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Anagnostopoulou C, Rosas IM, Singh N, Gugnani N, Chockalingham A, Singh K, Desai D, Darbandi M, Manoharan M, Darbandi S, Leonardi Diaz SI, Gupta S, Henkel R, Sallam HN, Boitrelle F, Wirka KA, Agarwal A. Oocyte quality and embryo selection strategies: a review for the embryologists, by the embryologists. Panminerva Med 2022; 64:171-184. [PMID: 35179016 DOI: 10.23736/s0031-0808.22.04680-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With the advance of assisted reproduction techniques, and the trend towards blastocyst culture and single embryo transfer, gamete and embryo assessment have gained greater importance in ART treatment. Embryo quality depends mainly on gamete quality and culture conditions. Oocyte maturity identification is necessary in order to plan fertilization timing. Mature oocytes at the metaphase II stage show a higher fertilization rate compared to immature oocytes. Morphology assessment is a critical yet challenging task that may serve as a good prognostic tool for future development and implantation potential if done effectively. Various grading systems have been suggested to assess embryos at pronuclear, cleavage, and blastocyst stages. By identifying the embryo with the highest implantation potential, it is possible to reduce the number of embryos transferred without compromising the chances of a successful pregnancy. Apart from the conventional morphology assessment, there are several invasive or non-invasive methods for embryo selection such as preimplantation genetic testing, morphokinetics, proteomics, metabolomics, oxygen consumption, and measurement of oxidative stress in culture medium. Morphokinetics is a method based on time-lapse technology and continuous monitoring of embryos. In this review, we aim to describe and compare the most effective and widely used methods for gamete and embryo assessment as well as embryo selection.
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Affiliation(s)
| | - Israel M Rosas
- Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico
| | | | - Nivita Gugnani
- Milann-The Fertility Centre, Delhi, India.,All India Institute of Medical Sciences, Delhi, India
| | | | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados
| | - Dimple Desai
- DPU IVF & ENDOSCOPY CENTER, Dr. D. Y. Patil Hospital & Research Centre, Pune, India
| | - Mahsa Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran.,Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | | | - Sara Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran.,Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | | | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland, OH, USA.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.,Logix X Pharma, Theale, Berkshire, UK
| | - Hassan N Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.,Department of Biology, Reproduction, Epigenetics, Environment and Development, ParisSaclay University, UVSQ, INRAE, BREED, Jouyen-Josas, France
| | - Kelly A Wirka
- Fertility & Endocrinology, Medical Affairs, EMD Serono, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland, OH, USA -
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Ji M, Jin B, Guo X, Wu R, Jiang Y, Zhang L, Shu J. It is not worth postponing frozen embryo transfers after oocyte pickup: A retrospective cohort study based on propensity score matching. Front Endocrinol (Lausanne) 2022; 13:971616. [PMID: 36133317 PMCID: PMC9483166 DOI: 10.3389/fendo.2022.971616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
This study was to explore whether postponing frozen embryo transfers (FET) after oocyte pickup (OPU) improves clinical and neonatal outcomes. From May 2018 to Dec 2020, a total of 1109 patients underwent their first OPU cycles adopting a non-selective freeze-all policy were included in this retrospective cohort study. In the immediate group (n=219), patients underwent FET in the first menstrual cycle after OPU, and patients in the postponed group (n=890) waited for more than 1 menstrual cycle after OPU to perform FET. A propensity score matching (PSM) model was used to evaluate the clinical outcomes and neonatal outcomes between the two groups. There were 209 patients in the immediate group and 499 patients in the postponed one after PSM. Patients waited for a significantly shorter period for FET in the immediate group (30.74 ± 3.85 days) compared with the postponed group (80.39 ± 26.25 days, P<0.01). The clinical pregnancy rate (CPR) and live birth rate (LBR) in the immediate group were 58.4% and 48.3%, respectively, which were comparable to those of the postponed one (58.1%, 49.7%, P > 0.05). No statistical significance was found in the average birth weight (3088.82 ± 565.35 g vs 3038.64 ± 625.78 g, P > 0.05) and height (49.08 ± 1.87 cm vs 49.30 ± 2.52 cm) of neonates between the two groups. The gender ratio, the incidence of macrosomia and low birth weight did not differ significantly between the two groups. In conclusion, postponing FET does not improve clinical and neonatal outcomes. If patients have no contraindications, FETs should be carried out immediately after OPU.
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Affiliation(s)
- Mengxia Ji
- Department of Reproductive Endocrinology, Center for Reproductive Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Bihui Jin
- Department of Reproductive Endocrinology, Center for Reproductive Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Xiaoyan Guo
- Department of Reproductive Endocrinology, Center for Reproductive Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Ruifang Wu
- Department of Reproductive Endocrinology, Center for Reproductive Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Yunqing Jiang
- Department of Reproductive Endocrinology, Center for Reproductive Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Ling Zhang
- Department of Reproductive Endocrinology, Center for Reproductive Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Jing Shu
- Department of Reproductive Endocrinology, Center for Reproductive Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
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Associations between embryo grading and congenital malformations in IVF/ICSI pregnancies. Reprod Biomed Online 2019; 39:981-989. [DOI: 10.1016/j.rbmo.2019.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/19/2019] [Accepted: 07/25/2019] [Indexed: 12/12/2022]
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Vogiatzi P, Pouliakis A, Siristatidis C. An artificial neural network for the prediction of assisted reproduction outcome. J Assist Reprod Genet 2019; 36:1441-1448. [PMID: 31218565 PMCID: PMC6642243 DOI: 10.1007/s10815-019-01498-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/28/2019] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To construct and validate an efficient artificial neural network (ANN) based on parameters with statistical correlation to live birth, to be used as a comprehensive tool for the prediction of the clinical outcome for patients undergoing ART. METHODS Data from 257 infertile couples that underwent a total of 426 IVF/ICSI cycles from 2010 to 2017 was collected on an ensemble of 118 parameters for each cycle. Statistical correlation of the parameters with the outcome of live birth was performed, using either t test or χ2 test, and the parameters that demonstrated statistical significance were used to construct the ANN. Cross-validation was performed by random separation of data and repeating the training-testing procedure by 10 times. RESULTS 12 statistically significant parameters out of the initial ensemble were used for the ANN construction, which exhibited a cumulative sensitivity and specificity of 76.7% and 73.4%, respectively. During cross-validation, the system exhibited the following: sensitivity 69.2% ± 2.36%, specificity 69.19% ± 2.8% (OR 5.21 ± 1.27), PPV 36.96 ± 3.44, NPV 89.61 ± 1.09, and OA 69.19% ± 2.69%. A rather small standard deviation in the performance indices between the training and test sets throughout the validation process indicated a stable performance of the constructed ANN. CONCLUSIONS The constructed ANN is based on statistically significant variables with the outcome of live birth and represents a stable and efficient system with increased performance indices. Validation of the system allowed an insight of its clinical value as a supportive tool in medical decisions, and overall provides a reliable approach in the routine practice of IVF units in a user-friendly environment.
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Affiliation(s)
- Paraskevi Vogiatzi
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Medical School, "Attikon" University Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, Chaidari, 12642, Athens, Greece
| | - Abraham Pouliakis
- Second Department of Pathology, Medical School, "Attikon" University Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, Chaidari, 12642, Athens, Greece
| | - Charalampos Siristatidis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Medical School, "Attikon" University Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, Chaidari, 12642, Athens, Greece.
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Goto K, Kumasako Y, Koike M, Kanda A, Kido K, Nagaki M, Otsu E, Kawabe F, Kai Y, Utsunomiya T. Prediction of the in vitro developmental competence of early-cleavage-stage human embryos with time-lapse imaging and oxygen consumption rate measurement. Reprod Med Biol 2018; 17:289-296. [PMID: 30013431 PMCID: PMC6046524 DOI: 10.1002/rmb2.12104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/27/2018] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To assess an embryo's ability to develop into a good-quality blastocyst during the early-cleavage stage using time-lapse imaging and the oxygen consumption rate. METHODS In total, 942 zygotes had their oxygen consumption rates measured. In total, 282 zygotes were assessed by using time-lapse imaging. In total, 121 zygotes were examined by using both their oxygen consumption rate and time-lapse imaging. RESULTS The embryos with moderate respiration rates of between 0.41 and 0.61 (×1014/mol s-1) on day 3 had a 22.1% chance of becoming good-quality blastocysts; those outside that range had a 14.3% chance. With the time-lapse system, when the first division was within 24 hours, 22.3% of the embryos grew to good blastocysts. After 24 hours, the rate dropped to 8.6%. The intervals between two consecutive cleavages were calculated and the duration of the second cell cycle was defined. When the time was between nine hours and 13 hours, there was a higher rate of good blastocysts. Regarding both criteria, when the embryos had progressed in the optimal range, a high percentage of them had become good blastocysts; it was 8.0% outside of that range. CONCLUSION Individual embryos with the potential to develop into good-quality blastocysts could be selected at day 3 of culture using these systems.
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Almasi-Hashiani A, Ghaheri A, Omani Samani R. Determinants of The Grade A Embryos in Infertile Women; Zero-Inflated Regression Model. CELL JOURNAL 2017; 19:506-511. [PMID: 28836413 PMCID: PMC5570415 DOI: 10.22074/cellj.2017.4214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 08/21/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In assisted reproductive technology, it is important to choose high quality embryos for embryo transfer. The aim of the present study was to determine the grade A embryo count and factors related to it in infertile women. MATERIALS AND METHODS This historical cohort study included 996 infertile women. The main outcome was the number of grade A embryos. Zero-Inflated Poisson (ZIP) regression and Zero-Inflated Negative Binomial (ZINB) regression were used to model the count data as it contained excessive zeros. Stata software, version 13 (Stata Corp, College Station, TX, USA) was used for all statistical analyses. RESULTS After adjusting for potential confounders, results from the ZINB model show that for each unit increase in the number 2 pronuclear (2PN) zygotes, we get an increase of 1.45 times as incidence rate ratio (95% confidence interval (CI): 1.23-1.69, P=0.001) in the expected grade A embryo count number, and for each increase in the cleavage day we get a decrease 0.35 times (95% CI: 0.20-0.61, P=0.001) in expected grade A embryo count. CONCLUSIONS There is a significant association between both the number of 2PN zygotes and cleavage day with the number of grade A embryos in both ZINB and ZIP regression models. The estimated coefficients are more plausible than values found in earlier studies using less relevant models.
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Affiliation(s)
- Amir Almasi-Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Azadeh Ghaheri
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Reza Omani Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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Liu L, Cai J, Li P, Jiang X, Ren J. Clinical outcome of cycles with oocyte degeneration after intracytoplasmic sperm injection. Syst Biol Reprod Med 2017; 63:113-119. [PMID: 28151020 DOI: 10.1080/19396368.2016.1272648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
There are variant rates of oocyte degeneration after intracytoplasmic sperm injection (ICSI) among different patients. Oocyte degeneration after ICSI may reflect the cohort of oocyte quality and subsequent embryo development capacity and clinical outcome. This retrospective study analyzed 255 cycles with at least one degenerated oocyte after ICSI (degeneration group) and 243 cycles with no degenerated oocytes after ICSI (control group). Basic characteristics like female age, body mass index, duration of infertility, hormone (FSH, LH, E2) levels on day 3 of menses, and primary infertility patient rate were similar between the two groups (p > 0.05). Total dose of gonadotropin and length of stimulation were also similar between the two groups (p > 0.05), but the degeneration group exhibited a more exuberant response to ovarian stimulation as reflected by more oocytes retrieved (p < 0.05). The number of 2PN embryos available and high quality embryos were similar between the two groups (p > 0.05), but the high quality embryo rate, early cleavage embryo rate, and available embryo rate were all statistically lower than the control group (p < 0.05). Embryo developmental kinetics seemed to be disturbed and embryo fragmentation rate increased in the degeneration group (p < 0.05). However, there was no statistical difference in the distribution of graded embryos transferred, and there were no statistical differences in the pregnancy rate, implantation rate, and abortion rate between the two groups (p > 0.05). We deduce that the presence of oocyte degeneration after ICSI may be associated with decreased embryo quality with embryo development kinetics disturbed. However, the clinical outcomes may not be affected if the premise that sufficient high quality degeneration group embryos are available for transfer.
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Affiliation(s)
- Lanlan Liu
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Jiali Cai
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Ping Li
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Xiaoming Jiang
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
| | - Jianzhi Ren
- a Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University , Xiamen , Fujian , China.,b The 174th Hospital of PLA , Xiamen , Fujian , China
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Lin PY, Huang FJ, Kung FT, Lin YC, Chiang HJ, Lin YJ, Lan KC. Reassessing the feasibility of the zygote score for predicting embryo viability in IVF/ICSI using the GnRH antagonist protocol compared to the long protocol. PLoS One 2017; 12:e0171465. [PMID: 28152037 PMCID: PMC5289632 DOI: 10.1371/journal.pone.0171465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/03/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Many factors from the oocyte/sperm or the process of fertilization may affect the zygote formation. The zygote score (Z-score) describes the quality of a human zygote based on its pronuclear morphology, nucleolar precursor bodies, and alignment of polar bodies, and it can be used in the selection process at the zygote stage for embryo transfer or cryopreservation. OBJECTIVE The aim of this retrospective cohort study was to investigate the relationship between different controlled ovarian stimulation (COS) protocols and the zygote score (Z-score) and to assess the feasibility of the Z-score for predicting embryo survival in the GnRH-antagonist (GnRH-ant) protocol. METHODS It is a retrospective, single-center cohort study. A total of 3,826 zygotes with normal fertilization were analyzed from 744 in vitro fertilization /intra-cytoplasmic sperm injection (IVF/ICSI) cycles (long protocol n = 392; GnRH-ant n = 352) between Jan 2010 and April 2014 in the IVF unit of Chang-Gung Memorial Hospital Kaohsiung Medical Center. RESULTS The Z-score distribution differed significantly between these two protocols. The overall Z-score was poorer for zygotes from GnRH-ant cycles (p<0.05). Univariate and multivariate analyses indicated the type of COS protocol is one of the main determinants of Z-score grading. Our study found good-quality day 3 embryo/blastocyst formation and the cumulative embryo survival rate were correlated with the Z-score but not the COS protocol. With the GnRH-ant protocol, the number of Z1 in the transferred cohort embryos was significantly correlated with the clinical pregnancy rate (r = 0.976; p = 0.024) and live birth rate (r = 0.971; p = 0.029). This correlation was not seen with the long protocol. CONCLUSIONS The Z-score distribution for the GnRH antagonist cycles was poorer than that of the long protocol, but the Z-score system is a valuable parameter for predicting embryo viability in the GnRH-ant protocol, providing a strong correlation with the clinical pregnancy rate and live birth rate.
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Affiliation(s)
- Pin-Yao Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kaohsiung, Taiwan
| | - Fu-Jen Huang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Tsai Kung
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Chi Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsin-Ju Chiang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ju Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuo-Chung Lan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- * E-mail:
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Kim J, Kim SH, Jun JH. Prediction of blastocyst development and implantation potential in utero based on the third cleavage and compaction times in mouse pre-implantation embryos. J Reprod Dev 2016; 63:117-125. [PMID: 27980237 PMCID: PMC5401804 DOI: 10.1262/jrd.2016-129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cytokinesis and cell division during pre-implantation embryonic development occur as an orchestrated spatiotemporal program. Cleavage, compaction, and
blastulation in pre-implantation embryos are essential for successful implantation and pregnancy. Their alteration is associated with chromosomal imbalance and
loss of developmental competence. In this study, we evaluated the time of cleavage and compaction as predictors for in vitro pre- and
peri-implantation development and in utero implantation potential by time-lapse monitoring. Mouse 2-cell embryos were collected on 1.5 days
post coitum (dpc) and were individually cultured to the outgrowth (OG) stage (7.5 dpc). Developmental stages were classified as 3-cell,
4-cell, 8-cell, morula, blastocyst, and OG. Cut-off times for successful blastocyst development were determined by receiver operating characteristic curve
analysis. When cut-off times were set as 9 h for the third cleavage from the 2- to 4-cell stage, and 40 h for compaction from the 2-cell to morula stage,
blastocyst and OG development rates, respectively, were significantly higher (P < 0.0001). Embryos were grouped according to the above cut-off time and
transferred to the contralateral uterine horn on 3.5 dpc. Implantation rates in utero on 5.5 dpc were significantly higher in early third
cleaved (≤ 9 h from 2- to 4-cell) and early compacted embryos (≤ 40 h from 2-cell to morula) than those in delayed embryos (P < 0.05). Therefore, the time of
the third cleavage from 2- to the 4-cell stage and compaction from 2-cell to morula stage may be a useful morphokinetic parameter for predicting developmental
potential, including successful implantation and pregnancy in human in vitro fertilization-embryo transfer programs.
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Affiliation(s)
- Jihyun Kim
- Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University, Gyeonggi-do 461-713, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jin Hyun Jun
- Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University, Gyeonggi-do 461-713, Korea.,Department of Biomedical Laboratory Science, Graduate School of Health Science, Eulji University, Gyeonggi-do 461-713, Korea.,Eulji Medi-Bio Research Institute (EMBRI), Eulji University, Gyeonggi-do 461-713, Korea
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Non-invasive methods for embryo selection. Facts Views Vis Obgyn 2016; 8:87-100. [PMID: 27909565 PMCID: PMC5130307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
With the widespread use of assisted reproduction, a simple and practical method for embryo selection is needed to optimize the chances of pregnancy while diminishing the incidence of multiple pregnancy and its accompanying problems. Many non-invasive methods for embryo selection have been proposed and some are more promising than others. This review summarizes these methods and attempts to evaluate them in the light of the best currently available evidence and to find out whether any of them is ripe for replacing or supplementing the time-honored method of morphological assessment.
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Guo N, Yang F, Liu Q, Ren X, Zhao H, Li Y, Ai J. Effects of cumulus cell removal time during in vitro fertilization on embryo quality and pregnancy outcomes: a prospective randomized sibling-oocyte study. Reprod Biol Endocrinol 2016; 14:18. [PMID: 27072537 PMCID: PMC4830045 DOI: 10.1186/s12958-016-0151-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/04/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To investigate whether cumulus cell removal after a 3 h co-incubation of gametes can affect the outcomes of in vitro fertilization. METHODS A prospective randomized sibling-oocyte study was performed in which sibling oocytes obtained from each patient were randomly assigned to either a 3 h or 20 h group (cumulus cells removed at 3 h or 20 h after insemination, respectively). Same origin embryos (either 3 h or 20 h) were transferred. The study participants were patients < 38 years old and with infertility due to tubal factors. The study outcomes included fertilization, embryo quality, and birth status. RESULTS The study enrolled 172 patients, from whom 2275 oocytes were retrieved (1139 oocytes for the 3 h group and 1136 oocytes for the 20 h group). A total of 134 patients received embryo transfers (74 patients in the 3 h group and 60 patients in the 20 h group), and there were 54 live births (32 in the 3 h group and 22 in the 20 h group). When compared with patients in the 20 h group, patients in the 3 h group produced a larger number of optimal quality embryos, but had higher rates of polyspermy and low birth weight newborns. The two groups showed no differences in their rates of normal fertilization, pregnancy, and live birth. CONCLUSIONS When compared with results obtained using a traditional cumulus cell removal protocol, early cumulus cell removal has both advantages and disadvantages. Further studies, and especially long-term outcome studies on newborns, need to be performed. TRIAL REGISTRATION Current controlled trial ChiCTR-OOC-15006878.
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Affiliation(s)
- Na Guo
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030 China
| | - Fei Yang
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030 China
| | - Qun Liu
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030 China
| | - Xinling Ren
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030 China
| | - Hua Zhao
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030 China
| | - Yufeng Li
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030 China
| | - Jihui Ai
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030 China
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The effect of serum and follicular fluid amyloid-associated protein levels on in vitro fertilization outcome in patients with polycystic ovary syndrome. J Assist Reprod Genet 2015; 32:1637-42. [PMID: 26463878 DOI: 10.1007/s10815-015-0582-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 09/23/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE In this study, we aimed to investigate serum and follicular fluid amyloid A protein levels in non-obese non-hyperandrogenic patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) and IVF outcome. METHODS A total of 81 patients undergoing IVF treatment, 41 patients diagnosed as PCOS according to the Rotterdam criteria (group I) and 40 patients with the etiology of male factor infertility (group II), were included in the study. On the day of oocyte pickup, serum and follicular fluid samples were collected from all patients. RESULTS Serum E2 level on the day of hCG (2849.93 ± 541.54 vs. 2494.28 ± 712.98) and total number of retrieved oocytes (13.73 ± 3.57 vs. 10.53 ± 4.07) were significantly higher in group I when compared to group II (p < 0.05). However, number of mature oocytes, fertilization rate, and clinical pregnancy rate did not differ (p > 0.05). No significant difference was found between two groups regarding the serum and follicular fluid amyloid A protein levels on the day of oocyte retrieval (p > 0.05).
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Gingold JA, Lee JA, Rodriguez-Purata J, Whitehouse MC, Sandler B, Grunfeld L, Mukherjee T, Copperman AB. Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers. Fertil Steril 2015; 104:620-8.e5. [PMID: 26079695 PMCID: PMC4561002 DOI: 10.1016/j.fertnstert.2015.05.036] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/29/2015] [Accepted: 05/29/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the relationship of endometrial thickness (EnT) and endometrial pattern (EnP) to euploid embryo transfer (ET) outcomes. DESIGN Retrospective cohort. SETTING Private academic clinic. PATIENT(S) Patients (n = 277; age 36.1 ± 4.0 years) whose embryos (n = 476) underwent aneuploidy screening with fresh (n = 176) or frozen (n = 180) ET from July 2010 to March 2014. INTERVENTION(S) The EnT and EnP were measured on trigger day and at ET. Patients were stratified by age and cycle type (fresh or frozen). Cycle data were combined at trigger day, but separated at ET day. MAIN OUTCOME MEASURE(S) Outcome measures were implantation rate, pregnancy rate, and clinical pregnancy rate. Analysis was conducted using χ(2) analysis and Fisher's exact test. RESULT(S) A total of 234 gestational sacs, 251 pregnancies, and 202 clinical pregnancies resulted from 356 cycles. The EnT (9.6 ± 1.8 mm; range: 5-15 mm) at trigger day (n = 241 cycles), as a continuous or categorical variable (≤8 vs. >8 mm), was not associated with implantation rate, pregnancy rate, or clinical pregnancy rate. The EnT at day of fresh ET (9.7 ± 2.2 mm; range: 4.4-17.9 mm) (n = 176 cycles) or frozen ET (9.1 ± 2.1 mm; range: 4.2-17.7 mm) (n = 180 cycles) was not associated with implantation rate, pregnancy rate, or clinical pregnancy rate. Type 3 EnP at trigger day was associated with increased serum progesterone at trigger and a decreased implantation rate, compared with type 2 EnP. The EnP at fresh or frozen ET was not associated with implantation rate, pregnancy rate, or clinical pregnancy rate. CONCLUSION(S) Within the study population, EnT was not significantly associated with clinical outcomes of euploid ETs. A type 3 EnP at trigger day suggests a prematurely closed window of implantation.
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Affiliation(s)
- Julian A Gingold
- Reproductive Medicine Associates of New York, New York, New York; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Joseph A Lee
- Reproductive Medicine Associates of New York, New York, New York
| | | | | | - Benjamin Sandler
- Reproductive Medicine Associates of New York, New York, New York; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lawrence Grunfeld
- Reproductive Medicine Associates of New York, New York, New York; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Tanmoy Mukherjee
- Reproductive Medicine Associates of New York, New York, New York; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alan B Copperman
- Reproductive Medicine Associates of New York, New York, New York; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
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