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Gatimel N, Moreau J, Bettiol C, Parinaud J, Léandri RD. Semi-automated versus manual embryo vitrification: inter-operator variability, time-saving, and clinical outcomes. J Assist Reprod Genet 2021; 38:3213-3222. [PMID: 34755236 DOI: 10.1007/s10815-021-02346-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Does semi-automated vitrification have lower inter-operator variability and better clinical outcomes than manual vitrification? METHODS Retrospective analyses of 282 patients whose embryos had been cryopreserved, manually with Irvine®-CBS® (MV) or semi-automatically vitrified with the GAVI® method (AV) (from November 2017 to September 2020). Both techniques were performed during the same period by 5 operators. Inter-operator variability was statistically analyzed between operators who performed the vitrification and those who performed the warming process to compare the intact survival rate (% embryos with 100% intact blastomeres) and the positive survival rate (at least 50% intact blastomeres). Additionally, the complete vitrification time was assessed for the 2 techniques according to the number of vitrified embryos. RESULTS Manual vitrification involved warming 338 embryos in 266 cycles for 181 couples compared to 212 embryos in 162 AV cycles for 101 patients. The positive survival rate was higher (p < 0.05) after MV (96%; 323/338) than after AV (90%; 191/212). The intact survival rate (86 vs 84%) and the clinical pregnancy rate (27 vs 22%) were not significantly different between MV and AV. Regarding the inter-operator variability, no significant difference in positive and intact survival rate was evident between the 5 technicians, neither by vitrification nor by warming steps with MV and AV. Concerning time-saving, the MV technique proved to be quicker than AV (minus 11 ± 9 min). CONCLUSIONS Manual vitrification exhibited favorable total survival rates and was more time efficient, while both MV and AV cooling and warming treatments showed little operator variability.
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Affiliation(s)
- Nicolas Gatimel
- Department of Reproductive Medicine, Paule de Viguier Hospital, Toulouse University Hospital, 330 Avenue de Grande Bretagne, 31059, Toulouse, France. .,DEFE (Développement Embryonnaire, Fertilité Et Environnement), UMR1203 INSERM - Université de Montpellier - Université Toulouse III, Toulouse Teaching Hospital Group, 330 avenue de Grande Bretagne, 31059, Toulouse, France.
| | - Jessika Moreau
- Department of Reproductive Medicine, Paule de Viguier Hospital, Toulouse University Hospital, 330 Avenue de Grande Bretagne, 31059, Toulouse, France.,TOXALIM, EXPER Group, Toulouse National Vetenary School, 23, chemin des Capelles, 31076, Toulouse Cedex 3, France
| | - Célia Bettiol
- Department of Reproductive Medicine, Paule de Viguier Hospital, Toulouse University Hospital, 330 Avenue de Grande Bretagne, 31059, Toulouse, France
| | - Jean Parinaud
- Department of Reproductive Medicine, Paule de Viguier Hospital, Toulouse University Hospital, 330 Avenue de Grande Bretagne, 31059, Toulouse, France.,TOXALIM, EXPER Group, Toulouse National Vetenary School, 23, chemin des Capelles, 31076, Toulouse Cedex 3, France
| | - Roger D Léandri
- Department of Reproductive Medicine, Paule de Viguier Hospital, Toulouse University Hospital, 330 Avenue de Grande Bretagne, 31059, Toulouse, France.,TOXALIM, EXPER Group, Toulouse National Vetenary School, 23, chemin des Capelles, 31076, Toulouse Cedex 3, France
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Simon C, Moreau J, Gatimel N, Cohade C, Parinaud J, Leandri R. Impact of estradiol and progesterone levels during the late follicular stage on the outcome of GnRH antagonist protocols. Gynecol Endocrinol 2019; 35:481-484. [PMID: 30600726 DOI: 10.1080/09513590.2018.1538346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The study aimed to assess the impacts and the targets of progesterone (P4) and estradiol (E2) levels on IVF outcomes in GnRH antagonist protocols. The study was retrospective and concerned patients for their first fresh embryo transfers, after stimulation by a recombinant FSH (rFSH)-GnRH antagonist protocol, between September 2012 and July 2017 in the Toulouse University Hospital. Multivariable analysis, taking into account female age and the ovarian stimulation index, showed that E2 levels had no impact on IVF outcomes, while high P4 levels (>1.10 ng/mL) were associated to low pregnancy rate. The P4 concentrations were significantly negatively correlated to the percentage of top embryos and to the implantation rate. Therefore, the deleterious effect of high levels P4 could to act mainly by impairing embryo quality, which questions the place of the freeze-all strategy in these cases.
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Affiliation(s)
- Cynthia Simon
- a Médecine de la Reproduction , CHU Toulouse , Toulouse , France
| | - Jessika Moreau
- a Médecine de la Reproduction , CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine , Université Paul Sabatier , Toulouse , France
| | - Nicolas Gatimel
- a Médecine de la Reproduction , CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine , Université Paul Sabatier , Toulouse , France
| | | | - Jean Parinaud
- a Médecine de la Reproduction , CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine , Université Paul Sabatier , Toulouse , France
| | - Roger Leandri
- a Médecine de la Reproduction , CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine , Université Paul Sabatier , Toulouse , France
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Association between progesterone to number of mature oocytes index and live birth in GnRH antagonist protocols. Reprod Biomed Online 2019; 38:901-907. [PMID: 30952493 DOI: 10.1016/j.rbmo.2019.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/13/2018] [Accepted: 01/15/2019] [Indexed: 11/21/2022]
Abstract
RESEARCH QUESTION What is the association between blood progesterone level alone, progesterone to mature oocytes index (PMOI) and IVF outcomes? DESIGN Clinical data from 960 couples undergoing their first fresh embryo transfer after an intracytoplasmic sperm injection attempt carried out between September 2012 and July 2017 were analysed. All patients underwent ovarian stimulation combining recombinant FSH and gonadotrophin releasing hormone antagonist. Progesterone was measured on the day on which ovulation was triggered. The PMOI was divided into four groups based on 25th, 50th and 75th percentiles, and live birth and implantation rates were compared between the groups. RESULTS A negative association was found between PMOI levels, live birth and implantation rates. When adjusting for age, ovarian stimulation index (OSI) and number of embryos transferred, the PMOI remained negatively correlated to live birth rate (LBR) (OR = 0.147 [0.031 to 0.701]; P = 0.0161), whereas total blood progesterone was no longer evident. Moreover, the LBR (18.5% versus 28.4%; P < 0.01) and implantation rate (12.4% versus 21.0%; P < 0.01) were significantly decreased only when PMOI was 0.167 ng/ml or greater, irrespective of progesterone concentration (< or ≥1.08 ng/ml). The opposite was not true, however. Similar PMOIs were recorded in the same patient from one attempt to the next, and were partially linked to basal FSH, anti-Müllerian hormone, antral follicle count and OSI. CONCLUSIONS PMOI seems to be more predictive than total progesterone level of IVF outcome and reflects the ability of embryos to develop as it is linked to the implantation rate.
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Meldrum DR, Adashi EY, Garzo VG, Gleicher N, Parinaud J, Pinborg A, Van Voorhis B. Prevention of in vitro fertilization twins should focus on maximizing single embryo transfer versus twins are an acceptable complication of in vitro fertilization. Fertil Steril 2018; 109:223-229. [PMID: 29447664 DOI: 10.1016/j.fertnstert.2017.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
- David R Meldrum
- Reproductive Partners San Diego, San Diego, California; Division of Reproductive Endocrinology and Infertility, University of California, San Diego, California.
| | - Eli Y Adashi
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - V Gabriel Garzo
- Reproductive Partners San Diego, San Diego, California; Division of Reproductive Endocrinology and Infertility, University of California, San Diego, California
| | | | - Jean Parinaud
- Department of Reproductive Medicine, Paule de Viguier Hospital, Toulouse Teaching Hospital Group, Toulouse, France
| | - Anja Pinborg
- Fertility Clinic, Department of Obstetrics and Gynecology, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark
| | - Brad Van Voorhis
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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