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Li J, Cui Y, Shi H, Bu Z, Wang F, Sun B, Zhang Y. Effects of trigger-day progesterone in the preimplantation genetic testing cycle on the embryo quality and pregnancy outcomes of the subsequent first frozen-thawed blastocyst transfer. Front Endocrinol (Lausanne) 2023; 14:990971. [PMID: 36950680 PMCID: PMC10025458 DOI: 10.3389/fendo.2023.990971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/23/2023] [Indexed: 03/08/2023] Open
Abstract
Objective To assess whether progesterone (P) levels on the trigger day during preimplantation genetic testing (PGT) cycles are associated with embryo quality and pregnancy outcomes in the subsequent first frozen-thawed blastocyst transfer (FET) cycle. Methods In this retrospective analysis, 504 eligible patients who underwent ICSI followed by frozen-thawed embryo transfer (FET) with preimplantation genetic test (PGT) between December 2014 and December 2019 were recruited. All patients adopted the same protocol, namely, the midluteal, short-acting, gonadotropin-releasing hormone agonist long protocol. The cutoff P values were 0.5 and 1.5 ng/ml when serum P was measured on the day of human chorionic gonadotropin (HCG) administration, and cycles were grouped according to P level on the day of HCG administration. Furthermore, the effect of trigger-day progesterone on embryo quality and the subsequent clinical outcome of FET in this PGT population was evaluated. Results In total, 504 PGT cycles were analyzed. There was no significant difference in the number of euploid blastocysts, top-quality blastocysts, euploidy rate, or miscarriage rate among the three groups (P>0.05). The 2PN fertilization rate (80.32% vs. 80.17% vs. 79.07%) and the top-quality blastocyst rate (8.71% vs. 8.24% vs. 7.94%) showed a downward trend with increasing P, and the between-group comparisons showed no significant differences (P>0.05). The clinical pregnancy rate (41.25% vs. 64.79%; P<0.05) and live birth rate (35.00% vs. 54.93%; P<0.05) in subsequent FET cycles were substantially lower in the high-P group than in the P ≤ 0.5 ng/ml group. After adjustments were made for confounding variables, multivariate logistic regression analysis revealed that the high-P group had a lower clinical pregnancy rate (adjusted OR, 0.317; 95% CI, 0.145-0.692; P=0.004) and live birth rate (adjusted OR, 0.352; 95% CI, 0.160-0.773; P=0.009) than the low-P group in subsequent FET cycles, and the differences were significant. Conclusions This study demonstrates that in the PGT population, elevated P on the trigger day may diminish the top-quality blastocyst rate (although there is no difference in the euploidy rate). Trigger-day P is an important factor influencing clinical outcomes in subsequent FET cycles.
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Affiliation(s)
- Jingdi Li
- Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yueyue Cui
- Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hao Shi
- Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhiqin Bu
- Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fang Wang
- Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Sun
- Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yile Zhang
- Reproductive Medical Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Oliva M, Briton-Jones C, Gounko D, Lee JA, Copperman AB, Sekhon L. Factors associated with vitrification-warming survival in 6167 euploid blastocysts. J Assist Reprod Genet 2021; 38:2671-2678. [PMID: 34309745 DOI: 10.1007/s10815-021-02284-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To understand the clinical factors associated with embryo survival after vitrification in a cohort of human blastocysts screened by preimplantation genetic testing for aneuploidy (PGT-A). METHODS Patient demographic, embryo, and cycle characteristics associated with failed euploid blastocyst survival were compared in a cohort of women (n = 6167) who underwent IVF-PGT-A. RESULTS Compared to those that survived warming, vitrified euploid embryos that failed to survive after warming came from IVF cycles with significantly higher estradiol levels at time of surge (2754.8 ± 1390.2 vs. 2523.1 ± 1190.6 pg/mL, p = 0.03), number of oocytes retrieved (19.6 ± 10.7 vs. 17.5 ± 9.8, p = 0.005), and basal antral follicle count (BAFC) (15.3 ± 8.5 vs. 13.9 ± 7.2, p = 0.05). Euploid embryos were less likely to survive warming if they came from cycles before 2015 (24.6% vs. 13.2%, p < 0.001), were cryopreserved on day 7 versus day 5 or 6 (9.1% vs. 3.0%, p < 0.001), underwent two trophectoderm biopsies (6.9% vs. 2.3%, p < 0.001), had a grade C inner cell mass (15.4% vs. 7.7%, p < 0.001), or were fully hatched (41.1% vs. 12.2%, p < 0.001). In the multivariate model, which controlled for relevant confounders, the association between decreased survival and increased BAFC, year of IVF cycle, double trophectoderm biopsy, and fully hatched blastocysts remained statistically significant. CONCLUSION Euploid embryos that are fully hatched at time of vitrification, come from patients with high ovarian reserve, or require repeat trophectoderm biopsy are less likely to survive vitrification-warming. Our results provide a framework for reproductive counseling and offer realistic expectations to patients about the number of embryos needed to achieve family building goals.
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Affiliation(s)
- Margeaux Oliva
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, Klingenstein Pavilion, 1176 Fifth Ave., 9th Floor, New York, NY, 10029, USA.
| | - Christine Briton-Jones
- Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Dmitry Gounko
- Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Joseph A Lee
- Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Alan B Copperman
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, Klingenstein Pavilion, 1176 Fifth Ave., 9th Floor, New York, NY, 10029, USA.,Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Lucky Sekhon
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, Klingenstein Pavilion, 1176 Fifth Ave., 9th Floor, New York, NY, 10029, USA.,Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
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Vining LM, Zak LJ, Harvey SC, Harvey KE. The role of apoptosis in cryopreserved animal oocytes and embryos. Theriogenology 2021; 173:93-101. [PMID: 34365139 DOI: 10.1016/j.theriogenology.2021.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/24/2021] [Accepted: 07/25/2021] [Indexed: 01/11/2023]
Abstract
Cryopreservation of both gametes and embryos, both for storage and for the preservation of their developmental capacity is a critical aspect of assisted reproductive technology. The survival of reproductive material following cryopreservation protocols is not only vital to clinical applications in the human in vitro fertilisation clinic, but is also important in the in vitro production of livestock embryos. The ability to routinely cryopreserve oocytes and embryos of livestock species has the potential to improve animal welfare, reduce environmental impact, and reduce the associated costs for breeding companies through the reduction of live animal transportation. Unfortunately, frozen oocytes and embryos are regularly documented to contain a higher proportion of apoptotic cells compared to their non-frozen counterparts, with freezing procedures thought to trigger apoptotic pathways of cell death. Comparisons between frozen and non-frozen samples also show changes in the gene expression of apoptotic factors such as Bcl-2 and Bax in response to cryopreservation. Apoptotic inhibition has the potential to improve cryosurvival, and how to achieve this is subject to debate. Here, we review how exposure to low temperatures during cryopreservation may be responsible for the abnormal activation of apoptotic pathways in mammalian oocytes and embryos, and discuss the ways in which they can be influenced to improve cryopreservation protocols, particularly in agriculturally important species.
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Affiliation(s)
- Lucy May Vining
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, CT1 1QU, UK
| | | | - Simon Crawford Harvey
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, CT1 1QU, UK
| | - Katie Evelyn Harvey
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
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Ješeta M, Celá A, Žáková J, Mádr A, Crha I, Glatz Z, Kempisty B, Ventruba P. Metabolic Activity of Human Embryos after Thawing Differs in Atmosphere with Different Oxygen Concentrations. J Clin Med 2020; 9:jcm9082609. [PMID: 32806506 PMCID: PMC7466109 DOI: 10.3390/jcm9082609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 12/25/2022] Open
Abstract
The vitrification of human embryos is more and more frequently being utilized as a method of assisted reproduction. For this technique, gentle treatment of the embryos after thawing is crucial. In this study, the balance of amino acids released to/consumed from the cultivation media surrounding the warmed embryos was observed in the context of a cultivation environment, which was with the atmospheric oxygen concentration ≈20% or with a regulated oxygen level—hysiological (5%). It is the first time that total amino acid turnover in human embryos after their freezing at post compaction stages has been evaluated. During this study, progressive embryos (developed to blastocyst stage) and stagnant embryos (without developmental progression) were analyzed. It was observed that the embryos cultivated in conditions of physiological oxygen levels (5% oxygen) showed a significantly lower consumption of amino acids from the cultivation media. Progressively developing embryos also had significantly lower total amino acid turnovers (consumption and production of amino acids) when cultured in conditions with physiological oxygen levels. Based on these results it seems that a cultivation environment with a reduced oxygen concentration decreases the risk of degenerative changes in the embryos after thawing. Therefore, the cultivation of thawed embryos in an environment with physiological oxygen levels may preclude embryonal stagnation, and can support the further development of human embryos after their thawing.
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Affiliation(s)
- Michal Ješeta
- Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University and University Hospital Brno, 602 00 Brno, Czech Republic; (J.Ž.); (I.C.); (P.V.)
- Department of Veterinary Sciences, Czech University of Life Sciences in Prague, 165 00 Prague, Czech Republic
- Correspondence: ; Tel.: +420-532-238-286
| | - Andrea Celá
- Department of Biochemistry, Faculty of Science, Masaryk University, 602 00 Brno, Czech Republic; (A.C.); (A.M); (Z.G.)
| | - Jana Žáková
- Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University and University Hospital Brno, 602 00 Brno, Czech Republic; (J.Ž.); (I.C.); (P.V.)
| | - Aleš Mádr
- Department of Biochemistry, Faculty of Science, Masaryk University, 602 00 Brno, Czech Republic; (A.C.); (A.M); (Z.G.)
| | - Igor Crha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University and University Hospital Brno, 602 00 Brno, Czech Republic; (J.Ž.); (I.C.); (P.V.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, 602 00 Brno, Czech Republic
| | - Zdeněk Glatz
- Department of Biochemistry, Faculty of Science, Masaryk University, 602 00 Brno, Czech Republic; (A.C.); (A.M); (Z.G.)
| | - Bartosz Kempisty
- Department of Veterinary Surgery, Nicolaus Copernicus University, 87 100 Torun, Poland;
- Department of Histology and Embryology, Poznan University of Medical Sciences, 61 701 Poznan, Poland
- Department of Anatomy, Poznan University of Medical Sciences, 61 701 Poznan, Poland
| | - Pavel Ventruba
- Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University and University Hospital Brno, 602 00 Brno, Czech Republic; (J.Ž.); (I.C.); (P.V.)
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Wang YJ, Liu WJ, Fan L, Li ZT, Huang YQ, Chen CQ, Liu D, Zhang XQ, Liu FH. The impacts of the number of prefreeze and postthaw blastomeres on embryo implantation potential: A systematic analysis. Medicine (Baltimore) 2020; 99:e19591. [PMID: 32221078 PMCID: PMC7220464 DOI: 10.1097/md.0000000000019591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
To systematically analyze the potential of embryo implantation through comparison between the number of surviving blastomeres, the growth, and implantation rate.Retrospective analysis on implantation rate and the growth of prefreeze-postthaw embryos with different blastomeres in 1487 frozen embryo transfer cycles.In groups of postthaw embryos without damage, implantation rate and the average number of blastomere growth increased significantly with increasing number of blastomeres. The implantation rate and the number of blastomeres of embryos with 8-8c (the number of blastomeres in prefreeze embryo-the number of blastomeres in postthaw embryo) continued to grow at a significantly higher rate than that of 5-5c and 6-6c (P < .05). In groups of embryos with the same number of blastomeres before freezing and with partial damage after resuscitation, the implantation rates were lower and the average numbers of blastomere growth reduced as the number of damaged blastomeres increased. For embryos with good quality before freezing, 1 to 3 damaged blastomeres in postthawed embryos did not affect the development and implantation rate. Both implantation rate and growth rate of embryos with 8-6c were significantly higher than those of embryos with 6-6c (P < .05).The number of surviving blastomeres and growth in frozen-thawed embryos could be important index to predict embryo development potential and clinical outcome of implantation. For embryos with good quality, a small amount of damaged blastomeres would not weaken embryo development potential and implantation rate after being thawed.
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Ramezanali F, Arabipoor A, Hafezi M, Salman-Yazdi R, Zolfaghari Z, Asharfi M. Serum estradiol level on trigger day impacts clinical pregnancy rate in modified natural frozen embryo transfer cycles. Int J Gynaecol Obstet 2019; 145:312-318. [PMID: 30916782 DOI: 10.1002/ijgo.12806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/15/2018] [Accepted: 03/19/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the predictive value of serum estradiol and progesterone on the day of human chorionic gonadotropin (hCG) administration and embryo transfer for clinical pregnancy rate in modified natural-cycle frozen embryo transfer (NC-FET). METHODS In a longitudinal prospective study, all eligible women who underwent NC-FET cycles with hCG triggering in Royan Institute, Tehran, Iran, from June 1, 2015, to December 31, 2016, were evaluated. Serum estradiol and progesterone levels were measured at menstrual cycle initiation, on day of trigger with hCG, on day of embryo transfer, and in pregnant women every 7 days until the observation of a gestational sac with embryonic heartbeat. RESULTS In total, 101 modified natural FET cycles were assessed, and the clinical pregnancy and live birth rates achieved were 34 (33.6%) and 32 (31.6%), respectively. The changes in estradiol level during early pregnancy showed an increase by an average of 200 pg/mL per week. Multivariable logistic regression analysis showed that only the estradiol level on the hCG day was a significant predictive variable for clinical pregnancy following NC-FET (P=0.04). CONCLUSION Estradiol level on the day of hCG trigger predicted the clinical pregnancy rates after modified NC-FET; this likely mirrored the developmental competence of the corpus luteum and an appropriate luteal structure-function.
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Affiliation(s)
- Fariba Ramezanali
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Arezoo Arabipoor
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Maryam Hafezi
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Reza Salman-Yazdi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Zahra Zolfaghari
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahnaz Asharfi
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.,Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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7
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Oliveira RD, Cabral FG, Carvalho WDAP, Cordts EB, Bianco B, Barbosa CP. Progesterone level on the day of hCG administration in relation to the pregnancy rates of patients undergoing assisted reproduction techniques. EINSTEIN-SAO PAULO 2017; 15:273-277. [PMID: 29091147 PMCID: PMC5823039 DOI: 10.1590/s1679-45082017ao4091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/09/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the predictive capacity for pregnancy of the progesterone level on the day of administering human chorionic gonadotropin, in women submitted to assisted reproductive techniques. METHODS An observational study with 914 women submitted to assisted reproductive techniques from August 2014 to June 2016. RESULTS Total pregnancy rate was 34.58%; in that, the pregnancy rate in women <35 years, between 35 and 38, and >38 years was, respectively, 42.3%, 38.7% and 16.1% (p<0.001). For embryo transfer in the same cycle, and progesterone of 1.3ng/dL, sensitivity was 4.78%, specificity, 84.18%, accuracy, 56.72%, positive likelihood ratio of 0.3019, and negative likelihood ratio of 1.1312, with receiver operating characteristic curve of 0.46 (95%CI: 0.42-0.49). CONCLUSION The progesterone level on the day of administering human chorionic gonadotropin of 1.3ng/dL differs from that empirically adopted at the study site (1.7ng/dL), and has a better predictive capacity for pregnancy in the patients studied. However, the low sensitivity of this examination raises questions about its real importance.
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Affiliation(s)
- Renato de Oliveira
- Instituto Ideia Fértil, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | | | | | | | - Bianca Bianco
- Instituto Ideia Fértil, Faculdade de Medicina do ABC, Santo André, SP, Brazil
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Takahashi T, Hasegawa A, Igarashi H, Amita M, Matsukawa J, Takehara I, Suzuki S, Nagase S. Prognostic factors for patients undergoing vitrified-warmed human embryo transfer cycles: a retrospective cohort study. HUM FERTIL 2016; 20:140-146. [PMID: 27876421 DOI: 10.1080/14647273.2016.1255786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We examined the prognostic factors for pregnancy in 210 vitrified-warmed embryo transfer (ET) cycles in 121 patients. The univariate analysis showed that age, gravida, the number of cycles associated with infertility caused by endometriosis, the number of previous assisted reproductive technology (ART) treatment cycles, and the number of ICSI procedures were significantly lower in pregnant cycles compared with non-pregnant cycles. The percentages of ET using at least one intact embryo and of ET using at least one embryo that had developed further after warming were significantly higher in pregnant cycles compared with non-pregnant cycles. Multivariate logistic regression analysis showed that previous ART treatment cycles, ET with at least one intact embryo, and ET using at least one embryo that had developed further were independent prognostic factors for pregnancy in vitrified-warmed ET cycles. We conclude that fewer previous ART treatment cycles, ET using at least one intact embryo, and ET with embryos that have developed further after warming might be favourable prognostic factors for pregnancy in vitrified-warmed ET cycles.
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Affiliation(s)
- Toshifumi Takahashi
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
| | - Ayumi Hasegawa
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
| | - Hideki Igarashi
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
| | - Mitsuyoshi Amita
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
| | - Jun Matsukawa
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
| | - Isao Takehara
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
| | - Satoko Suzuki
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
| | - Satoru Nagase
- a Department of Obstetrics and Gynecology , Yamagata University Faculty of Medicine , Yamagata , Japan
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Healy MW, Patounakis G, Connell MT, Devine K, DeCherney AH, Levy MJ, Hill MJ. Does a frozen embryo transfer ameliorate the effect of elevated progesterone seen in fresh transfer cycles? Fertil Steril 2016; 105:93-9.e1. [DOI: 10.1016/j.fertnstert.2015.09.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 09/09/2015] [Accepted: 09/10/2015] [Indexed: 11/24/2022]
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10
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Liu Q, Lian Y, Huang J, Ren X, Li M, Lin S, Liu P, Qiao J. The safety of long-term cryopreservation on slow-frozen early cleavage human embryos. J Assist Reprod Genet 2014; 31:471-5. [PMID: 24682782 DOI: 10.1007/s10815-014-0197-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 02/14/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To evaluate the impact of cryopreservation storage time on cleavage-stage embryo survival rate, pregnancy rate, implantation rate, singleton birth weight, and live birth rate. METHODS This study was a retrospective analysis, including 867 thaw cycles and 3,367 embryos. Women who underwent IVF-FET cycles between 2005 and 2012 were analyzed. The patients were divided into four groups, as follows: group 1 (12-23 months); group 2 (24-35 months); group 3 (36-48 months); and group 4 (≥48 months). RESULTS The storage time did not have a significant effect on survival, damage rate of the blastomeres, implantation rate, pregnancy rate, singleton birth weight, and live birth rate for embryos frozen at cleavage stages. CONCLUSION Storage time did not influence the survival and pregnancy outcomes of slow-frozen early cleavage human embryos. The developmental potential of cryopreserved human embryos with different storage times does not appear to have a negative influence on further development.
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Affiliation(s)
- Qinli Liu
- Reproductive Medical Centre, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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11
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Youssry M, Orief Y, Palapelas V, Al-Hasani S. Embryo cryopreservation: is vitrification ready to replace slow freezing? ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17474108.3.4.455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Matsuo K, Takahashi T, Igarashi H, Hara S, Amita M, Kurachi H. Effects of Different Trehalose Concentrations in a Warming Medium on Embryo Survival and Clinical Outcomes in Vitrified Human Embryos. Gynecol Obstet Invest 2013; 76:214-20. [DOI: 10.1159/000355318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 08/28/2013] [Indexed: 11/19/2022]
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13
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The Alpha consensus meeting on cryopreservation key performance indicators and benchmarks: proceedings of an expert meeting. Reprod Biomed Online 2012; 25:146-67. [DOI: 10.1016/j.rbmo.2012.05.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 05/11/2012] [Accepted: 05/17/2012] [Indexed: 11/20/2022]
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14
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[Frozen embryo transfer protocol: does spontaneous cycle give good results?]. ACTA ACUST UNITED AC 2012; 41:648-52. [PMID: 22342107 DOI: 10.1016/j.gyobfe.2011.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 07/21/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Frozen embryos' transfer optimize the pregnancy rates per retrieval. In France, 60% of transfer cycles occur in stimulated cycles. The aim of this study was to evaluate the outcomes of frozen embryo transfers in spontaneous, substituted and stimulated cycle. PATIENTS AND METHODS This retrospective study includes patients who are 18-43 years old and had a frozen embryo transfer between 1st January 2008 and 31st December 2008. Three transfer protocols have been used: the spontaneous cycle (group 1), substituted cycle (group 2), and stimulated cycle (group 3). The characteristics of couples, embryonic parameters and data transfer cycles, and their outcomes were evaluated. RESULT(S) Among the 333 patients, 132 were included in the first group, 24 in the second group and 177 in the third group. After checking the homogeneity of the three groups, we found pregnancy rates (respectively 20.49 vs 13.04% and 11.32%, P=0.0348), and deliveries (respectively 13.93 vs 8,7 and 6.29%, P=0.0314), significantly higher in spontaneous cycles. DISCUSSION AND CONCLUSION Currently there is no consensus on the best technique for endometrial preparation for frozen embryo transfer. Our results support transfers in spontaneous cycle for normo-ovulating patients. Natural cycles can achieve good pregnancy rates while minimizing the costs and side effects.
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15
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Chua W, Boothroyd C, Walls M, Hart RJ. Slow freeze versus vitrification for embryo cryopreservation. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Wei Chua
- The University of Western Australia; School of Women's and Infants Health; 374 Bagot Road Perth Australia
| | - Clare Boothroyd
- Greenslopes Specialist Centre; Reproductive, Endocrinology, Gynaecology and Infertility; Suite 25 121 Newdegate St Greenslopes Queensland Australia 4120
| | - Melanie Walls
- Fertility Specialists of Western Australia; Perth Australia
| | - Roger J Hart
- The University of Western Australia, King Edward Memorial Hospital and Fertility Specialists of Western Australia; School of Women's and Infants Health; 374 Bagot Road Subiaco Western Australia Australia 6008
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Non-invasive viability assessment of day-4 frozen–thawed human embryos using near infrared spectroscopy. Reprod Biomed Online 2011; 23:769-76. [DOI: 10.1016/j.rbmo.2011.08.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 08/17/2011] [Accepted: 08/17/2011] [Indexed: 10/17/2022]
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17
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Wood MJ, Mollison J, Harrild K, Ferguson E, McKay T, Srikantharajah A, Bell L, Bhattacharya S. A pragmatic RCT of conventional versus increased concentration sucrose in freezing and thawing solutions for human embryos. Hum Reprod 2011; 26:1987-96. [PMID: 21586432 PMCID: PMC3137387 DOI: 10.1093/humrep/der147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 03/28/2011] [Accepted: 04/11/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intact frozen-thawed embryos have a greater potential than damaged embryos to establish successful pregnancies. This study aimed to determine whether elevated concentrations of sucrose during freezing would increase the proportion of patients with ≥ 50% of embryos intact after thawing (primary outcome), and improve clinical outcome. METHODS In a two arm, parallel group, pragmatic trial, IVF/ICSI couples were randomized prospectively to have their supernumerary embryos frozen in a medium containing 0.1 M sucrose (control; n = 99) or 0.3 M sucrose (intervention; n = 102). RESULTS More control (74/99) than intervention (63/102) couples had at least one embryo thawed (P = 0.07). Significantly more (P = 0.005) intervention (53/63) than control (45/74) couples had ≥ 50% of embryos intact. Freezing in a medium containing 0.3 M sucrose increased by 3.4-fold [95% confidence interval (CI) (1.45, 7.82)] the likelihood of a couple having ≥ 50% of their embryos intact. In the fresh cycle, live birth rate per transfer was similar in the control (35/95) and intervention (36/93) groups (P = 0.91). More control (19/63) than intervention (9/59) couples had a live birth after frozen embryo transfer (P = 0.08). When fresh and frozen cycles were combined, fewer intervention (n = 102) than control (n = 99) couples had at least one live birth (42 versus 53%). The difference in cumulative live birth rate was not significant [hazard ratio = 0.75, 95% CI (0.49, 1.13); P = 0.17]. CONCLUSIONS Increasing the concentration of sucrose in the freezing medium improves embryo survival, but this is not reflected by increased cumulative birth rates. CLINICAL TRIALS REGISTRATION NUMBER ISRCTN93314892.
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Affiliation(s)
- M J Wood
- Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
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18
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The number of blastomeres in post-thawing embryos affects the rates of pregnancy and delivery in freeze-embryo-transfer cycles. J Assist Reprod Genet 2009; 26:569-73. [PMID: 19898930 DOI: 10.1007/s10815-009-9360-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 10/16/2009] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To observe the differences in pregnancy rates (PRs), delivery rates, and abortion rates associated with frozen-embryo-transfer (FET)-based use of post-thawing embryos with different numbers of blastomeres. METHODS 959 FET cycles and 361 successful FET cycles performed between January 2007 and December 2007. Compare the PRs and abortion rates in post-thawing embryos with 8 blastomeres (8c), 7c, 6c, 5c, 4c,and 3c. RESULTS 1. The total PRs of post-thawing 8c, 7c, 6c, 5c, 4c, and 3c embryos were 44.1%, 41.0%, 34.4%, 23.8%, 12.5%, and 0%, respectively (p < 0.05). 2. The abortion rates for the transferred embryos of the 8c, 7c, 6c, 5c, and 4c groups were 17.92%, 19.35%, 27.69%, 24%, 20%, respectively (p < 0.05). CONCLUSION The number of blastomeres in the post-thawing embryos is an important factor influencing the occurrence of pregnancy in FET procedures; however, the criterion that post-thawing embryos with 50% intact blastomeres will lead to pregnancy may not be valid.
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Olivius C, Lundin K, Bergh C. Predictive factors for live birth in cryopreservation single embryo transfer cycles. Reprod Biomed Online 2008; 17:676-83. [PMID: 18983752 DOI: 10.1016/s1472-6483(10)60315-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
IVF cryopreservation cycles are known to be less successful than fresh cycles. The objective of this study was to investigate what variables, maternal and embryonic, that independently predict the live birth rate in cryopreservation single embryo transfers (SET). A retrospective analysis was performed on 622 cryopreservation SET originating from 371 consecutive patients performing 410 fresh cycles. Maternal and embryonic variables were analysed using logistic regression. The overall pregnancy and live birth rates were 22 and 16% respectively. Blastomere survival rate, number of previous fresh cycles and IVF as fertilization method compared with intracytoplasmic sperm injection (ICSI), were positive predictors of live birth. Number of embryos thawed to obtain one transfer was negatively associated with pregnancy rate but not with live birth rate. No statistical difference in live birth rate was found whether the couple had performed one, two or three failed cryopreservation cycles previously from the same egg retrieval. Knowledge of certain predictors for live birth contributes to the estimation of prognosis in cryopreservation SET, and is important when deciding whether to perform single or double embryo transfer in cryopreservation cycles. However, despite being independently associated with live birth and pregnancy, the predictive value of identified variables was low.
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Affiliation(s)
- C Olivius
- Department of Endocrinology, Institute of Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Polotsky AJ, Daif JL, Jindal S, Lieman HJ, Santoro N, Pal L. Serum progesterone on the day of human chorionic gonadotropin administration predicts clinical pregnancy of sibling frozen embryos. Fertil Steril 2008; 92:1880-5. [PMID: 18851847 DOI: 10.1016/j.fertnstert.2008.09.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 09/02/2008] [Accepted: 09/04/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate patient characteristics and fresh in vitro fertilization (IVF) cycle parameters that influence success of sibling frozen-thawed embryo transfer (FET) cycles. DESIGN Retrospective study. SETTING Academic infertility practice. PATIENT(S) Infertile women undergoing FET cycles using embryos cryopreserved on day 3 after insemination after an initial fresh IVF cycle. INTERVENTION(S) 90 FET cycles. MAIN OUTCOME MEASURE(S) Clinical pregnancy (CP). RESULT(S) The likelihood of CP after FET was statistically significantly higher in women who had achieved CP in the preceding fresh IVF cycle (71.4% vs. 40.6%). Multivariable logistic regression analysis confirmed that patients achieving CP after the fresh IVF cycle were more likely to achieve CP after FET (OR 5.5; 95% CI, 1.2-25.3) after adjusting for age, number, and cleavage status of embryos transferred. Additionally, higher serum levels of progesterone on the day of human chorionic gonadotropin administration emerged as predictive of CP after FET at a statistically significant level. CONCLUSION(S) The outcome of the fresh embryo transfer cycle is the foremost predictor of CP after FET of the sibling embryos. The relationship between serum progesterone on the day of human chorionic gonadotropin administration in the fresh cycle and the outcome of subsequent FET is noteworthy and merits further investigation.
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Affiliation(s)
- Alex J Polotsky
- Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461, USA.
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Abstract
Cryopreservation of human gametes and embryos has become an essential part of assisted reproduction. Successful cryopreservation of human blastocysts is increasingly relevant as extended in-vitro culture of human embryos becomes more common, permitting routine use of blastocyst transfer in IVF programmes. This reduces the number of embryos transferred, thereby reducing multiple pregnancies and maximizing cumulative pregnancy rates per oocyte retrieval. The superiority of blastocyst freezing over earlier stage freezing in terms of implantation per thawed embryo transferred improves overall expectations for the cryopreservation programme. Therefore, a reliable procedure for the cryopreservation of blastocysts is needed because, after transfer, only a small number of supernumerary blastocysts are likely to be available for cryopreservation. Since the early 1980s, two common techniques have been used in cryopreservation: the conventional slow cooling method and the more recent rapid procedure known as vitrification. Vitrification has become an attractive alternative to slow freezing, since it appears to result in significantly higher survival and pregnancy rates. The aim of this review is to focus on the cryopreservation of human blastocysts using slow and rapid protocols and to assess the impact of the crypreservation protocol used on the survival, implantation and pregnancy rates.
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Urman B, Balaban B, Yakin K. Impact of fresh-cycle variables on the implantation potential of cryopreserved-thawed human embryos. Fertil Steril 2007; 87:310-5. [DOI: 10.1016/j.fertnstert.2006.06.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2006] [Revised: 06/10/2006] [Accepted: 06/10/2006] [Indexed: 11/30/2022]
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Stokes PJ, Hawkhead JA, Fawthrop RK, Picton HM, Sharma V, Leese HJ, Houghton FD. Metabolism of human embryos following cryopreservation: Implications for the safety and selection of embryos for transfer in clinical IVF. Hum Reprod 2006; 22:829-35. [PMID: 17138583 DOI: 10.1093/humrep/del447] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cryopreservation of supernumerary embryos is routinely performed in human-assisted reproduction, providing a source of embryos which can be thawed for use in subsequent treatment cycles. However, the viability of cryopreserved embryos has traditionally relied on morphological assessment, which is a poor predictor of embryo health since freezing leads to a significant overall reduction in implantation potential, and its long-term efficacy is unknown. This study describes how the post-thaw metabolism of human embryos can be used to predict future development to the blastocyst stage. METHODS HPLC was used to analyse the post-thaw amino acid metabolism of human embryos from day 2 to day 3 of development. RESULTS It was possible to predict with 87% accuracy which frozen-thawed embryo would develop to the blastocyst stage. Developmentally competent embryos were more metabolically quiescent than their arresting counterparts. Amino acid turnover was also capable of distinguishing between the developmental potential of the best, Grade I embryos P < 0.05. CONCLUSIONS The data suggests that cryopreservation in IVF is a safe procedure and that amino acid turnover can be used to select which cryopreserved embryo will develop to the blastocyst stage, irrespective of their post-thaw grade.
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Coppus SFPJ, van der Veen F, Bossuyt PMM, Mol BWJ. Quality of reporting of test accuracy studies in reproductive medicine: impact of the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. Fertil Steril 2006; 86:1321-9. [PMID: 16978620 DOI: 10.1016/j.fertnstert.2006.03.050] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2005] [Revised: 03/28/2006] [Accepted: 03/28/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the extent to which test accuracy studies published in two leading reproductive medicine journals in the years 1999 and 2004 adhered to the Standards for Reporting of Diagnostic Accuracy (STARD) initiative parameters, and to explore whether the introduction of the STARD statement has led to an improved quality of reporting. DESIGN Structured literature search. Articles that reported on the diagnostic performance of a test in comparison with a reference standard were eligible for inclusion. For each article we scored how well the 25 items of the STARD checklist were reported. These items deal with the study question, study participants, study design, test methods, reference standard, statistical methods, reporting of results, and conclusions. We calculated the total number of reported STARD items per article, summary scores for each STARD item, and the average number of reported STARD items per publication year. SETTING Not applicable. PATIENT(S) Not applicable. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Quality of reporting. RESULT(S) We found 24 studies reporting on test accuracy in reproductive medicine in 1999 and 27 studies in 2004. The mean number of reported STARD items for articles published in 1999 was 12.1 +/- 3.3 (range 6.5-20) and 12.4 +/- 3.2 (range 7-17.5) in 2004, after publication of the STARD statement. Overall, less than half of the studies reported adequately on 50% or more of the STARD items. The reporting of individual items showed a wide variation. There was no significant improvement in mean number of reported items for the articles published after the introduction of the STARD statement. CONCLUSION(S) Authors of test accuracy studies in the two leading fertility journals poorly report the design, conduct, methodology, and statistical analysis of their study. Strict adherence to the STARD guidelines should be encouraged.
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Affiliation(s)
- Sjors F P J Coppus
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands.
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Sifer C, Sellami A, Poncelet C, Martin-Pont B, Porcher R, Hugues JN, Wolf JP. Day 3 compared with day 2 cryopreservation does not affect embryo survival but improves the outcome of frozen-thawed embryo transfers. Fertil Steril 2006; 86:1537-40. [PMID: 16978617 DOI: 10.1016/j.fertnstert.2006.03.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2005] [Revised: 03/15/2006] [Accepted: 03/15/2006] [Indexed: 11/29/2022]
Abstract
A retrospective study was performed to determine the differences in embryo survival and frozen-thawed embryo transfers outcome between cryopreservation performed on day 3 versus day 2. We conclude that freezing supernumerary embryos on day 3 provides similar thawing survival parameters, better implantation, pregnancy, and live-birth rates compared with day 2 cryopreservation.
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Affiliation(s)
- Christophe Sifer
- Laboratoire de Biologie de la Reproduction, Service d'Histologie-Embryologie-Cytogénétique, Bondy, France
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Tang R, Catt J, Howlett D. Towards defining parameters for a successful single embryo transfer in frozen cycles. Hum Reprod 2006; 21:1179-83. [PMID: 16410326 DOI: 10.1093/humrep/dei490] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Twin pregnancies in IVF should be avoided by transferring embryos one at a time, even for frozen cycles. In this study, we investigated the effect of blastomere lysis and cleavage in singleton frozen embryo transfer (sFET) cycles. Outcomes were compared with the transfer of two embryos in frozen transfer cycles (dFET). METHODS A retrospective analysis was performed on 891 FET cycles, involving 404 sFET and 487 dFET cycles. RESULTS Overall, in sFET cycles, the pregnancy and implantation rates were 8.9 and 8.7%. When blastomere lysis was more than 25% but no greater than 50%, the pregnancy and implantation rates were 3.2%. If blastomere lysis was greater than 50% there were no pregnancies. If blastomere lysis was less than 25%, but with no cleavage, the pregnancy and implantation rates were 4.1%. The results significantly improved (P = 0.007) in the group with less than 25% lysis, when cleavage occurred. The pregnancy and implantation rates for this group were 17.3 and 16.6%. This was not significantly different from unselected two embryo transfers (22 and 12.7%,P = 0.2 and 0.19, respectively). There were 21 twins with dFET (19.6% of pregnancies) and none in sFET. CONCLUSION Both blastomere lysis and cleavage affect the outcome in sFET. To avoid the risk of twins, sFET should be considered when the embryo shows less than 25% blastomere lysis and at least one blastomere cleaves.
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Affiliation(s)
- R Tang
- Monash IVF, Clayton, Victoria, Australia
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Current World Literature. Curr Opin Obstet Gynecol 2005. [DOI: 10.1097/01.gco.0000169110.00376.bd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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