturing embryos up to cleavage or blastocyst stages showing controversial results. A recent systematic review suggested that data in the literature are insufficient to conclude the best culture medium for embryo quality, pregnancy and implantation. The objective of this study was to evaluate whether there is any difference between two commercial culture media regarding clinical outcomes after IMSI cycles. METHODS A total of 120 patients, ≤39 years of age, undergoing ART treatment submitted to the IMSI program were prospectively broken down and randomized into two groups: Group I (Cook media) and Group II (Vitrolife media). RESULTS Our data demonstrated that there was no difference using all the media from Cook or all the media from Vitrolife, for culturing embryos till day 2, in the bench incubator at low O2 concentration, in relation to fertilization, embryo quality, pregnancy and implantation rates (p>0.05). CONCLUSION Both culture media used, Cook medium and Vitrolife medium, for the IMSI procedure and for later embryo culture with transfer on the second day, are equally effective and can be used depending on the ease and availability of acquisition.
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Affiliation(s)
- Claudia G Petersen
- Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
| | - Ana L Mauri
- Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
| | - Laura D Vagnini
- Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
| | - Adriana Renzi
- Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
| | - Bruna Petersen
- Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
| | | | | | - Juliana Ricci
- Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil
| | | | - João Batista A Oliveira
- Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
| | - Ricardo L R Baruffi
- Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
| | - Jose G Franco
- Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirao Preto, Brazil
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6
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Continuous embryo culture elicits higher blastulation but similar cumulative delivery rates than sequential: a large prospective study. J Assist Reprod Genet 2018; 35:1329-1338. [PMID: 29725911 DOI: 10.1007/s10815-018-1195-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/24/2018] [Indexed: 10/17/2022] Open
Abstract
PURPOSE To assess whether continuous embryo culture involves better embryological and/or clinical outcomes than sequential. METHODS Prospective study at a private IVF center. All consecutive IVF cycles (September 2013-2015) fulfilling the inclusion criteria underwent embryo culture in either Continuous-Single-Culture-Media (CSCM, n = 972) or sequential media (Quinn's Advantage, n = 514), respectively. ICSI, blastocyst culture in either standard (MINC) or undisturbed (Embryoscope) incubation, transfer (until September 2016), and pregnancy follow-up (until September 2017) were performed. When aneuploidy testing was required, trophectoderm biopsy and qPCR were performed. Sub-analyses and logistic regression corrected for confounders were performed. The primary outcomes were overall blastocyst rate per oocyte and mean blastocyst rate per cycle. The sample size was defined to reach 95 and 80% statistical power for the former and the latter outcome, respectively. Secondary outcomes were euploidy (if assessed), cumulative delivery rates, gestational age, and birthweight. RESULTS Continuous embryo culture resulted into a higher overall blastocyst rate per inseminated oocyte than sequential (n = 2211/5841, 37.9% vs. 1073/3216, 33.4%; p < 0.01), confirmed also from a cycle-based analysis (mean blastocyst rate: 38.7% ± 29.7% vs. 34.3% ± 29.4%; p = 0.01). The continuous media (OR = 1.23), the undisturbed incubation system (OR = 1.22), the maternal age (OR = 0.92), and the sperm factor (OR = 0.85) were outlined as positive predictors of blastulation. However, the cumulative delivery rates per ended cycle (i.e., delivery achieved or no blastocyst produced or left; > 90%) were comparable in the two groups (n = 244/903, 27.0% vs. 129/475, 27.2%). The neonatal outcomes were similar. CONCLUSIONS Continuous culture involves better embryological but similar clinical outcomes than sequential. This large prospective study supports the absence of clinical disparity among the two approaches.
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7
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Dieamant F, Petersen CG, Mauri AL, Comar V, Mattila M, Vagnini LD, Renzi A, Petersen B, Ricci J, Oliveira JBA, Baruffi RLR, Franco JG. Single versus sequential culture medium: which is better at improving ongoing pregnancy rates? A systematic review and meta-analysis. JBRA Assist Reprod 2017; 21:240-246. [PMID: 28837034 PMCID: PMC5574647 DOI: 10.5935/1518-0557.20170045] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
This study aimed to evaluate if single medium is better than sequential medium at
improving ongoing pregnancy rates in patients undergoing assisted reproductive
technology (ART) procedures. The data featured in this meta-analysis were
extracted from four randomized controlled trials yielded from a systematic
search carried out on electronic databases. The primary endpoint was ongoing
pregnancy rate. Secondary endpoints included clinical pregnancy and miscarriage
rates. The endpoints for ongoing pregnancy rate were also analyzed based on the
time at which the embryo transfers were performed: cleavage stage (day 2/3)
and/or blastocyst stage (day 5/6). There were no significant differences between
single and sequential medium for clinical pregnancy (RR=1.09; 95%CI=0.83-1.44;
p=0.53), ongoing pregnancy (RR=1.11; 95%CI=0.87-1.40;
p=0.39), or miscarriage rates (RR=0.89; 95%CI=0.44-1.81;
p=0.74). No significant difference was found for ongoing
pregnancy rate (RR=1.29; 95%CI=0.93-1.78; p=0.12) between
single and sequential medium when only trials in which embryos were transferred
at the blastocyst stage were included. In conclusion, the choice of embryo
culture approach - single or sequential medium - did not affect the ongoing
pregnancy rates of patients undergoing ART cycles.
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Affiliation(s)
- Felipe Dieamant
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Claudia G Petersen
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Ana L Mauri
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Vanessa Comar
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil
| | - Marina Mattila
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil
| | - Laura D Vagnini
- Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Adriana Renzi
- Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Bruna Petersen
- Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Juliana Ricci
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil
| | - João Batista A Oliveira
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Ricardo L R Baruffi
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
| | - Jose G Franco
- Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.,Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil
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8
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Le Gac S, Nordhoff V. Microfluidics for mammalian embryo culture and selection: where do we stand now? Mol Hum Reprod 2016; 23:213-226. [DOI: 10.1093/molehr/gaw061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 09/02/2016] [Indexed: 12/26/2022] Open
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9
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Goldman RH, Kaser DJ, Missmer SA, Srouji SS, Farland LV, Racowsky C. Building a model to increase live birth rate through patient-specific optimization of embryo transfer day. J Assist Reprod Genet 2016; 33:1525-1532. [PMID: 27614634 DOI: 10.1007/s10815-016-0803-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Many practices are moving away from cleavage-stage transfer in favor of blastocyst transfer. The purpose of this study is to evaluate how the overall live birth rate for fresh IVF cycles may increase by optimizing the day of transfer for each patient. METHODS This is a retrospective cohort study of 1225 first fresh autologous IVF cycles performed between May 2012 and November 2013. Stepwise logistic regression was used to determine characteristics associated with live birth following cleavage-stage versus blastocyst transfer. The optimal transfer day (i.e., the day that maximized the odds of live birth) was determined for each patient, and the actual live birth rate was compared with the projected rate had each patient undergone transfer on her optimal day. RESULTS With transfer on the optimal day for each patient, the overall birth rate would have increased from its actual value of 34.8 % to a projected 43.0 %, a 24 % increase. The majority of this increase (21 %) was due to optimization of patients who underwent cleavage-stage transfer but had a higher projected birth rate from blastocyst transfer. These patients were older (37.8 versus 36.0 years, p < 0.01) and had more follicles ≥18 mm than patients who should have remained with a cleavage-stage transfer. CONCLUSIONS A model can be built enabling patient-specific identification of optimal transfer day; within this discovery cohort, such optimization was estimated to increase live birth following a fresh transfer by 24 %. This study suggests blastocyst transfer should be more widely offered; however, there remain patients for whom a cleavage-stage transfer may yield better outcomes.
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Affiliation(s)
- R H Goldman
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | - D J Kaser
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - S A Missmer
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - S S Srouji
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - L V Farland
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - C Racowsky
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
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10
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Sfontouris IA, Martins WP, Nastri CO, Viana IGR, Navarro PA, Raine-Fenning N, van der Poel S, Rienzi L, Racowsky C. Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials. J Assist Reprod Genet 2016; 33:1261-1272. [PMID: 27491772 DOI: 10.1007/s10815-016-0774-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 07/10/2016] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The purpose of this study was to undertake a review of the available evidence comparing the use of a single medium versus sequential media for embryo culture to the blastocyst stage in clinical IVF. METHODS We searched the Cochrane Central, PubMed, Scopus, ClinicalTrials.gov, Current Controlled Trials and WHO International Clinical Trials Registry Platform to identify randomized controlled trials comparing single versus sequential media for blastocyst culture and ongoing pregnancy rate. Included studies randomized either oocytes/zygotes or women. Eligible oocyte/zygote studies were analyzed to assess the risk difference (RD) and 95 % confidence intervals (CI) between the two media systems; eligible woman-based studies were analyzed to assess the risk ratio (RR) and 95 % CI for clinical pregnancy rate. RESULTS No differences were observed between single and sequential media for either ongoing pregnancy per randomized woman (relative risk (RR) = 0.9, 95 % CI = 0.7 to 1.3, two studies including 246 women, I 2 = 0 %) or clinical pregnancy per randomized woman (RR = 1.0, 95 % CI = 0.7 to 1.4, one study including 100 women); or miscarriage per clinical pregnancy: RR = 1.3, 95 % CI = 0.4 to 4.3, two studies including 246 participants, I 2 = 0 %). Single media use was associated with an increase blastocyst formation per randomized oocyte/zygote (relative distribution (RD) = +0.06, 95 % CI = +0.01 to +0.12, ten studies including 7455 oocytes/zygotes, I 2 = 83 %) but not top/high blastocyst formation (RD = +0.05, 95 % CI = -0.01 to +0.11, five studies including 3879 oocytes/zygotes, I 2 = 93 %). The overall quality of the evidence was very low for all these four outcomes. CONCLUSIONS Although using a single medium for extended culture has some practical advantages and blastocyst formation rates appear to be higher, there is insufficient evidence to recommend either sequential or single-step media as being superior for the culture of embryos to days 5/6. Future studies comparing these two media systems in well-designed trials should be performed.
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Affiliation(s)
- Ioannis A Sfontouris
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK.,Eugonia Assisted Reproduction Unit, Athens, Greece
| | - Wellington P Martins
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Carolina O Nastri
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.,SEMEAR fertilidade, Reproductive Medicine, Ribeirao Preto, Brazil
| | - Iara G R Viana
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.,SEMEAR fertilidade, Reproductive Medicine, Ribeirao Preto, Brazil
| | - Paula A Navarro
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Nick Raine-Fenning
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sheryl van der Poel
- HRP (the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction), Geneva, Switzerland.,Population Council, Reproductive Health Programme, New York, USA
| | - Laura Rienzi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, via de Notaris 2b, Rome, Italy
| | - Catherine Racowsky
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, 02115, MA, USA.
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11
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Maas K, Galkina E, Thornton K, Penzias AS, Sakkas D. No change in live birthweight of IVF singleton deliveries over an 18-year period despite significant clinical and laboratory changes. Hum Reprod 2016; 31:1987-96. [DOI: 10.1093/humrep/dew173] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/10/2016] [Indexed: 11/14/2022] Open
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12
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Zdravkovic T, Nazor KL, Larocque N, Gormley M, Donne M, Hunkapillar N, Giritharan G, Bernstein HS, Wei G, Hebrok M, Zeng X, Genbacev O, Mattis A, McMaster MT, Krtolica A, Valbuena D, Simón C, Laurent LC, Loring JF, Fisher SJ. Human stem cells from single blastomeres reveal pathways of embryonic or trophoblast fate specification. Development 2015; 142:4010-25. [PMID: 26483210 PMCID: PMC4712832 DOI: 10.1242/dev.122846] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 10/05/2015] [Indexed: 01/04/2023]
Abstract
Mechanisms of initial cell fate decisions differ among species. To gain insights into lineage allocation in humans, we derived ten human embryonic stem cell lines (designated UCSFB1-10) from single blastomeres of four 8-cell embryos and one 12-cell embryo from a single couple. Compared with numerous conventional lines from blastocysts, they had unique gene expression and DNA methylation patterns that were, in part, indicative of trophoblast competence. At a transcriptional level, UCSFB lines from different embryos were often more closely related than those from the same embryo. As predicted by the transcriptomic data, immunolocalization of EOMES, T brachyury, GDF15 and active β-catenin revealed differential expression among blastomeres of 8- to 10-cell human embryos. The UCSFB lines formed derivatives of the three germ layers and CDX2-positive progeny, from which we derived the first human trophoblast stem cell line. Our data suggest heterogeneity among early-stage blastomeres and that the UCSFB lines have unique properties, indicative of a more immature state than conventional lines.
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Affiliation(s)
- Tamara Zdravkovic
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Division of Maternal Fetal Medicine, University of California San Francisco, San Francisco, CA 94143, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Human Embryonic Stem Cell Program, University of California San Francisco, San Francisco, CA 94143, USA
| | - Kristopher L Nazor
- Center for Regenerative Medicine, Department of Chemical Physiology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Nicholas Larocque
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Division of Maternal Fetal Medicine, University of California San Francisco, San Francisco, CA 94143, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Human Embryonic Stem Cell Program, University of California San Francisco, San Francisco, CA 94143, USA
| | - Matthew Gormley
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Division of Maternal Fetal Medicine, University of California San Francisco, San Francisco, CA 94143, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Human Embryonic Stem Cell Program, University of California San Francisco, San Francisco, CA 94143, USA
| | - Matthew Donne
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Division of Maternal Fetal Medicine, University of California San Francisco, San Francisco, CA 94143, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Department of Anatomy, University of California San Francisco, San Francisco, CA 94143, USA
| | - Nathan Hunkapillar
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Division of Maternal Fetal Medicine, University of California San Francisco, San Francisco, CA 94143, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Human Embryonic Stem Cell Program, University of California San Francisco, San Francisco, CA 94143, USA
| | | | - Harold S Bernstein
- The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Grace Wei
- The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Diabetes Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Matthias Hebrok
- Diabetes Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Xianmin Zeng
- Buck Institute for Research on Aging, Novato, CA 94945, USA
| | - Olga Genbacev
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Division of Maternal Fetal Medicine, University of California San Francisco, San Francisco, CA 94143, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Human Embryonic Stem Cell Program, University of California San Francisco, San Francisco, CA 94143, USA
| | - Aras Mattis
- The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Department of Pathology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Michael T McMaster
- The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Human Embryonic Stem Cell Program, University of California San Francisco, San Francisco, CA 94143, USA Department of Cell and Tissue Biology, University of California San Francisco, San Francisco, CA 94143, USA
| | | | - Diana Valbuena
- Fundación Instituto Valenciano de Infertilidad (IVI), Parc Científic Universitat de València, 46980, Valencia, Spain
| | - Carlos Simón
- Fundación Instituto Valenciano de Infertilidad (IVI), Parc Científic Universitat de València, 46980, Valencia, Spain
| | - Louise C Laurent
- Center for Regenerative Medicine, Department of Chemical Physiology, The Scripps Research Institute, La Jolla, CA 92037, USA Department of Reproductive Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Jeanne F Loring
- Center for Regenerative Medicine, Department of Chemical Physiology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Susan J Fisher
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA Division of Maternal Fetal Medicine, University of California San Francisco, San Francisco, CA 94143, USA Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA The Eli & Edythe Broad Center for Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA 94143, USA Human Embryonic Stem Cell Program, University of California San Francisco, San Francisco, CA 94143, USA Department of Anatomy, University of California San Francisco, San Francisco, CA 94143, USA
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