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Martirosyan YO, Silachev DN, Nazarenko TA, Birukova AM, Vishnyakova PA, Sukhikh GT. Stem-Cell-Derived Extracellular Vesicles: Unlocking New Possibilities for Treating Diminished Ovarian Reserve and Premature Ovarian Insufficiency. Life (Basel) 2023; 13:2247. [PMID: 38137848 PMCID: PMC10744991 DOI: 10.3390/life13122247] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Despite advancements in assisted reproductive technology (ART), achieving successful pregnancy rates remains challenging. Diminished ovarian reserve and premature ovarian insufficiency hinder IVF success-about 20% of in vitro fertilization (IVF) patients face a poor prognosis due to a low response, leading to higher cancellations and reduced birth rates. In an attempt to address the issue of premature ovarian insufficiency (POI), we conducted systematic PubMed and Web of Science research, using keywords "stem cells", "extracellular vesicles", "premature ovarian insufficiency", "diminished ovarian reserve" and "exosomes". Amid the complex ovarian dynamics and challenges like POI, stem cell therapy and particularly the use of extracellular vesicles (EVs), a great potential is shown. EVs trigger paracrine mechanisms via microRNAs and bioactive molecules, suppressing apoptosis, stimulating angiogenesis and activating latent regenerative potential. Key microRNAs influence estrogen secretion, proliferation and apoptosis resistance. Extracellular vesicles present a lot of possibilities for treating infertility, and understanding their molecular mechanisms is crucial for maximizing EVs' therapeutic potential in addressing ovarian disorders and promoting reproductive health.
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Affiliation(s)
- Yana O. Martirosyan
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (T.A.N.); (A.M.B.); (P.A.V.); (G.T.S.)
| | - Denis N. Silachev
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (T.A.N.); (A.M.B.); (P.A.V.); (G.T.S.)
- Department of Functional Biochemistry of Biopolymers, A.N. Belozersky Research Institute of Physico-Chemical Biology, Moscow State University, 119992 Moscow, Russia
| | - Tatiana A. Nazarenko
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (T.A.N.); (A.M.B.); (P.A.V.); (G.T.S.)
| | - Almina M. Birukova
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (T.A.N.); (A.M.B.); (P.A.V.); (G.T.S.)
| | - Polina A. Vishnyakova
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (T.A.N.); (A.M.B.); (P.A.V.); (G.T.S.)
- Research Institute of Molecular and Cellular Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Gennadiy T. Sukhikh
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (T.A.N.); (A.M.B.); (P.A.V.); (G.T.S.)
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Di Guardo F, Racca A, Coticchio G, Borini A, Drakopoulos P, Mackens S, Tournaye H, Verheyen G, Blockeel C, Van Landuyt L. Impact of cell loss after warming of human vitrified day 3 embryos on obstetric outcome in single frozen embryo transfers. J Assist Reprod Genet 2022; 39:2069-2075. [PMID: 35857255 PMCID: PMC9474781 DOI: 10.1007/s10815-022-02572-3] [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: 05/31/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE Does cell loss (CL) after vitrification and warming (V/W) of day 3 embryos have an impact on live birth rate (LBR) and neonatal outcomes? METHOD This retrospective analysis includes cleavage stage day 3 embryos vitrified/warmed between 2011 and 2018. Only single vitrified/warmed embryo transfers were included. Pre-implantation genetic screening, oocyte donation, and age banking were excluded from the analysis. The sample was divided into two groups: group A (intact embryo after warming) and group B (≤ 50% blastomere loss after warming). RESULTS On the total embryos (n = 2327), 1953 were fully intact (83.9%, group A) and 374 presented cell damage (16.1%, group B). In group B, 62% (232/374) of the embryos had lost only one cell. Age at cryopreservation, cause of infertility, insemination procedure, and semen origin were comparable between the two groups. The positive hCG rate (30% and 24.3%, respectively, for intact vs CL group, p = 0.028) and LBR (13.7% and 9.4%, respectively, for intact vs CL group, p = 0.023) per warming cycle were significantly higher for intact embryos. However, LBR per positive hCG was equivalent between intact and damaged embryos (45.6% vs 38.5%, respectively, p = 0.2). Newborn measurements (length, weight, and head circumference at birth) were comparable between the two groups. Multivariate logistic regression showed that the presence of CL is not predictive for LB when adjusting for patients' age. CONCLUSIONS LBR is significantly higher after transfer of an intact embryo compared to an embryo with CL after warming; however, neonatal outcomes are comparable between the two groups.
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Affiliation(s)
- Federica Di Guardo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, 95125, Catania, Italy.
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium.
| | - A Racca
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Gran Via de Carles III, 71, 08028, Barcelona, Spain
| | - G Coticchio
- 9.Baby Family and Fertility Center, Via Dante 15, 40125, Bologna, Italy
| | - A Borini
- 9.Baby Family and Fertility Center, Via Dante 15, 40125, Bologna, Italy
| | - P Drakopoulos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium
| | - S Mackens
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium
| | - H Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium
- Department of Obstetrics, Gynecology, Perinatology and Reproduction, Institute of Professional Education, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Trubetskaya str., 8, b. 2, 119992, Moscow, Russia
| | - G Verheyen
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium
| | - C Blockeel
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium
| | - L Van Landuyt
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090, Brussels, Belgium
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Jiang S, Jin W, Zhao X, Xi Q, Chen L, Gao Y, Li W, Kuang Y. The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles. J Ovarian Res 2022; 15:62. [PMID: 35585606 PMCID: PMC9116052 DOI: 10.1186/s13048-022-00997-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blastomere loss is a common phenomenon that occurs following cryopreservation. To date, studies have drawn conflicting conclusions regarding the impact of blastomere loss on pregnancy outcomes. Besides, limited information is available concerning the neonatal safety of embryos with blastomere loss. In the present study, we aimed to investigate the impact of blastomere loss on pregnancy and neonatal outcomes of vitrified/warmed Day3 cleavage-stage embryos in single embryo transfer cycles. METHODS This retrospective cohort study included all vitrified/warmed D3 cleavage-stage single frozen-thawed embryo transfer (FET) cycles between April 2015 and February 2021. We compared pregnancy and subsequent neonatal outcomes between the intact embryos group and the blastomere loss group in single FET cycles. RESULTS A total of 6287 single FET cycles were included in the study, in which 5873 cycles were classified into the intact embryo group and 414 cycles were classified into the blastomere loss group. The outcomes of the blastomere loss group were significantly inferior to those of the intact embryo group, in terms of implantation/biochemical pregnancy/clinical pregnancy/ongoing pregnancy rate and live birth rate per embryo transfer cycle/per clinical pregnancy. Further binary logistic regression confirmed that blastomere loss was negatively associated with live birth. Moreover, the blastomere loss group presented with an elevated early miscarriage rate. The neonatal conditions were broadly similar between the two groups. Additionally, multiple binary logistic regression analysis demonstrated that primary infertility and intracytoplasmic sperm injection (ICSI) were common influencing factors of blastomere loss (aOR 1.447, 95% CI 1.038-2.019, P = 0.029; aOR: 1.388, 95% CI: 1.044-51.846, P = 0.024). CONCLUSIONS The transfer of vitrified/warmed D3 embryos with blastomere loss is related to impaired embryo developmental potentials and reduced probabilities of conception. Moreover, even if the embryos with blastomere loss have implanted and reached clinical pregnancies, they present with a lower possibility of developing to live birth owing to a higher early miscarriage rate. However, once the embryos with blastomere loss result in a live birth, no adverse neonatal outcomes are observed. Primary infertility and ICSI were found to be risk factors for blastomere loss.
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Affiliation(s)
- Shutian Jiang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Wei Jin
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xinxi Zhao
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Qianwen Xi
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Li Chen
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yining Gao
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Wenzhi Li
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Yanping Kuang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Di Guardo F, Blockeel C, De Vos M, Palumbo M, Christoforidis N, Tournaye H, Drakopoulos P. Poor ovarian response and the possible role of natural and modified natural cycles. Ther Adv Reprod Health 2022; 16:26334941211062026. [PMID: 35072076 PMCID: PMC8771731 DOI: 10.1177/26334941211062026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022] Open
Abstract
About 20% of women undergoing in vitro fertilization struggle with poor ovarian response, indicating a poor prognosis related to low response following ovarian stimulation. Indeed, poor ovarian response, that is associated with both high cancelation rates and low live birth rates, still represents one of the most important therapeutic challenges in in vitro fertilization. In this context, natural cycle/modified natural cycle–in vitro fertilization, as a ‘milder’ approach, could be a reasonable alternative to high-dose/conventional ovarian stimulation in poor ovarian responders, with the aim to retrieve a single oocyte with better characteristics that may result in a single top-quality embryo, transferred to a more receptive endometrium. Moreover, modified natural cycle–in vitro fertilization may be cost-effective because of the reduced gonadotropin consumption. Several studies have been published during the last 20 years reporting conflicting results regarding the use of natural cycle/modified natural cycle–in vitro fertilization in women with poor ovarian response; however, while most of the studies concluded that mild stimulation regimens, including natural cycle/modified natural cycle–in vitro fertilization, have low, but acceptable success rates in this difficult group of patients, others did not replicate these findings. The aim of this narrative review is to appraise the current evidence regarding the use of natural cycle/modified natural cycle–in vitro fertilization in poor ovarian responders.
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Affiliation(s)
- Federica Di Guardo
- Gynecology and Obstetrics Section, Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Christophe Blockeel
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Michel De Vos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marco Palumbo
- Gynecology and Obstetrics Section, Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | | | - Herman Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Panagiotis Drakopoulos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
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Ilina IV, Khramova YV, Ivanova AD, Filatov MA, Silaeva YY, Deykin AV, Sitnikov DS. Controlled hatching at the prescribed site using femtosecond laser for zona pellucida drilling at the early blastocyst stage. J Assist Reprod Genet 2020; 38:517-529. [PMID: 33205358 DOI: 10.1007/s10815-020-01998-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/27/2020] [Indexed: 01/16/2023] Open
Abstract
PURPOSE To study whether the application of femtosecond laser pulses for zona pellucida (ZP) drilling of blastocysts at the embryonic or abembryonic poles can promote hatching to start immediately through the hole formed and ensure high hatching rates and embryo viability. METHODS Mouse blastocyst (E3.5) ZP were microdissected with femtosecond laser pulses (514-nm wavelength, 280-fs pulse duration, 2.5-kHz repetition rate) close to the trophoblast or inner cell mass (ICM). The sizes of the holes formed were in the range of 4.5-8.5 μm. Additional longitudinal incisions (5-7-μm long) on either side of the hole were created to determine whether hatching had started at the correct position. Embryos post-laser-assisted ZP drilling and intact embryos were cultured under standard conditions for 2 days; embryo quality was assessed twice daily. The hatching rates and in vitro and in vivo implantation rates (only for embryos with ZP dissected close to the ICM) were estimated. RESULTS Femtosecond laser-assisted ZP drilling at the early blastocyst stage facilitated embryo hatching to start at the artificial opening with probability approaching 100%. Despite the artificial opening's small size, no embryo trapping during hatching was observed. Both experimental groups had higher hatching rates than the control groups (93.3-94.7% vs. 83.3-85.7%, respectively). The in vitro implantation rate was comparable with that of the control group (92.3% vs. 95.4%). No statistically significant differences were obtained in the in vivo implantation rates between the experimental and control groups. CONCLUSIONS Blastocyst-stage femtosecond laser microsurgery of ZP is fast and delicate and enables the hatching process to be initiated in a controlled manner through a relatively small opening, with no embryo trapping.
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Affiliation(s)
- Inna V Ilina
- Joint Institute for High Temperatures of the Russian Academy of Sciences, Izhorskaya st. 13 Bd.2, Moscow, Russian Federation, 125412.
| | - Yulia V Khramova
- Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory, 12-1, Moscow, Russian Federation, 119234
| | - Anna D Ivanova
- Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory, 12-1, Moscow, Russian Federation, 119234
| | - Maxim A Filatov
- Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory, 12-1, Moscow, Russian Federation, 119234
| | - Yuliya Yu Silaeva
- Core Facility Centre, Institute of Gene Biology, Russian Academy of Sciences, Vavilova st. 34/5, Moscow, Russian Federation, 119334
| | - Alexey V Deykin
- Core Facility Centre, Institute of Gene Biology, Russian Academy of Sciences, Vavilova st. 34/5, Moscow, Russian Federation, 119334.,Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Institute of Gene Biology, Russian Academy of Sciences, Vavilova st. 34/5, Moscow, Russian Federation, 119334
| | - Dmitry S Sitnikov
- Joint Institute for High Temperatures of the Russian Academy of Sciences, Izhorskaya st. 13 Bd.2, Moscow, Russian Federation, 125412
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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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Abstract
The complexity of predicting embryo development potential at the cleavage stages and the emergence of epigenetic risks during prolonged in vitro culture of pre-implantation embryos made it more advantageous to transfer embryos at the morula stage to the uterine cavity. The criteria for estimating embryos at this stage that allow prediction of cryopreservation outcomes have been poorly described. All day 4 embryos (n = 224) were graded 1, 2, 3, 4 or 5 according to blastomere compaction degree (BCD = 100, 75, 50, 25 or 0%, respectively) and the survival and blastocyst formation rate of these morulae were studied after cryopreservation. An inverse dependence was found between survival rate and BCD. Excluded fragments were characterized by low osmotic reaction during exposure to cryoprotective medium and, after freeze-thawing, they were destroyed. As damaged necrotic areas of the embryo can affect their further development rate we proposed blastomeres and biopsy fragments of incomplete compacted morula be removed before embryo cryopreservation. This step led to significant increase in the post-thawing survival rate up to 93.1 ± 4.1%, 75 ± 8.8% and blastocyst formation rate up to 85.2 ± 10.4%, 59.4 ± 5.2% in grade 2 and grade 3 embryos, respectively. There was no significant difference in grade 4 embryos. Therefore the removal of blastomeres and biopsy fragments in incomplete compacted morulae can improve cryopreservation outcomes of grade 2 and grade 3 embryos with BCD.
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Davidson LM, Liu Y, Griffiths T, Jones C, Coward K. Laser technology in the ART laboratory: a narrative review. Reprod Biomed Online 2019; 38:725-739. [DOI: 10.1016/j.rbmo.2018.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/01/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022]
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Wu YT, Li C, Zhu YM, Zou SH, Wu QF, Wang LP, Wu Y, Yin R, Shi CY, Lin J, Jiang ZR, Xu YJ, Su YF, Zhang J, Sheng JZ, Fraser WD, Liu ZW, Huang HF. Outcomes of neonates born following transfers of frozen-thawed cleavage-stage embryos with blastomere loss: a prospective, multicenter, cohort study. BMC Med 2018; 16:96. [PMID: 29914496 PMCID: PMC6006714 DOI: 10.1186/s12916-018-1077-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/15/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite limited information on neonatal safety, the transfer of frozen-thawed cleavage-stage embryos with blastomere loss is common in women undergoing in vitro fertilization. We aimed to evaluate the pregnancy outcomes and safety of frozen-thawed cleavage-stage embryos with blastomere loss. METHODS This prospective, multicenter, cohort study included all frozen-thawed cleavage-stage embryo transfer (FET) cycles between 2002 and 2012. Pregnancy outcomes and subsequent neonatal outcomes were compared between FET cycles with intact embryos and those with blastomere loss. RESULTS A total of 12,105 FET cycles were included in the analysis (2259 cycles in the blastomere loss group and 9846 cycles in the intact embryo group). The blastomere loss group showed significantly poorer outcomes with respect to implantation, pregnancy, and live birth rates than the intact embryo group. However, following embryo implantation, the two groups were similar with respect to live birth rates per clinical pregnancy. Among multiple pregnancies (4229 neonates), neonates from the blastomere loss group were at an increased risk of being small for gestational age (aOR = 1.50, 95% CI 1.00-2.25) compared to those from the intact group. A similar trend was observed among singletons (aOR = 1.84, 95% CI 0.99-3.37). No associations were found between blastomere loss and the subsequent occurrence of congenital anomalies or neonatal mortality. However, neonates from the blastomere loss group were at an increased risk of transient tachypnea of the newborn (aOR = 5.21, 95% CI 2.42-11.22). CONCLUSIONS The transfer of embryos with blastomere loss is associated with reduced conception rates. Once the damaged embryos have implanted, pregnancies appear to have the same probability of progressing to live birth but with an increased risk of small for gestational age neonates and transient tachypnea of the newborn. STUDY REGISTRATION This study was retrospectively registered at Chinese Clinical Trial Registry. Registration number: ChiCTR-OOC-16007753 . Registration date: 13 January 2016.
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Affiliation(s)
- Yan-Ting Wu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cheng Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Min Zhu
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Shu-Hua Zou
- Department of Reproductive Medicine, Qingdao Women and Children's Hospital, Shandong, China
| | - Qiong-Fang Wu
- Department of Reproductive Medicine, Jiangxi Maternal and Child Health Hospital, Jiangxi, China
| | - Li-Ping Wang
- Department of Reproductive Medicine, Jiaxing Maternity and Child Health Care Hospital, Zhejiang, China
| | - Yan Wu
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Rong Yin
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Chao-Yi Shi
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Lin
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zi-Ru Jiang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Jing Xu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun-Fei Su
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China.,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Zhong Sheng
- Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Zhejiang, China.,Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University), Zhejiang, China
| | - William D Fraser
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke (CRCHUS) and Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Zhi-Wei Liu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China. .,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - He-Feng Huang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Rd, Shanghai, 200030, China. .,Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Halvaei I, Ghazali S, Nottola SA, Khalili MA. Cleavage-stage embryo micromanipulation in the clinical setting. Syst Biol Reprod Med 2018; 64:157-168. [PMID: 29297236 DOI: 10.1080/19396368.2017.1422197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Embryo micromanipulation was developed after introduction of microinjection to overcome infertility. Embryo micromanipulation may be performed at any embryo stage from pronuclear to blastocyst. The technique started out as basic and turned out to be increasingly more complex. Embryo micromanipulation at the cleavage-stage includes a wide range of techniques, from opening the zona pellucida in order to improve the chance of implantation, to removing detrimental components from the embryo to enhance embryo development or blastomeres for preimplantation genetic diagnosis and embryo splitting. Evaluating the impact(s) of different micromanipulation techniques on epigenetics of the embryo and considering quality control during these techniques are important issues in this regard. This review aims to discuss the micromanipulation of cleavage-stage embryos in clinical assisted reproductive technology (ART). ABBREVIATIONS ART: assisted reproductive technology; ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilization; PGD: preimplantation genetic diagnosis; PZD: partial zona dissection; ZP: zona pellucida; SUZI: subzonal insemination; PVS: perivitelline space; AH: assisted hatching; LAH: laserassisted hatching; ZT: zona thinning; UV: ultraviolet; IR: infrared; PCR: polymerase chain reaction; FISH: fluorescent in situ hybridization; NGS: next generation sequencing; QC: quality control; QA: quality assurance.
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Affiliation(s)
- Iman Halvaei
- a Department of Anatomical Sciences, Faculty of Medical Sciences , Tarbiat Modares University , Tehran , Iran
| | - Shahin Ghazali
- b Department of Midwifery, Islamic Azad University, Sanandaj Branch , Sanandaj , Iran
| | - Stefania A Nottola
- c Department of Anatomy, Histology, Forensic Medicine and Orthopaedics , La Sapienza University of Rome , Rome , Italy
| | - Mohammad Ali Khalili
- d Research and Clinical Center for Infertility , Shahid Sadoughi University of Medical Sciences , Yazd , Iran
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Lee VCY, Chow JF, Yeung WSB, Ho PC. Preimplantation genetic diagnosis for monogenic diseases. Best Pract Res Clin Obstet Gynaecol 2017; 44:68-75. [DOI: 10.1016/j.bpobgyn.2017.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/05/2017] [Accepted: 04/07/2017] [Indexed: 02/04/2023]
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Yu L, Jia C, Lan Y, Song R, Zhou L, Li Y, Liang Y, Wang S. Analysis of embryo intactness and developmental potential following slow freezing and vitrification. Syst Biol Reprod Med 2017; 63:285-293. [PMID: 28795845 DOI: 10.1080/19396368.2017.1362060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to identify the parameters that are related to intactness and developmental potential of a day 3 embryo after warming to improve the selection criteria used to cryopreserve and transfer embryos. We also sought to compare slow freezing and vitrification methods of cryopreservation and to evaluate the viability of non-intact embryos. Embryos warmed following slow freezing (n=220) or vitrification (n=522) were divided into 3 groups according to the proportion of surviving blastomeres (I<50%; II=50-99%; and III=100%). The developmental potential of embryos, including the mitosis resumption rate, blastocyst formation rate, and formation rate of grade A blastocysts (i.e., fully expanded blastocysts with an inner cell mass and grade A or B trophectoderm) were retrospectively assessed in embryos. Cleavage-stage embryos with <50% blastomere survival were analyzed using next-generation sequencing (NGS). Logistic regression analysis showed that vitrification and grade 1 were independent predictive factors of embryo intactness and developmental potential (all p<0.05). On day 3, embryos with 4-6 cells or blastomere damage had lower developmental potential than those with 7-9 cells or intact blastomeres (all p<0.05). NGS results showed that the chromosomal status was completely normal in 8 embryos that developed into expanded blastocysts, whereas 4 out of 5 embryos in which development was arrested were abnormal. The results of this study suggest that vitrification is a better choice than slow freezing for embryo cryopreservation. Embryos showing poor quality (fragmentation >30% and/or a non-stage-specific cell size) and lower cell numbers (4-6 cells) on day 3 should be cultured to the blastocyst stage and then vitrified if they develop into good-quality blastocysts. The developmental potential of non-intact embryos is lower than that of intact embryos; however, after they are cultured to the fully expanded blastocyst stage, embryos with <50% blastomere survival appear to be better candidates for transfer. Abbreviations ART: assisted reproductive technology; grade A blastocyst: fully expanded blastocyst with an inner cell mass and grade A or B trophectoderm; NGS: next-generation sequencing; IVF: in vitro fertilization; ICSI: intracytoplasmic sperm injection; FET: frozen-thawed embryo transfer.
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Affiliation(s)
- Lan Yu
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Chanwei Jia
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Yonglian Lan
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Rui Song
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Liying Zhou
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Ying Li
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Yu Liang
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Shuyu Wang
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
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Preliminary investigation of the prevalence and implantation potential of abnormal embryonic phenotypes assessed using time-lapse imaging. Reprod Biomed Online 2017; 34:455-462. [DOI: 10.1016/j.rbmo.2017.02.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 11/20/2022]
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Cimadomo D, Capalbo A, Ubaldi FM, Scarica C, Palagiano A, Canipari R, Rienzi L. The Impact of Biopsy on Human Embryo Developmental Potential during Preimplantation Genetic Diagnosis. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7193075. [PMID: 26942198 PMCID: PMC4749789 DOI: 10.1155/2016/7193075] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/15/2015] [Accepted: 01/05/2016] [Indexed: 01/23/2023]
Abstract
Preimplantation Genetic Diagnosis and Screening (PGD/PGS) for monogenic diseases and/or numerical/structural chromosomal abnormalities is a tool for embryo testing aimed at identifying nonaffected and/or euploid embryos in a cohort produced during an IVF cycle. A critical aspect of this technology is the potential detrimental effect that the biopsy itself can have upon the embryo. Different embryo biopsy strategies have been proposed. Cleavage stage blastomere biopsy still represents the most commonly used method in Europe nowadays, although this approach has been shown to have a negative impact on embryo viability and implantation potential. Polar body biopsy has been proposed as an alternative to embryo biopsy especially for aneuploidy testing. However, to date no sufficiently powered study has clarified the impact of this procedure on embryo reproductive competence. Blastocyst stage biopsy represents nowadays the safest approach not to impact embryo implantation potential. For this reason, as well as for the evidences of a higher consistency of the molecular analysis when performed on trophectoderm cells, blastocyst biopsy implementation is gradually increasing worldwide. The aim of this review is to present the evidences published to date on the impact of the biopsy at different stages of preimplantation development upon human embryos reproductive potential.
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Affiliation(s)
- Danilo Cimadomo
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via G. de Notaris 2/b, 00197 Rome, Italy
- Dipartimento di Scienze Anatomiche, University of Rome “La Sapienza”, Istologiche, Medico Legali e dell'Apparato Locomotore, Sezione Istologia ed Embriologia Medica, Via Antonio Scarpa 16, 00161 Rome, Italy
| | - Antonio Capalbo
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via G. de Notaris 2/b, 00197 Rome, Italy
- GENETYX, Molecular Biology Laboratory, Via Fermi 1, 36063 Marostica, Italy
| | - Filippo Maria Ubaldi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via G. de Notaris 2/b, 00197 Rome, Italy
- GENETYX, Molecular Biology Laboratory, Via Fermi 1, 36063 Marostica, Italy
| | - Catello Scarica
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via G. de Notaris 2/b, 00197 Rome, Italy
- Dipartimento di Scienze Anatomiche, University of Rome “La Sapienza”, Istologiche, Medico Legali e dell'Apparato Locomotore, Sezione Istologia ed Embriologia Medica, Via Antonio Scarpa 16, 00161 Rome, Italy
| | - Antonio Palagiano
- Seconda Università di Napoli, Via Antonio Vivaldi 43, 81100 Caserta, Italy
| | - Rita Canipari
- Dipartimento di Scienze Anatomiche, University of Rome “La Sapienza”, Istologiche, Medico Legali e dell'Apparato Locomotore, Sezione Istologia ed Embriologia Medica, Via Antonio Scarpa 16, 00161 Rome, Italy
| | - Laura Rienzi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via G. de Notaris 2/b, 00197 Rome, Italy
- GENETYX, Molecular Biology Laboratory, Via Fermi 1, 36063 Marostica, Italy
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Wang XL, Zhang X, Qin YQ, Hao DY, Shi HR. Outcomes of day 3 embryo transfer with vitrification using Cryoleaf: a 3-year follow-up study. J Assist Reprod Genet 2012; 29:883-9. [PMID: 22684538 DOI: 10.1007/s10815-012-9814-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 05/28/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To compare success rates of vitrified-warmed with fresh and frozen-thawed ETs DESIGN Retrospective. SETTING Public fertility center. PATIENT(S) Cryopreserved- thawed/warmed ETs were included in this study. Fresh cycles, in which supernumerary embryos were cryopreserved, were set as the fresh control group. INTERVENTION(S) Supernumerary day 3 embryos were cryopreserved by slow-freezing or vitrification and transferred after thawing or warming. MAIN OUTCOME MEASURE(S) Comparison of two cryopreservation techniques with respect to post-thaw survival of embryos, implantation and pregnancy rates, neonatal outcome, and congenital birth defects. RESULTS A total of 962 fresh, 151 freezing-thawed and 300 vitrified-warmed cycles were included in this study. The survival and intact cell rates in the vitrification group were significantly higher compared with those in the slow freezing group (88.5 % vs 74.5 % and 86.6 % vs 64.0 %). The implantation, clinical pregnancy and live birth rates of the vitrification group were similar to the fresh and significant higher than slow freezing group. There were no significant differences in mean gestational age, birth weight, stillbirth, birth defects and the prevalence of neonatal diseases among three groups. CONCLUSION Vitrified-warmed ETs yield comparable outcomes with fresh ETs and is superior to frozen-thawed ETs regarding the survival rate and clinical outcomes.
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Affiliation(s)
- Xing-ling Wang
- Department of gynecology, the first affiliated hospital of Zhengzhou University, Zheng Zhou, China
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Edgar DH, Gook DA. A critical appraisal of cryopreservation (slow cooling versus vitrification) of human oocytes and embryos. Hum Reprod Update 2012; 18:536-54. [PMID: 22537859 DOI: 10.1093/humupd/dms016] [Citation(s) in RCA: 215] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Vitrification is now a commonly applied technique for cryopreservation in assisted reproductive technology (ART) replacing, in many cases, conventional slow cooling methodology. This review examines evidence relevant to comparison of the two approaches applied to human oocytes and embryos at different developmental stages. METHODS Critical review of the published literature using PubMed with particular emphasis on studies which include data on survival and implantation rates, data from fresh control groups and evaluation of the two approaches in a single setting. RESULTS Slow cooling is associated with lower survival rates and compromised development relative to vitrification when applied to metaphase II (MII) oocytes, although the vitrification results have predominantly been obtained using direct contact with liquid nitrogen and there is some evidence that optimal protocols for slow cooling of MII oocytes are yet to be established. There are no prospective randomized controlled trials (RCTs) which support the use of either technique with pronuclear oocytes although vitrification has become the method of choice. Optimal slow cooling, using modifications of traditional methodology, and vitrification can result in high survival rates of early embryos, which implant at the same rate as equivalent fresh counterparts. Many studies report high survival and implantation rates following vitrification of blastocysts. Although slow cooling of blastocysts has been reported to be inferior in some studies, others comparing the two approaches in the same clinical setting have demonstrated comparable results. The variation in the extent of embryo selection applied in studies can lead to apparent differences in clinical efficiency, which may not be significant if expressed on a 'per oocyte used' basis. CONCLUSIONS Available evidence suggests that vitrification is the current method of choice when cryopreserving MII oocytes. Early cleavage stage embryos can be cryopreserved with equal success using slow cooling and vitrification. Successful blastocyst cryopreservation may be more consistently achieved with vitrification but optimal slow cooling can produce similar results. There are key limitations associated with the available evidence base, including a paucity of RCTs, limited reporting of live birth outcomes and limited reporting of detail which would allow assessment of the impact of differences in female age. While vitrification has a clear role in ART, we support continued research to establish optimal slow cooling methods which may assist in alleviating concerns over safety issues, such as storage, transport and the use of very high cryoprotectant concentrations.
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Affiliation(s)
- David H Edgar
- Reproductive Services/Melbourne IVF, Royal Women's Hospital, Parkville, Victoria 3052, Australia
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Abstract
Embryo density is defined as the embryo-to-volume ratio achieved during in vitro culture; in other words, it is the number of embryos in a defined volume of culture medium. The same density can be achieved by manipulating either the number of embryos in a given volume of medium, or manipulating the volume of the medium for a given number of embryos: for example, a microdrop with five embryos in a 50 μl volume under oil has the same embryo-to-volume ratio (1:10 μl) as a microdrop with one embryo in a 10 μl volume under oil (1:10 μl). Increased embryo density can improve mammalian embryo development in vitro; however, the mechanism(s) responsible for this effect may be different with respect to which method is used to increase embryo density.Standard, flat sterile plastic petri dishes are the most common, traditional platform for embryo culture. Microdrops under a mineral oil overlay can be prepared to control embryo density, but it is critical that dish preparation is consistent, where appropriate techniques are applied to prevent microdrop dehydration during preparation, and results of any data collection are reliable, and repeatable. There are newer dishes available from several manufacturers that are specifically designed for embryo culture; most are readily available for use with human embryos. The concept behind these newer dishes relies on fabrication of conical and smaller volume wells into the dish design, so that embryos rest at the lowest point in the wells, and where putative embryotrophic factors may concentrate.Embryo density is not usually considered by the embryologist as a technique in and of itself; rather, the decision to culture embryos in groups or individually is protocol-driven, and is based more on convenience or the need to collect data on individual embryos. Embryo density can be controlled, and as such, it can be utilized as a simple, yet effective tool to improve in vitro development of human embryos.
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Affiliation(s)
- Michael L Reed
- Center for Reproductive Medicine of New Mexico, Albuquerque, NM, USA.
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Cryopreservation of in vitro produced bovine embryos: effects of lipid segregation and post-thaw laser assisted hatching. Theriogenology 2011; 75:24-33. [DOI: 10.1016/j.theriogenology.2010.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 06/28/2010] [Accepted: 07/02/2010] [Indexed: 11/21/2022]
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AbdelHafez FF, Desai N, Abou-Setta AM, Falcone T, Goldfarb J. Slow freezing, vitrification and ultra-rapid freezing of human embryos: a systematic review and meta-analysis. Reprod Biomed Online 2009; 20:209-22. [PMID: 20113959 DOI: 10.1016/j.rbmo.2009.11.013] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Revised: 04/16/2009] [Accepted: 09/21/2009] [Indexed: 11/26/2022]
Abstract
Embryo cryopreservation is an important aspect of assisted reproduction. Many methods have been described, but they have been poorly investigated in randomized trials, highlighting the need for a systematic review of the literature. Meticulous electronic/hand searches were performed to locate randomized trials (RCT) comparing embryo cryopreservation methods. Primary outcomes were clinical pregnancy rate (CPR) and incidence of congenital abnormalities. Secondary outcomes included live-birth (LBR), ongoing pregnancy (OPR), implantation (IR), and miscarriage (MR) rates. Data were extracted to allow for an intention-to-treat analysis and analysed using a random-effects model. Literature search revealed 11 RCT, of which five were excluded. The quality of the included studies was variable, but generally poor. There was a significantly higher CPR, OPR and IR with vitrification compared with slow freezing (odds ratio (OR)=1.55, 95% confidence interval (CI)=1.03-2.32, OR=1.82, 95% CI=1.04-3.20 and OR=1.49, 95% CI=1.03-2.15, respectively). In addition, there was a significantly lower CPR and OPR with embryo ultra-rapid freezing compared with slow freezing (OR=0.35, 95% CI=0.16-0.76 and OR=0.37, 95% CI=0.17-0.81, respectively). Vitrification is superior to slow freezing, which in turn is superior to ultra-rapid freezing. However, more well-designed and powered studies are needed to further corroborate these findings.
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Affiliation(s)
- Faten F AbdelHafez
- Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, OH, USA
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Granne I, Child T, Hartshorne G, (on behalf of the British Fertility. Embryo cryopreservation: Evidence for practice. HUM FERTIL 2009; 11:159-72. [DOI: 10.1080/14647270802242205] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Morphology of vitrified/warmed day-5 embryos predicts rates of implantation, pregnancy and live birth. Reprod Biomed Online 2009; 19:72-8. [DOI: 10.1016/s1472-6483(10)60049-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Effect of laser-assisted hatching and necrotic blastomere removal on the development of vitrified-warmed four-cell mouse embryos. J Assist Reprod Genet 2008; 25:333-9. [PMID: 18688708 DOI: 10.1007/s10815-008-9238-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2008] [Accepted: 06/25/2008] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To investigate the effect of laser-assisted hatching and necrotic blastomere removal on the development of vitrified-warmed mouse embryos. METHODS The vitrified-warmed four-cell stage mouse embryos were divided into five groups; vitrified intact with no laser-assisted hatching, vitrified intact with laser-assisted hatching, vitrified damaged with neither laser assisted hatching nor necrotic blastomere removal, vitrified damaged with laser-assisted hatching, and vitrified damaged with necrotic blastomere removal. Thereafter blastocyst formation, blastomere and apoptotic cell number within all groups were statistically compared. RESULTS The rate of blastocyst formation showed a significant improvement in the group vitrified intact with laser-assisted hatching. However, neither laser-assisted hatching nor necrotic blastomere removal can improve a delayed vitrified-warmed damaged embryos in term of blastocyst formation and total cell number. Nevertheless, apoptotic cell number was significantly reduced after application of both techniques. CONCLUSIONS Laser-assisted hatching can improve the development of vitrified-warmed intact four-cell stage mouse embryos, whereas necrotic blastomere removal has no significant effect on the development of vitrified-warmed four-cell stage damaged embryos.
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Zheng X, Liu P, Chen G, Qiao J, Wu Y, Fan M. Viability of frozen-thawed human embryos with one-two blastomeres lysis. J Assist Reprod Genet 2008; 25:281-5. [PMID: 18607715 DOI: 10.1007/s10815-008-9224-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Accepted: 04/23/2008] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To assess the impact of one-two blastomeres lysis on the viability of thawed day 3 human embryos. METHODS A retrospective analysis was performed on 248 frozen-thawed embryo replacement cycles in which all embryos were frozen at day 3 at the seven-eight cell stage with <or=10% fragmentation. RESULTS Outcomes of transfer cycles with fully intact embryos (intact group) were compared with those in which all transferred embryos have lost one-two blastomeres (damage group). Comparable pregnancy rates (38.46% vs 38.64%), birth rates (34.62% vs 36.36%) and implantation rates (26.31% vs 26.25%) were obtained in intact and damage groups. These results were also not significantly different from mixed transfer cycles in which one intact embryo and one damaged embryo were transferred together. CONCLUSION The developmental potential of partially damaged cryopreserved human embryos with less than 25% cells loss is comparable to that of fully intact embryos. Presence of one-two lysed blastomeres in the thawed day 3 embryo does not appear to have a negative influence on the further development of the sibling intact cells.
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Affiliation(s)
- Xiaoying Zheng
- Department of Ob & Gyn, The Third Hospital, Peking University, Beijing, China
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Van de Velde H, Cauffman G, Tournaye H, Devroey P, Liebaers I. The four blastomeres of a 4-cell stage human embryo are able to develop individually into blastocysts with inner cell mass and trophectoderm. Hum Reprod 2008; 23:1742-7. [DOI: 10.1093/humrep/den190] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Elliott TA, Colturato LFA, Taylor TH, Wright G, Kort HI, Nagy ZP. Lysed cell removal promotes frozen–thawed embryo development. Fertil Steril 2007; 87:1444-9. [PMID: 17296186 DOI: 10.1016/j.fertnstert.2006.11.064] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Revised: 11/07/2006] [Accepted: 11/07/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To develop a mouse model to investigate the possible causes for increased success rates when lysed cells are removed from thawed embryos. DESIGN Experimental study. SETTING Clinical IVF laboratory. INTERVENTION(S) Assisted hatching, cell lysis, and removal of lysed cells. MAIN OUTCOME MEASURE(S) Embryonic growth rate and morphology. RESULT(S) The mouse embryos were divided into three groups; control (no cell lysis), group 1 (cell lysis and removal), and group 2 (cell lysis only). There was no significant difference in the initial number of blastomeres in each group or the number of cells lysed artificially in groups 1 and 2. The rate of embryonic development showed a significant delay in group 2 (7.97 +/- 4.92; control, 10.42 +/- 8.18; group 1, 5.74 +/-4.42; group 2). The embryo morphology on day 4 was significantly improved in group 1 and the control group when compared with group 2. CONCLUSION(S) Mouse embryos with artificially lysed cells after thawing had poorer developmental quality and growth rates compared with control embryos. However, removal of lysed cells restored the embryo's developmental potential to that of the control. Cell number and morphology was also significantly improved compared with embryos without lysed cell removal. These findings are consistent with human embryo development after thawing when lysed cells are present and thus mechanical lysis seems to be an appropriate method by which to further study frozen-thawed lysed cell removal.
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Devaux A, Lévy R. [How to improve assisted reproductive techniques results? Biological aspects]. ACTA ACUST UNITED AC 2006; 34:781-5. [PMID: 16935017 DOI: 10.1016/j.gyobfe.2006.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2006] [Accepted: 07/20/2006] [Indexed: 12/01/2022]
Abstract
In spite of recent improvements in IVF, pregnancy rates remained dramatically low. Better criteria are therefore necessary to establish the viability of a transferable top quality embryo. Observation of both pronuclei patterns at the zygote stage and early cleavage appears to offer an additional prognostic tool, correlating with chromosomal status and IVF outcome. Developmental ability and morphological evaluation of the embryo on days 2-3 remains the most used and valid method of selection, even though it is not sufficient to select embryos with the higher implantation potential. Blastocyst culture is another possible strategy for selecting the ideal embryo with theoretical, reduced risk of aneuploidies, though not all major chromosomal aberrations are excluded by prolonged in-vitro-culture. Concerning micro-manipulation of embryo such as hatching or cleaning or cytoplasm transfer, only controversial data are still available. In the field of ART, recent meta-analysis could not conclude to a positive effect concerning hatching, blastocyst culture or systematic PGD-AS (preimplantation genetic diagnosis with aneuploidy screening). Beside the technological aspect, Quality Management System is of great importance. Staff development and monitoring of staff performance in the IVF laboratory has to be considered in the next future.
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Affiliation(s)
- A Devaux
- Département d'histologie, CHU Saint-Antoine, faculté de médecine Pierre-et-Marie-Curie, université Paris-VI, 27, rue de Chaligny, 75012 Paris, France.
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