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Barrière P, Procu-Buisson G, Avril C, Hamamah S. Added value of anti-Müllerian hormone serum concentration in assisted reproduction clinical practice using highly purified human menopausal gonadotropin (HP-hMG). J Gynecol Obstet Hum Reprod 2021; 51:102289. [PMID: 34906691 DOI: 10.1016/j.jogoh.2021.102289] [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: 04/19/2021] [Revised: 11/22/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The individual response to controlled ovarian stimulation (COS) depends on several factors, including the initial dose of gonadotropin. In repeated in vitro fertilization (IVF) cycles, the initial dose of gonadotropin is mainly established on the basis of the previous attempts' outcomes. Conversely, in naive patients, the ovarian response should be estimated using other criteria, such as the serum concentration of anti-Müllerian hormone (AMH). However, in clinical practice, the initial gonadotropin dose is not systematically adapted to the AMH level, despite the known relationship between AMH and ovarian reserve. MATERIAL AND METHODS French non-interventional, longitudinal, prospective, multicentre, cohort study that included infertile women who underwent COS with highly purified human menopausal gonadotropin (HP-hMG 600 IU/mL) during their first IVF/intracytoplasmic sperm injection (ICSI) cycle. Data were collected prospectively during routine follow-up visits from COS initiation to 10-11 weeks after embryo transfer. RESULTS Data from 235 of the 297 enrolled women were used for the study. Serum AMH level was negatively correlated with the initial and total HP-hMG doses (p<0.001), and positively correlated with the number of retrieved oocytes (p<0.007). Embryos were obtained for 94.0% of women, and fresh embryo transfer was performed in 72.8% of them. The clinical pregnancy rate was 28.5% after the first embryo transfer. CONCLUSION Selecting the appropriate starting dose of gonadotropin is crucial to optimize the IVF/ICSI procedure. For the first attempt, the serum AMH level is a good biomarker to individualize treatment.
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Affiliation(s)
- Paul Barrière
- University Hospital Centre Nantes, Reproductive Biology and Medicine, INSERM CRTI U 1064, University Nantes, France
| | | | | | - Samir Hamamah
- University Hospital Centre Montpellier, Reproductive Biology and Medicine, INSERM DEFE, Montpellier University, France.
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Comparison of two culture media on morphokinetics and ploidy status of sibling embryos. ZYGOTE 2021; 30:410-415. [PMID: 34879892 DOI: 10.1017/s0967199421000927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To investigate the effects of culture media with different lactate concentrations on early embryonic development, data collected from our patients undergoing preimplantation genetic testing (PGT) were assessed using the EmbryoScope™ time-lapse culturing system. After intracytoplasmic sperm injection (ICSI), sibling oocytes were cultured in the same EmbryoScope (Vitrolife) slides including two different commercially available media. The patients with fewer than five mature oocytes were not included in the analyses. All embryos were hatched on day 3, and trophectoderm biopsies (n = 212) were performed accordingly. PGT for aneuploidy (PGT-A) on biopsied materials was carried out using next generation sequencing. Morphokinetic parameters, fertilization, irregular division, degeneration, blastulation, euploidy, and pregnancy rates of embryos cultured in LifeGlobal Global Total medium (LGGT) and Continuous Single Culture-NX Complete medium (CSCM-NXC) were compared. There were no differences observed in time to pronuclear fade, or in time spent as 2-cell (cc2) and 3-cell (s2), to 4-cell, 5-cell, morula and blastocyst stages (P > 0.05). Embryos reached the 2-cell (t2) and 3-cell (t3) stages significantly faster in LGGT (P < 0.05), whereas embryos grown in CSCM-NXC with lower lactate reached starting blastulation significantly sooner (P = 0.026). However, there were no statistical differences observed in fertilization, blastulation, degeneration, irregular division euploidy, and pregnancy rates between the two groups (P > 0.05). Even though pregnancy and fertilization rates did not indicate statistical differences, results are significant to provide better insight on potential roles of lactate in embryo development. These finding will advance the fundamental knowledge of human embryo development and assisted reproductive technologies.
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Bilibio JP, Lorenzzoni PL, Meireles AJC, Maciel Y, Sales P, Nascimento FCD. The usefulness of metaphase I oocytes in women who undergo controlled ovarian hyperstimulation for intracytoplasmic sperm injection. JBRA Assist Reprod 2021; 25:115-121. [PMID: 33021764 PMCID: PMC7863097 DOI: 10.5935/1518-0557.20200062] [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: The aim of this study was to evaluate the fertilization and blastocyst formation rates of oocytes in metaphase I (MI) obtained from women who underwent controlled ovarian hyperstimulation (COH) for intracytoplasmic injection. Methods: A prospective cohort study that included women from whom at least 1 MI and 1 MII oocyte were obtained after COH was performed. We collected 1,907 oocytes from 164 women (1291 MII, 352 MI and 258 prophase I or atretic). After oocyte classification, the MII and MI oocytes were incubated for 4 hours. Results: After 4 hours, the rescue maturation rate was 57.2%; 205 MI oocytes matured to MII oocytes in vitro (rescued MI-MII group), and 153 remained in MI (arrested MI group). The normal fertilization rates were directly associated with oocyte maturation, with rates of 79.1%, 60.2%, and 31.9% in MII, MI-MII and MI oocytes, respectively (p<0.001). Group arrested MI had an odds ratio (OR) of 7.6 (CI 5.2 - 11.2, p<0.001) for abnormal fertilization compared with Group MII. The blastocyst formation rate was directly associated with oocyte maturation, at 36.4% for MII, 11.4% for MI-MII and 0.6% for MI. Conclusion: Oocytes collected at the MI stage after OCH that did not mature to MII after rescue maturation had a blastocyst formation rate of only 0.6%, while those in MII and MI-MII had rates of 36.4% and 11.4%, respectively. However, we found a pregnancy with the birth of a healthy baby from a blastocyst formed after intracytoplasmic sperm injection (ICSI) of an MI oocyte.
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Affiliation(s)
- João Paolo Bilibio
- Department of Obstetrics and Gynecology, Universidade Federal do Pará, Belém, Pará, Brazil.,Clínica de Reprodução Assistida Pronatus, Belém, PA, Brazil.,Grupo de Pesquisa Bilibio, Universidade Federal do Pará, Belém, PA, Brazil
| | - Pânila Longhi Lorenzzoni
- Clínica de Reprodução Assistida Pronatus, Belém, PA, Brazil.,Grupo de Pesquisa Bilibio, Universidade Federal do Pará, Belém, PA, Brazil.,Programa de Pós Graduação de Ciências Médicas da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Arivaldo José Conceição Meireles
- Clínica de Reprodução Assistida Pronatus, Belém, PA, Brazil.,Grupo de Pesquisa Bilibio, Universidade Federal do Pará, Belém, PA, Brazil
| | - Yasmin Maciel
- Department of Obstetrics and Gynecology, Universidade Federal do Pará, Belém, Pará, Brazil.,Grupo de Pesquisa Bilibio, Universidade Federal do Pará, Belém, PA, Brazil
| | - Pablo Sales
- Clínica de Reprodução Assistida Pronatus, Belém, PA, Brazil.,Grupo de Pesquisa Bilibio, Universidade Federal do Pará, Belém, PA, Brazil
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Fabozzi G, Albricci L, Cimadomo D, Amendola MG, Sanges F, Maggiulli R, Ubaldi FM, Rienzi L. Blastulation rates of sibling oocytes in two IVF culture media: an evidence-based workflow to implement newly commercialized products. Reprod Biomed Online 2020; 42:311-322. [PMID: 33288477 DOI: 10.1016/j.rbmo.2020.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 11/15/2022]
Abstract
RESEARCH QUESTION An evidence-based novel commercially available continuous IVF culture medium in compliance with an efficient quality-management system is proposed. DESIGN Non-interventional study on sibling oocytes. Intracytoplasmic sperm injection cycles among women aged 42 years or younger that used ejaculated spermatozoa and retrieved four to eight oocytes were included. Sibling oocytes were randomized for culture in the novel Geri-medium or continuous single culture medium (CSCM). Primary outcome measure was blastulation rate per cohort of inseminated oocytes; 1182 oocytes were required to outline down to a 7% difference (power = 80%). RESULTS A total of 181 cohorts of sibling oocytes were included. Geri-medium (n = 631 oocytes) and CSCM (n = 643 oocytes) resulted in similar blastulation rates (mean ± SD: 42.8% ± 30.1% versus 43.1% ± 29.0%; Wilcoxon signed rank test = 0.77). Blastocysts cultured in the former (n = 275 versus n = 277) showed longer timings during preimplantation development (P < 0.01) and were poorer quality (26% versus 18%; P = 0.03). Euploidy rate was no different in cycles that underwent preimplantation genetic testing for aneuploidy (n = 113) (117/237 [49%] versus 117/249 blastocysts [47%]; P = 0.6). Ongoing implantation rate was comparable in the study arms after euploid (29/47 [63%] versus 14/ 34 [41%]; P = 0.1) or untested (12/31 [39%] versus 7/18 [39%]; P = 0.3) transfers. CONCLUSION Blastulation rate among cohorts of sibling oocytes cultured in the same incubator is a fast, reliable and comprehensive performance indicator to validate novel commercially available culture medium. The media tested were considered similarly efficient. The differences in blastocyst morphology and developmental timings warrant further investigation, although euploidy and ongoing implantation rates were similar.
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Affiliation(s)
- Gemma Fabozzi
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy.
| | - Laura Albricci
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy
| | - Danilo Cimadomo
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy
| | - Maria Giulia Amendola
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy
| | - Federica Sanges
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy
| | - Roberta Maggiulli
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy
| | - Filippo Maria Ubaldi
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy
| | - Laura Rienzi
- Clinica Valle Giulia, GENERA Center for Reproductive Medicine, via G de Notaris 2b, Rome 00197, Italy
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Sfontouris IA, Kolibianakis EM, Lainas GT, Venetis CA, Petsas GK, Tarlatzis BC, Lainas TG. Blastocyst utilization rates after continuous culture in two commercial single-step media: a prospective randomized study with sibling oocytes. J Assist Reprod Genet 2017; 34:1377-1383. [PMID: 28718081 DOI: 10.1007/s10815-017-0997-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/05/2017] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The aim of this study is to determine whether blastocyst utilization rates are different after continuous culture in two different commercial single-step media. METHODS This is a paired randomized controlled trial with sibling oocytes conducted in infertility patients, aged ≤40 years with ≥10 oocytes retrieved assigned to blastocyst culture and transfer. Retrieved oocytes were randomly allocated to continuous culture in either Sage one-step medium (Origio) or Continuous Single Culture (CSC) medium (Irvine Scientific) without medium renewal up to day 5 post oocyte retrieval. Main outcome measure was the proportion of embryos suitable for clinical use (utilization rate). RESULTS A total of 502 oocytes from 33 women were randomly allocated to continuous culture in either Sage one-step medium (n = 250) or CSC medium (n = 252). Fertilization was performed by either in vitro fertilization or intracytoplasmic sperm injection, and embryo transfers were performed on day 5. Two patients had all blastocysts frozen due to the occurrence of severe ovarian hyperstimulation syndrome. Fertilization and cleavage rates, as well as embryo quality on day 3, were similar in the two media. Blastocyst utilization rates (%, 95% CI) [55.4% (46.4-64.1) vs 54.7% (44.9-64.6), p = 0.717], blastocyst formation rates [53.6% (44.6-62.5) vs 51.9 (42.2-61.6), p = 0.755], and proportion of good quality blastocysts [36.8% (28.1-45.4) vs 36.1% (27.2-45.0), p = 0.850] were similar in Sage one-step and CSC media, respectively. CONCLUSIONS Continuous culture of embryos in Sage one-step and CSC media is associated with similar blastocyst development and utilization rates. Both single-step media appear to provide adequate support during in vitro preimplantation embryo development. Whether these observations are also valid for other continuous single medium protocols remains to be determined. CLINICAL TRIAL REGISTRATION NUMBER NCT02302638.
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Affiliation(s)
- Ioannis A Sfontouris
- Eugonia Assisted Reproduction Unit, 7 Ventiri Street, 11528, Athens, Greece.
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Efstratios M Kolibianakis
- Unit for Human Reproduction, First Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George T Lainas
- Eugonia Assisted Reproduction Unit, 7 Ventiri Street, 11528, Athens, Greece
| | - Christos A Venetis
- Women's and Children's Health, St. George Hospital, University of New South Wales, Sydney, Australia
| | - George K Petsas
- Eugonia Assisted Reproduction Unit, 7 Ventiri Street, 11528, Athens, Greece
| | - Basil C Tarlatzis
- Unit for Human Reproduction, First Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Tryfon G Lainas
- Eugonia Assisted Reproduction Unit, 7 Ventiri Street, 11528, Athens, Greece
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