1
|
Brouillet S, Gala A, Barry F, Anav M, Ferrieres-Hoa A, Andreeva A, Molinari N, Gaspari L, Loup V, Anahory T, Hamamah S. Artificial shrinkage before fresh blastocyst transfer and IVF outcomes: a pilot randomized controlled study. Reprod Biomed Online 2024; 49:103941. [PMID: 38824764 DOI: 10.1016/j.rbmo.2024.103941] [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: 10/31/2023] [Revised: 02/20/2024] [Accepted: 03/03/2024] [Indexed: 06/04/2024]
Abstract
RESEARCH QUESTION Does artificial shrinkage before fresh blastocyst transfer improve clinical pregnancy rates in IVF? DESIGN In this monocentric prospective, randomized, double-blind, controlled pilot study, 150 couples undergoing fresh single-blastocyst transfer were randomized between 20 May 2018 and 22 February 2022. In the artificial shrinkage group (AS group), a single laser pulse was directed to the cellular junction of the trophectoderm on the opposite side of the inner cell mass in each blastocyst. IVF outcomes were clinical pregnancy, multiple pregnancy and live birth rates. Cell-free DNA (cfDNA) concentration was also measured by quantitative real-time PCR in the blastocyst culture medium. RESULTS In total, 142 couples underwent fresh single-blastocyst transfer: control group, no artificial shrinkage, n = 47; and AS group, artificial shrinkage, n = 95; An intention-to-treat (ITT) analysis was employed. After a reassessment and the exclusion of patients with major protocol deviations, 139 couples underwent fresh single-blastocyst transfer under optimal conditions: control group, n = 47; and AS group, n = 92; a per-protocol analysis was used here. The clinical and laboratory characteristics were not significantly different between the groups. The clinical pregnancy rate was similar in the control and AS groups (ITT: 48.9% versus 49.5%, P = 0.97; per protocol: 48.94% versus 51.1%, P = 0.89). The multiple pregnancy rate and the live birth rate were also similar between the groups. No significant differences in gestational age, birthweight or proportion of male/female newborns were observed. The concentration of cfDNA in the blastocyst culture medium was not associated with IVF outcome. CONCLUSIONS Large-scale randomized controlled trials are required to confirm these preliminary results.
Collapse
Affiliation(s)
- Sophie Brouillet
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Anna Gala
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Fatima Barry
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Margaux Anav
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Alice Ferrieres-Hoa
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Aneta Andreeva
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Nicolas Molinari
- Institut Desbrest d'Epidémiologie et de Santé Publique, University of Montpellier, INSERM, PreMEdical, INRIA, CHU Montpellier, Montpellier, France
| | - Laura Gaspari
- Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Vanessa Loup
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France
| | - Tal Anahory
- Department of Reproductive Medicine, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Samir Hamamah
- Department of Reproductive Biology-CECOS, CHU and University of Montpellier, Montpellier, France; Developpement Embryonnaire Fertilite et Environnement, University of Montpellier, INSERM 1203, Montpellier, France.
| |
Collapse
|
2
|
Gonzalez Fernandez J, Moncayo Arlandi J, Ochando A, Simon C, Vilella F. The role of extracellular vesicles in intercellular communication in human reproduction. Clin Sci (Lond) 2023; 137:281-301. [PMID: 36762584 DOI: 10.1042/cs20220793] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/19/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
Embryo-maternal cross-talk has emerged as a vitally important process for embryo development and implantation, which is driven by secreted factors and extracellular vesicles (EVs). The EV cargo of bioactive molecules significantly influences target cells and primes them for critical stages of reproductive biology, including embryo development, adhesion, and implantation. Recent research has suggested that EVs and their cargo represent a powerful non-invasive tool that can be leveraged to assess embryo and maternal tissue quality during assisted reproduction treatments. Here, we review the current scientific literature regarding the intercellular cross-talk between embryos and maternal tissues from fertilization to implantation, focusing on human biology and signaling mechanisms identified in animal models.
Collapse
Affiliation(s)
- Javier Gonzalez Fernandez
- Carlos Simon Foundation, INCLIVA Health Research Institute, C/ Eduardo Primo Yúfera 3, 46012, Valencia, Spain
| | - Javier Moncayo Arlandi
- Carlos Simon Foundation, INCLIVA Health Research Institute, C/ Eduardo Primo Yúfera 3, 46012, Valencia, Spain
| | - Ana Ochando
- Carlos Simon Foundation, INCLIVA Health Research Institute, C/ Eduardo Primo Yúfera 3, 46012, Valencia, Spain
| | - Carlos Simon
- Carlos Simon Foundation, INCLIVA Health Research Institute, C/ Eduardo Primo Yúfera 3, 46012, Valencia, Spain
| | - Felipe Vilella
- Carlos Simon Foundation, INCLIVA Health Research Institute, C/ Eduardo Primo Yúfera 3, 46012, Valencia, Spain
| |
Collapse
|
3
|
Kayacık Günday Ö, Aldemir O, Özelçi R, Dilbaz S, Başer E, Moraloğlu Tekin Ö. Supraphysiological hCG day estradiol levels can predict pregnancy-associated plasma protein A levels in maternal serum in the first trimester. Gynecol Endocrinol 2022; 38:455-460. [PMID: 35384772 DOI: 10.1080/09513590.2022.2057946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To investigate the effect of hCG day estradiol (hCG-E2) used in Down Syndrome screening on maternal serum levels of PAPP-A in fresh in vitro fertilization (IVF) cycles. METHODS This study was a retrospective analysis of a cohort that resulted in a single pregnancy after a total of 92 fresh IVF cycles. The primary outcome of this study was to determine the effect of fresh IVF cycle parameters on the PAPP-A level and the cutoff value for hCG-E2 predicting a low PAPP-A level, while the secondary outcome was to determine whether the effect of IVF parameters on the PAPP-A level was significant. RESULTS There was a negative correlation between PAPP-A levels and the number of hCG-E2 and grade 1 embryos (respectively, p = .049; .047), while a positive correlation was observed between baby weight at birth and the PAPP-A (p < .05). At a PAPP-A value of 0.82, the difference between the two groups, in terms of hCG-E2, the number of grade 1 embryos, and pregnancy-related complications was significant (p = .050; .029; .033, respectively). The threshold value of hCG-E2 affecting PAPP-A levels was statistically significant (AUC = 0.618; p = .050; hCG-E2 = 4869.5 pg/ml). In the model, an increase in the number of grade 1 embryos resulted in higher PAPP-A levels (OR = 2.26; p = .044). CONCLUSION The fact that the hCG-E2 cutoff value, which lowers PAPP-A, reflects excessive ovarian stimulation argues for the correction of the dual screening test in a subset of patients with high response to the first-trimester screening test.
Collapse
Affiliation(s)
- Özlem Kayacık Günday
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Oya Aldemir
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Runa Özelçi
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Serdar Dilbaz
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Emre Başer
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Özlem Moraloğlu Tekin
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| |
Collapse
|