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Zhu M, Dong Q, Zhu Y, Le Y, Wang T, Zhou Y, Yang S. Developmental potential of non- and mono-pronuclear zygotes and associated clinical outcomes in IVF cycles. Front Endocrinol (Lausanne) 2024; 15:1361734. [PMID: 38532894 PMCID: PMC10964251 DOI: 10.3389/fendo.2024.1361734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
Purpose This study aims to evaluate the developmental potential of 0PN, 1PN, and 2PN zygotes in IVF cycles and compare their clinical outcomes. Methods We conducted a retrospective cohort study involving IVF patients. Blastocyst formation rates were assessed with 0PN, 1PN, and 2PN zygotes. Subsequently, we collected clinical outcome data following the transfer of these zygotes. Results The overall blastulation rate was similar between 0PN (29.6%) and 2PN (32.1%) zygotes, but 1PN zygotes exhibited a significantly lower blastulation rate (17.0%) compared to both 0PN and 2PN zygotes. Similarly, the overall rate of good-quality blastulation was comparable between 0PN (15.3%) and 2PN (17.5%) zygotes, while 1PN zygotes showed a significantly lower rate (7.0%) compared to both 0PN and 2PN. Clinical pregnancy, ectopic pregnancy, implantation, and live birth rates were similar among single blastocyst frozen embryo transfers (FET) of 0PN, 1PN, and 2PN. Additionally, no significant differences were observed between single- and double-blastocyst FET of 0PN and 2PN. Conclusions Our findings suggest that 0PN and 2PN zygotes have comparable developmental potential, while 1PN embryos exhibit lower developmental potential. Blastocyst FET outcomes appear similar among 0PN, 1PN, and 2PN zygotes.
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Affiliation(s)
| | | | | | | | | | | | - Sheng Yang
- Department of Assisted Reproduction, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang, China
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Zhu J, Wang C, Cao Z, Luan K, Wu Y, Yin H. Developmental competence and neonatal outcomes of nonpronuclear zygotes following single vitrified-warmed blastocyst transfers using propensity score matching analysis. Arch Gynecol Obstet 2024; 309:295-304. [PMID: 37787836 DOI: 10.1007/s00404-023-07235-x] [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: 05/11/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To investigate developmental competence and neonatal outcomes of nonpronuclear (0PN) zygotes following single vitrified-warmed blastocyst transfers (VBT). METHODS The clinical, laboratorial and neonatal data of 996 patients with ≤ 38 years who underwent blastocyst culture and single VBT were retrospectively analyzed. The pregnancy and neonatal outcomes of VBT were compared between 0PN and 2PN blastocysts using propensity score matching (PSM). Moreover, Day 3 (D3) embryo development and blastocyst formation were compared between 0PN and 2PN zygotes. RESULTS There were no significant differences in clinical pregnancy rate (CPR), live birth rate (LBR) and neonatal outcomes of VBT between the 0PN and 2PN blastocysts irrespectively of whether PSM was used. However, early abortion rate (EAR) was higher in blastocysts from 0PN D3 embryos > 10 cells (p < 0.05) before PSM. Moreover, the early developmental competence of 0PN zygotes was different from that of 2PN zygotes presenting higher percentages of D3 embryos ≤ 6 cells (p < 0.01) and > 10 cells (p < 0.01), lower available blastocyst formation rate (ABFR) (p < 0.01) and good-quality blastocyst formation rate (GBFR) (p < 0.01) in D3 embryos with 4-6 cells. ABFR and GBFR increased with cell number when compared among embryos with 4-6 cells, 7-10 cells and > 10 cells, irrespectively of 0PN or 2PN embryos. CONCLUSION The early developmental competence of 0PN zygotes was different from that of 2PN zygotes, but did not influence pregnancy and neonatal outcomes following VBT. ABFR and GBFR increased with cell number, irrespectively of 0PN or 2PN embryos.
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Affiliation(s)
- Jie Zhu
- Reproductive Medicine Center, the 901st Hospital of the Joint Logistics Support Force of PLA, 424 West Changjiang Road, Hefei, 230031, China
| | - Cunli Wang
- Reproductive Medicine Center, the 901st Hospital of the Joint Logistics Support Force of PLA, 424 West Changjiang Road, Hefei, 230031, China
| | - Zhenyi Cao
- Reproductive Medicine Center, the 901st Hospital of the Joint Logistics Support Force of PLA, 424 West Changjiang Road, Hefei, 230031, China
| | - Kang Luan
- Reproductive Medicine Center, the 901st Hospital of the Joint Logistics Support Force of PLA, 424 West Changjiang Road, Hefei, 230031, China
| | - Yan Wu
- Reproductive Medicine Center, the 901st Hospital of the Joint Logistics Support Force of PLA, 424 West Changjiang Road, Hefei, 230031, China
| | - Huiqun Yin
- Reproductive Medicine Center, the 901st Hospital of the Joint Logistics Support Force of PLA, 424 West Changjiang Road, Hefei, 230031, China.
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Braga DPAF, Setti A, Morishima C, Provenza RR, Iaconelli A, Borges E. The effect of sperm DNA fragmentation on ICSI outcomes depending on oocyte quality. Andrology 2023; 11:1682-1693. [PMID: 37004191 DOI: 10.1111/andr.13435] [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: 03/22/2022] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Sperm deoxyribonucleic acid (DNA) fragmentation is commonly encountered in spermatozoa, and the oocyte assumes responsibility for repairing sperm DNA fragmentation during the oocyte-embryo transition. OBJECTIVES This study aimed to investigate whether the effect of sperm DNA fragmentation on intracytoplasmic sperm injection outcomes depends on the incidence of oocyte dimorphisms. MATERIALS AND METHODS For the present cohort, 2942 fertilized oocytes from 525 patients submitted to intracytoplasmic sperm injection cycles were assessed. The present study was conducted in a private in vitro fertilization center affiliated to a university from June 2016 to July 2019. Semen samples were divided into the following two groups depending on the sperm DNA fragmentation index: a low fragmentation index group (<30% sperm DNA fragmentation, n = 1468) and a high fragmentation index group (≥30% sperm DNA fragmentation, n = 486). In addition, mature oocytes were examined before sperm injection, and intracytoplasmic and extracytoplasmic defects were recorded. The effect of the sperm DNA fragmentation index on laboratory and clinical intracytoplasmic sperm injection outcomes (depending on the presence of oocyte defects) was evaluated. RESULTS Significant increases in the rates of fertilization, high-quality embryo, implantation, and pregnancy were noted for cycles with <30% sperm DNA fragmentation than cycles with ≥30% sperm DNA fragmentation (regardless of the presence of oocyte dimorphisms). The presence of dimorphisms significantly impacted laboratory and clinical outcomes. The lowest fertilization and high-quality embryo rates were observed when a high sperm DNA fragmentation index was associated with the presence of dark cytoplasm, vacuoles, resistant membrane, and non-resistant membrane. The lowest implantation and pregnancy rates were observed when a high sperm DNA fragmentation index was associated with the presence of vacuoles, defective perivitelline space, and fragmented polar body. The effect of sperm DNA fragmentation on miscarriage rates was significantly influenced by the presence of centrally located cytoplasmic granulation, a defective perivitelline space and non-resistant membrane. CONCLUSION A high sperm DNA fragmentation index increases the likelihood of miscarriage in intracytoplasmic sperm injection cycles, an effect that may potentially be magnified by the presence of oocyte dysmorphisms.
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Affiliation(s)
| | | | - Christina Morishima
- Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Assistida, Sao Paulo, Brazil
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Tong X, Jin J, Xue Y, Fang L, Zhu H, Jiang L, Zhang S. Clinical outcomes of frozen-thawed blastocysts from zygotes with no or one pronucleus for in vitro fertilization and intracytoplasmic sperm injection cycles. Arch Gynecol Obstet 2023; 308:1015-1022. [PMID: 37391645 PMCID: PMC10348965 DOI: 10.1007/s00404-023-07118-1] [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: 01/21/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE To investigate the clinical outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles using frozen-thawed blastocyst transfers derived from zygotes with no (0PN) or one pronucleus (1PN). METHODS This retrospective study included 7084 0PN, 2238 1PN, and 72,266 two pronuclear (2PN) embryos cultured to the blastocyst stage from 19,631 IVF and 12,377 ICSI cycles between March 2018 and December 2021. Developmental potential and clinical outcomes of 0PN, 1PN, and 2PN embryos were analyzed. A total of 290 0PN-, 92 1PN-, and 1906 2PN-derived single frozen-thawed blastocyst transfers were performed. Chromosome euploid rates of 0PN-, 1PN-, and 2PN-derived blastocysts were analyzed by next-generation sequencing. Euploid 0PN- and 1PN-derived blastocysts underwent subsequent Infinium Asian Screening Array gene chip analysis to detect ploidy alterations. RESULTS Available blastocyst rates of 0PN and 1PN embryos were significantly lower than those of 2PN embryos in both IVF and ICSI cycles. Single 0PN and 1PN blastocysts transferred in frozen-thawed cycles resulted in a similar clinical pregnancy rate, miscarriage rate, live birth rate, and neonatal outcome to 2PN blastocysts in IVF and ICSI cycles. Genetic analysis showed that euploid rates of 0PN- and 1PN-derived blastocysts used for ICSI cycles were similar to that of 2PN-derived blastocysts. CONCLUSION Our study indicated that 0PN- and 1PN-derived blastocysts resulted in similar clinical outcomes to 2PN-derived blastocysts. The 0PN- and 1PN-derived blastocysts from ICSI cycles can be transferred as well as those from IVF cycles when the number of 2PN-derived blastocysts is insufficient.
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Affiliation(s)
- Xiaomei Tong
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, No. 3 Qingchun East Road, Hangzhou, 310016, China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China
| | - Jiamin Jin
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, No. 3 Qingchun East Road, Hangzhou, 310016, China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China
| | - Yamei Xue
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, No. 3 Qingchun East Road, Hangzhou, 310016, China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China
| | - Lu Fang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, No. 3 Qingchun East Road, Hangzhou, 310016, China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China
| | - Haiyan Zhu
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, No. 3 Qingchun East Road, Hangzhou, 310016, China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China
| | - Lingying Jiang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, No. 3 Qingchun East Road, Hangzhou, 310016, China.
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China.
| | - Songying Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, No. 3 Qingchun East Road, Hangzhou, 310016, China.
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China.
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Time-lapse monitoring of fertilized human oocytes focused on the incidence of 0PN embryos in conventional in vitro fertilization cycles. Sci Rep 2021; 11:18862. [PMID: 34552114 PMCID: PMC8458381 DOI: 10.1038/s41598-021-98312-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/06/2021] [Indexed: 11/22/2022] Open
Abstract
We aimed to investigate why the incidence of embryos derived from oocytes with no pronuclei (0PN) decreases using time-lapse monitoring (TLM) versus fixed-point assessment in conventional IVF cycles. We analyzed 514 embryos monitored with TLM 6–9 h after insemination and 144 embryos monitored using microscopic assessment 18–21 h after insemination. The primary endpoint of this study was the incidence of 0PN-derived embryos in short insemination followed by TLM. The secondary endpoint was the duration of insemination. As exploratory endpoints, we analyzed the blastulation rate and cryo-warmed blastocyst transfer outcome of embryos with early PN fading, whereby PN disappeared within < 20 h following the initiation of insemination. The incidence of 0PN-derived embryo reduced more significantly through TLM than through fixed-point observation. The microscopic assessment time was more significantly delayed in the 0PN-derived embryo than that in the 2PN-derived embryo. The embryo with early PN fading formed good-quality blastocysts, and their pregnancy outcomes were similar to those of other embryos. Most 0PN-derived embryos in the fixed-point assessment might have resulted from missed observation of PN appearance in the early-cleaved embryos. TLM or strict laboratory schedule management may reduce 0PN-derived embryos by reducing missed PN observations.
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Fu L, Zhou W, Li Y. Development and frozen-thawed transfer of non-pronuclear zygotes-derived embryos in IVF cycles. Eur J Obstet Gynecol Reprod Biol 2021; 264:206-211. [PMID: 34329946 DOI: 10.1016/j.ejogrb.2021.07.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To explore the development and pregnancy potential of non-pronuclear (0PN) zygote-derived embryos in conventional in vitro fertilization (IVF) cycles. STUDY DESIGN Embryonic development in 1039 oocyte retrieval cycles and clinical outcomes of 659 frozen-thawed blastocyst transfer cycles were retrospectively studied. RESULTS Developmental potential of embryos with different blastomere numbers on day 3 were inconsistent in 0PN and 2PN groups. For 0PN-derived embryos, blastocyst rate of fast developing embryos (75.4%) was similar to that of intermediately developing embryos (72.9%), but good quality blastocyst rate of the former (49.2%) was significantly higher than that of the later (39.6%). In 2PN group, intermediately developing embryos had the highest blastocyst rate (77.9%) and good quality blastocyst rate (51.5%) (statistically significant). Comparison of frozen-thawed transfer was carried out between 0PN- and 2PN-derived blastocysts. For both single (SBT) and double blastocyst transfer (DBT) groups, no statistical differences existed between 0PN- and 2PN-derived blastocysts in clinical pregnancy rates (45.2% and 49.1% in SBT group, 64.7% and 66.4% in DBT group), implantation rates (45.2% and 49.1% in SBT group, 41.2% and 47.7% in DBT group) and live birth rates (35.5% and 36.8% in SBT group, 52.9% and 51.2% in DBT group). CONCLUSION The developmental characteristic of 0PN-derived embryos was different from that of 2PN-derived embryos in IVF cycles. 0PN-derived blastocysts could obtain acceptable clinical pregnancy and live birth, but more studies are needed to confirm the safety..
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Affiliation(s)
- Lei Fu
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Wenhui Zhou
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Yuan Li
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Blastocyst cryopreservation and cryopreservation-warming transfer is an effective embryo transfer strategy for day 1 rescue intracytoplasmic sperm injection cycles. Sci Rep 2021; 11:8260. [PMID: 33859312 PMCID: PMC8050289 DOI: 10.1038/s41598-021-87693-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/30/2021] [Indexed: 11/08/2022] Open
Abstract
This was a retrospective analysis of a total of 625 r-ICSI cycles using freeze-all-embryos and embryo transfers (ET) in subsequent cryopreservation-warming cycles to determine the effect of the ET method for day 1 rescue intracytoplasmic sperm injection cycles (r-ICSI). Two methods were used: in method 1, cleavage-stage embryos were frozen and were directly transferred in a subsequent cryopreservation-warming cycle (r-ICSI frozen cleavage), and 144 cleavage-stage ETs occurred. Similarly, in method 2, there were 188 blastocyst-stage ETs (r-ICSI frozen blast) performed. The live birth rate (LBR) for r-ICSI frozen blast was better than that for r-ICSI frozen cleavage in calculation of ET cycles (19.44% vs. 37.77%) and also remained better after the use of logistic regression analysis (OR = 2.721, 95% CI 1.604–4.616). Conservative cumulative LBR were compared between r-ICSI frozen cleavage and r-ICSI frozen blast with regard to oocyte retrieval cycles (17.39% vs. 15.30%). The same results were obtained for conservative cumulative LBR after logistic regression analysis (OR = 0.925, 95% CI 0.557–1.535). The results of this study confirmed that it was valuable to perform r-ICSI if using freeze-all-embryos. Further, r-ICSI embryos were cultured to blastocyst stage, cryopreserved, and used in subsequent cryopreservation-warming cycles, which was an effective embryo transfer strategy and obtained satisfactory results.
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Hu J, Molinari E, Darmon S, Zhang L, Patrizio P, Barad DH, Gleicher N. Predictive value of cytoplasmic granulation patterns during in vitro fertilization in metaphase II oocytes: Part I, poor-prognosis patients. Fertil Steril 2021; 116:431-443. [PMID: 33865566 DOI: 10.1016/j.fertnstert.2021.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine whether 4 cytoplasmic granulation patterns of human metaphase II oocytes have a predictive value for in vitro fertilization outcomes. DESIGN A retrospective cohort study. SETTING An academically affiliated private clinical infertility and research center. PATIENT(S) A total of 2,690 consecutive fresh autologous oocytes collected from women aged 41.2 ± 5.0 years between 2017 and 2019. INTERVENTION(S) Determination of granulation pattern in every oocyte during intracytoplasmic sperm injection as fine, central, dispersed, and newly introduced uneven granulations. MAIN OUTCOME MEASURE(S) Fertilization outcomes (2 pronuclei [2PN], <2PN, and >2PN rates), pregnancy, and live birth rates for different granulation patterns at different ages. RESULT(S) Fine granulation produced the highest 2PN rate, followed by central, uneven, and dispersed granulation (91.8%, 83.9%, 77.9%, and 54.8%, respectively). Differences in fertilization were surprisingly relatively independent of age and other variables. Overall, compared with fine granulation, dispersed granulation resulted in lower pregnancy rates (4.6% vs. 10.7%) and known-outcome analysis (1.3% vs. 5.6%) as well as lower live birth rates (3.0% vs. 8.9%) and known-outcome analysis (0.6% vs. 5.6%). The known-outcome analysis demonstrated that uneven granulation had lower live birth rates than fine granulation (2.3% vs. 5.6%). Unexpectedly, the ooplasm granulation patterns were largely disassociated from embryo morphologic grades. CONCLUSION(S) We, for the first time, demonstrated that 4 distinct cytoplasmic granulation patterns in metaphase II oocytes had, largely independent of age and other variables, a predictive value for fertilization, pregnancy, and live birth outcomes in in vitro fertilization cycles of poor-prognosis patients. These data suggest that upstream ooplasm granulation patterns deserve closer attention in terms of embryo selection.
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Affiliation(s)
- Jianjun Hu
- The Center for Human Reproduction, New York, New York.
| | | | - Sarah Darmon
- The Center for Human Reproduction, New York, New York
| | - Lin Zhang
- The Center for Human Reproduction, New York, New York
| | - Pasquale Patrizio
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University Medical School, New Haven, Connecticut
| | - David H Barad
- The Center for Human Reproduction, New York, New York; The Foundation for Reproductive Medicine, New York, New York
| | - Norbert Gleicher
- The Center for Human Reproduction, New York, New York; The Foundation for Reproductive Medicine, New York, New York; Stem Cell Biology and Molecular Embryology Laboratory, Rockefeller University, New York, New York; Department of Obstetrics and Gynecology, Vienna University School of Medicine, Vienna, Austria
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Xu X, Hao Y, Zhong Q, Hang J, Zhao Y, Qiao J. Low KLOTHO level related to aging is associated with diminished ovarian reserve. Fertil Steril 2020; 114:1250-1255. [PMID: 33153705 DOI: 10.1016/j.fertnstert.2020.06.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To explore the relationship between KLOTHO expression and diminished ovarian reserve (DOR). DESIGN A case-control study. SETTING Reproductive medicine center. PATIENT(S) A total of 157 patients with DOR and 159 control women were recruited from the Centre of Reproductive Medicine, Peking University Third Hospital. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The granulosa cells were isolated from follicular fluid after oocyte retrieval, and the KLOTHO level of granulosa cell was measured using a modified quantitative polymerase chain reaction technique. The serum KLOTHO level was measured by solid-phase sandwich enzyme-linked immunosorbent assay. RESULT(S) In both granulosa cells and serum derived from women with DOR, KLOTHO expressions were significantly lower compared with normal ovarian reserve controls. Moreover, KLOTHO expression diminished with advancing age. CONCLUSION(S) Diminished KLOTHO expression was associated with DOR. Further longitudinal studies in a similar population accompanying disease progression and mechanism exploration are needed to substantiate the rules of KLOTHO in reproductive aging.
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Affiliation(s)
- Xiaofei Xu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China
| | - Yongxiu Hao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China
| | - Qihang Zhong
- Institute of Systems Biomedicine, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Jing Hang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China
| | - Yue Zhao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China; Beijing Advanced Innovation Center for Genomics, Beijing, People's Republic of China; Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Beijing, People's Republic of China.
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Fu L, Chu D, Zhou W, Li Y. Strictly selected Mono- and non-pronuclear blastocysts could result in appreciable clinical outcomes in IVF cycles. HUM FERTIL 2020; 25:470-477. [PMID: 32883122 DOI: 10.1080/14647273.2020.1815243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of the study was to examine the clinical value of blastocysts derived from mono-pronuclear (1PN) or non-pronuclear (0PN) zygotes with two polar bodies (2PB), which were selected by our criteria. We retrospectively analysed 610 frozen-thawed blastocyst transfer (FET) cycles and the corresponding oocyte retrieval cycles from 2014 to 2017. Developmental potential and clinical outcomes of embryos derived from zygotes with various numbers of pronuclei were analysed. Based on more detailed pre-selection settings, blastulation rates of 1PN/2PB and 0PN/2PB-derived embryos were 70.18% and 69.17%, respectively. Blastocyst FET results were not significantly different between 2PN/2PB, 1PN/2PB and 0PN/2PB groups in terms of clinical pregnancy rates (59.79%, 47.06% and 56.25%), implantation rates (47.24%, 40.00% and 47.62%), live birth rates (49.39%, 29.41% and 43.75%) or malformation rates (0%, 0% and 0%). In conclusion, after strict morphological selection and blastocyst culture, 1PN/2PB and 0PN/2PB-derived embryos in IVF cycles can have considerable clinical value. Blastocysts derived from 1PN/2PB or 0PN/2PB zygotes are worthwhile FET option for patients who have no available 2PN-derived embryos.
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Affiliation(s)
- Lei Fu
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Dapeng Chu
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Wenhui Zhou
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Yuan Li
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
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Obstetric and neonatal outcomes after the transfer of vitrified-warmed blastocysts developing from nonpronuclear and monopronuclear zygotes: a retrospective cohort study. Fertil Steril 2020; 115:110-117. [PMID: 32826046 DOI: 10.1016/j.fertnstert.2020.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the obstetric and neonatal outcomes after the transfer of vitrified-warmed single blastocysts developing from nonpronuclear (0PN) and monopronuclear (1PN) zygotes. DESIGN Cohort study. SETTING Affiliated hospital. PATIENT(S) This study was a retrospective analysis of 435 0PN and 281 1PN vitrified-warmed single blastocyst transfers, and 151 0PN and 75 1PN singletons, compared with 13,167 two-pronuclear (2PN) vitrified-warmed single blastocyst transfers and 4,559 2PN singletons, respectively. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Pregnancy rate (PR), abortion rate (AR), live birth rate (LBR), and singleton birthweight were the primary outcome measures. RESULT(S) PR, AR, and LBR were similar when compared between the 0PN and 2PN groups after vitrified-warmed blastocyst transfer. However, the 0PN group had a higher birthweights, higher z scores, and a greater proportion of very large for gestational age newborns. When comparing the 1PN and 2PN groups, we found that the PR was similar whereas the AR was higher and the LBR was lower. No differences were detected in the other neonatal outcomes. CONCLUSION(S) The results of the present study show that the transfer of 2PN blastocysts should be prioritized because of a higher AR and a lower LBR after 1PN blastocyst transfers and a higher birthweight after 0PN blastocyst transfers when compared with 2PN blastocyst transfers. Our data indicate the need for concern about the safety of 1PN and 0PN embryo transfers.
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Paz MV, Chiera M, Hovanyecz P, Cicaré J, Perfumo P, Domenech L, Ventura V. Blastocysts Derived From 0PN Oocytes: Genetic And Clinical Results. JBRA Assist Reprod 2020; 24:143-146. [PMID: 32202747 PMCID: PMC7169913 DOI: 10.5935/1518-0557.20190084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To analyze the genetic and clinical outcomes of blastocysts derived from 0PN oocytes after IVF/ICSI. Methods This retrospective observational study included patients aged 40 years or younger submitted to IVF/ICSI with their own oocytes and with blastocysts derived from 0PN oocytes between January 2015 and April 2018. The clinical outcomes of 0PN blastocyst transfers were analyzed. Genetic tests were performed on biopsied 0PN blastocysts with Next Generation Sequencing. Results A total of 27 0PN blastocysts were transferred, yielding an implantation rate of 48.0% and an ongoing pregnancy rate of 50.0%. The transfers resulted in 13 live births (59.0% live birth rate). Genetic test results revealed that four of the 17 0PN blastocysts biopsied were 46XX; three were 46XY; and 10 were aneuploid embryos, awarding a diploid rate to 76.4% (13/17). Conclusion Almost half of the 0PN blastocysts implanted (48.0%) and 13 healthy babies were born. More than three quarters (76.4%) of the 0PN blastocysts were diploid, thus ruling out the possibility of parthenogenetic activation. Our study indicated that the transfer of 0PN blastocysts is a safe, worthy option when the number of normal 2PN embryos is insufficient.
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Affiliation(s)
- Maria Valeria Paz
- Servicio de Medicina Reproductiva, Instituto Gamma, Rosario, Argentina
| | - Mariel Chiera
- Servicio de Medicina Reproductiva, Instituto Gamma, Rosario, Argentina
| | - Paula Hovanyecz
- Servicio de Medicina Reproductiva, Instituto Gamma, Rosario, Argentina
| | - Juliana Cicaré
- Servicio de Medicina Reproductiva, Instituto Gamma, Rosario, Argentina
| | - Patricia Perfumo
- Servicio de Medicina Reproductiva, Instituto Gamma, Rosario, Argentina
| | - Luciana Domenech
- Servicio de Medicina Reproductiva, Instituto Gamma, Rosario, Argentina
| | - Viviana Ventura
- Servicio de Medicina Reproductiva, Instituto Gamma, Rosario, Argentina
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Cell number considerations for blastocyst transfer in younger patients. J Assist Reprod Genet 2020; 37:619-627. [PMID: 31901111 DOI: 10.1007/s10815-019-01681-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 12/27/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To investigate the role of the cell number at day 3 in blastocyst selection. DESIGN Observational, retrospective, single-center clinical study. PATIENT(S) In part 1, 1211 single vitrified-warmed blastocyst transfer (SVBT) cycles were identified and reviewed. All the cycles were conventional in vitro fertilization (IVF) cycles and the first embryo transfer cycles. Most of patients had a risk of ovarian hyperstimulation syndrome and were young. In part 2, 864 IVF-derived blastocysts from 292 infertile couples underwent trophectoderm (TE) biopsy for preimplantation genetic testing for aneuploidies (PGT-A). INTERVENTION(S) No patient intervention. MAIN OUTCOME MEASURE(S) The first part was an analysis of the correlation between the cell number at day 3 and live birth rate (LBR) after SVBT, and the second part was an analysis of the correlation between the cell number at day 3 and euploid rate (ER) of blastocysts. RESULT(S) In part 1, after correcting for the effects of other confounders, the cell number at day 3 had no significant effect on the LBR (OR 1.001, 95% CI 0.938-1.068). In part 2, after correcting for the effects of other confounders, the cell number at day 3 had no significant effect on the ER (OR 0.960, 95% CI 0.866-1.063). CONCLUSION(S) When the vitrified-warmed blastocysts obtained by conventional IVF are transferred into young patients, the cell number at day 3 is not a strong predictor of the LBR. In addition, the cell number at day 3 is not a strong predictor of ER of IVF-derived blastocysts too.
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Hondo S, Arichi A, Muramatsu H, Omura N, Ito K, Komine H, Monzen S, Mukai N, Endo M, Katase S, Kidera N, Sasaki H, Koi H, Yorimitsu T, Ohara M, Kawamura T, Shimizu Y. Clinical outcomes of transfer of frozen and thawed single blastocysts derived from nonpronuclear and monopronuclear zygotes. Reprod Med Biol 2019; 18:278-283. [PMID: 31312107 PMCID: PMC6613012 DOI: 10.1002/rmb2.12275] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/16/2019] [Accepted: 04/15/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE In assisted reproductive technology, normal zygotes are bipronuclear (2PN) during fertilization confirmation; however, sometimes, nonpronuclear zygotes (0PN) and monopronuclear zygotes (1PN) are found during routine observations. METHODS To elucidate the clinical usefulness of in vitro-fertilized embryos, we investigated the rates of clinical pregnancy, live birth, miscarriage, and congenital abnormality after transfer of frozen-thawed 1PN- and 0PN-derived single blastocysts at Denentoshi Ladies Clinic, Kanagawa, Japan. RESULTS The rates of pregnancy and live birth for 1PN-derived blastocysts obtained by conventional in vitro fertilization were 37.5% and 27.1%, respectively, which was not significantly different from those for 2PN-derived blastocysts; however, the rates for 0PN-derived blastocysts were significantly lower. The pregnancy and live birth rates for 0PN-derived embryos obtained by intracytoplasmic sperm injection (ICSI) were 45.7% and 34.8%, respectively, which was not significantly different from those for 2PN-derived blastocysts; however, the rates for 1PN-derived blastocysts were significantly lower (4.0% for both) than those for 2PN- and 0PN-derived blastocysts. No congenital abnormalities were found in infants resulting from transfer of 0PN- or 1PN-derived blastocysts. CONCLUSIONS Both 1PN- and 0PN-derived blastocysts can be used for embryo transfer; however, care should be taken in making decisions about 1PN-derived blastocysts, especially if they are obtained by ICSI.
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Affiliation(s)
- Saki Hondo
- Denentoshi Ladies ClinicYokohama‐shiJapan
| | | | | | | | - Kaori Ito
- Denentoshi Ladies Clinic FutakotamagawaSetagaya‐kuJapan
| | | | - Shiho Monzen
- Denentoshi Ladies Clinic FutakotamagawaSetagaya‐kuJapan
| | | | | | | | | | | | - Hideki Koi
- Denentoshi Ladies Clinic FutakotamagawaSetagaya‐kuJapan
| | | | | | - Toshihiro Kawamura
- Denentoshi Ladies ClinicYokohama‐shiJapan
- Denentoshi Ladies Clinic FutakotamagawaSetagaya‐kuJapan
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Destouni A, Dimitriadou E, Masset H, Debrock S, Melotte C, Van Den Bogaert K, Zamani Esteki M, Ding J, Voet T, Denayer E, de Ravel T, Legius E, Meuleman C, Peeraer K, Vermeesch JR. Genome-wide haplotyping embryos developing from 0PN and 1PN zygotes increases transferrable embryos in PGT-M. Hum Reprod 2019; 33:2302-2311. [PMID: 30383227 PMCID: PMC6238370 DOI: 10.1093/humrep/dey325] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 10/14/2018] [Indexed: 02/06/2023] Open
Abstract
STUDY QUESTION Can genome-wide haplotyping increase success following preimplantation genetic testing for a monogenic disorder (PGT-M) by including zygotes with absence of pronuclei (0PN) or the presence of only one pronucleus (1PN)? SUMMARY ANSWER Genome-wide haplotyping 0PNs and 1PNs increases the number of PGT-M cycles reaching embryo transfer (ET) by 81% and the live-birth rate by 75%. WHAT IS KNOWN ALREADY Although a significant subset of 0PN and 1PN zygotes can develop into balanced, diploid and developmentally competent embryos, they are usually discarded because parental diploidy detection is not part of the routine work-up of PGT-M. STUDY DESIGN, SIZE, DURATION This prospective cohort study evaluated the pronuclear number in 2229 zygotes from 2337 injected metaphase II (MII) oocytes in 268 cycles. PGT-M for 0PN and 1PN embryos developing into Day 5/6 blastocysts with adequate quality for vitrification was performed in 42 of the 268 cycles (15.7%). In these 42 cycles, we genome-wide haplotyped 216 good quality embryos corresponding to 49 0PNs, 15 1PNs and 152 2PNs. The reported outcomes include parental contribution to embryonic ploidy, embryonic aneuploidy, genetic diagnosis for the monogenic disorder, cycles reaching ETs, pregnancy and live birth rates (LBR) for unaffected offspring. PARTICIPANTS/MATERIALS, SETTING, METHODS Blastomere DNA was whole-genome amplified and hybridized on the Illumina Human CytoSNP12V2.1.1 BeadChip arrays. Subsequently, genome-wide haplotyping and copy-number profiling was applied to investigate the embryonic genome architecture. Bi-parental, unaffected embryos were transferred regardless of their initial zygotic PN score. MAIN RESULTS AND THE ROLE OF CHANCE A staggering 75.51% of 0PN and 42.86% of 1PN blastocysts are diploid bi-parental allowing accurate genetic diagnosis for the monogenic disorder. In total, 31% (13/42) of the PGT-M cycles reached ET or could repeat ET with an unaffected 0PN or 1PN embryo. The LBR per initiated cycle increased from 9.52 to 16.67%. LIMITATIONS, REASONS FOR CAUTION The clinical efficacy of the routine inclusion of 0PN and 1PN zygotes in PGT-M cycles should be confirmed in larger cohorts from multicenter studies. WIDER IMPLICATIONS OF THE FINDINGS Genome-wide haplotyping allows the inclusion of 0PN and 1PN embryos and subsequently increases the cycles reaching ET following PGT-M and potentially PGT for aneuploidy (PGT-A) and chromosomal structural rearrangements (PGT-SR). Establishing measures of clinical efficacy could lead to an update of the ESHRE guidelines which advise against the use of these zygotes. STUDY FUNDING/COMPETING INTEREST(S) SymBioSys (PFV/10/016 and C1/018 to J.R.V. and T.V.), the Horizon 2020 WIDENLIFE: 692065 to J.R.V., T.V., E.D., A.D. and M.Z.E. M.Z.E., T.V. and J.R.V. co-invented haplarithmisis (‘Haplotyping and copy-number typing using polymorphic variant allelic frequencies’), which has been licensed to Agilent Technologies. H.M. is fully supported by the (FWO) (ZKD1543-ASP/16). The authors have no competing interests to declare.
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Affiliation(s)
- Aspasia Destouni
- Laboratory for Cytogenetics and Genome Research, Center for Human Genetics, University of Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Eftychia Dimitriadou
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Heleen Masset
- Laboratory for Cytogenetics and Genome Research, Center for Human Genetics, University of Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Sophie Debrock
- University Hospitals Leuven, Leuven University Fertility Center, Herestraat 49, Leuven, Belgium
| | - Cindy Melotte
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Kris Van Den Bogaert
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Masoud Zamani Esteki
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium.,Maastricht University Medical Center, Department of Clinical Genetics, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - Jia Ding
- Laboratory for Cytogenetics and Genome Research, Center for Human Genetics, University of Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Thiery Voet
- Laboratory of Reproductive Genomics, Center for Human Genetics, University of Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium.,Wellcome Sanger Institute, Wellcome Genome Campus Hinxton, Cambridgeshire, UK
| | - Ellen Denayer
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Thomy de Ravel
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Eric Legius
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
| | - Christel Meuleman
- University Hospitals Leuven, Leuven University Fertility Center, Herestraat 49, Leuven, Belgium
| | - Karen Peeraer
- University Hospitals Leuven, Leuven University Fertility Center, Herestraat 49, Leuven, Belgium
| | - Joris R Vermeesch
- Laboratory for Cytogenetics and Genome Research, Center for Human Genetics, University of Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium.,Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49, KU Leuven, Leuven, Belgium
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Xie PY, Tang Y, Hu L, Ouyang Q, Gu YF, Gong F, Leng LZ, Zhang SP, Xiong B, Lu GX, Lin G. Identification of biparental and diploid blastocysts from monopronuclear zygotes with the use of a single-nucleotide polymorphism array. Fertil Steril 2018; 110:545-554.e5. [DOI: 10.1016/j.fertnstert.2018.04.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/06/2018] [Accepted: 04/24/2018] [Indexed: 01/09/2023]
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Yao G, Xu J, Xin Z, Niu W, Shi S, Jin H, Song W, Wang E, Yang Q, Chen L, Sun Y. Developmental potential of clinically discarded human embryos and associated chromosomal analysis. Sci Rep 2016; 6:23995. [PMID: 27045374 PMCID: PMC4820740 DOI: 10.1038/srep23995] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/18/2016] [Indexed: 01/30/2023] Open
Abstract
Clinically discarded human embryos, which are generated from both normal and abnormal fertilizations, have the potential of developing into blastocysts. A total of 1,649 discarded human embryos, including zygotes containing normal (2PN) and abnormal (0PN, 1PN, 3PN and ≥4PN) pronuclei and prematurely cleaved embryos (2Cell), were collected for in vitro culture to investigate their developmental potential and chromosomal constitution using an SNP array-based chromosomal analysis. We found that blastocyst formation rates were 63.8% (for 2Cell embryos), 22.6% (2PN), 16.7% (0PN), 11.2% (3PN) and 3.6% (1PN). SNP array-based chromosomal analysis of the resultant blastocysts revealed that the percentages of normal chromosomes were 55.2% (2Cell), 60.7% (2PN), 44.4% (0PN) and 47.4% (0PN). Compared with clinical preimplantation genetic diagnosis (PGD) data generated with clinically acceptable embryos, results of the SNP array-based chromosome analysis on blastocysts from clinically discarded embryos showed similar values for the frequency of abnormal chromosome occurrence, aberrant signal classification and chromosomal distribution. The present study is perhaps the first systematic analysis of the developmental potential of clinically discarded embryos and provides a basis for future studies.
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Affiliation(s)
- Guidong Yao
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiawei Xu
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhimin Xin
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenbin Niu
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Senlin Shi
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haixia Jin
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenyan Song
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Enyin Wang
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qingling Yang
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Chen
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingpu Sun
- Center for Reproductive Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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