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Al Hashimi B, Linara-Demakakou E, Harvey SC, Harvey KE, Griffin DK, Ahuja K, Macklon NS. Double vitrification and warming of blastocysts does not affect pregnancy, miscarriage or live birth rates. Reprod Biomed Online 2024; 49:104103. [PMID: 39024926 DOI: 10.1016/j.rbmo.2024.104103] [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: 12/22/2023] [Revised: 04/10/2024] [Accepted: 05/01/2024] [Indexed: 07/20/2024]
Abstract
RESEARCH QUESTION Does double blastocyst vitrification and warming affect pregnancy, miscarriage or live birth rates, or birth outcomes, from embryos that have undergone preimplantation genetic testing for aneuploidies (PGT-A) testing? DESIGN This retrospective observational analysis of embryo transfers was performed at a single centre between January 2017 and August 2022. The double-vitrification group included frozen blastocysts that were vitrified after 5-7 days of culture, warmed, biopsied (either once or twice) and re-vitrified. The single vitrification (SV) group included fresh blastocysts that were biopsied at 5-7 days and then vitrified. RESULTS A comparison of the 84 double-vitrification blastocysts and 729 control single-vitrification blastocysts indicated that the double-vitrification embryos were frozen later in development and had expanded more than the single-vitrification embryos. Of the 813 embryo transfer procedures reported, 452 resulted in the successful delivery of healthy infants (56%). There were no significant differences between double-vitrification and single-vitrification embryos in the pregnancy, miscarriage or live birth rates achieved after single-embryo transfer (55% versus 56%). Logistic regression indicated that while reduced live birth rates were associated with increasing maternal age at oocyte collection, longer culture prior to freezing and lower embryo quality, double vitrification was not a significant predictor of live birth rate. CONCLUSIONS Blastocyst double vitrification was not shown to impact pregnancy, miscarriage or live birth rates. Although caution is necessary due to the study size, no effects of double vitrification on miscarriage rates, birthweight or gestation period were noted. These data offer reassurance given the absence of the influence of double vitrification on all outcomes after PGT-A.
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Affiliation(s)
- Balsam Al Hashimi
- London Women's Clinic, London, UK.; School of Biosciences, University of Kent, Canterbury, Kent, UK..
| | | | - Simon C Harvey
- Faculty of Engineering and Science, University of Greenwich, Gillingham, Chatham, Kent, UK
| | - Katie E Harvey
- School of Life, Health and Chemical Sciences, The Open University, Milton Keynes, Buckinghamshire, UK
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Ding M, Diao Z, Zhou J. The preimplantation genetic testing clinical outcomes of biopsy on vitrification-warming embryos: A retrospective study. J Obstet Gynaecol Res 2022; 48:1621-1631. [PMID: 35585784 DOI: 10.1111/jog.15275] [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: 11/19/2021] [Revised: 03/21/2022] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
AIM The objective of this study was to assess whether PGT conducted with previously untested vitrified embryos affect the clinical outcomes. METHODS A total of 49 patients who underwent biopsy on vitrification-warming embryos for PGT were enrolled from January 2016 to January 2019. The cleavage-stage embryos were thawed and cultured into the blastocyst stage for biopsy. During this period, 195 patients underwent routine PGT and FET, whose embryos were biopsied before frozen were used as the control group. The clinical outcomes were further compared between the two groups after a 1:2 PSM. RESULTS There were 47 transferable blastocysts in 30 patients, while 19 patients without transferable embryos, who performed biopsy on vitrification-warming embryos for PGT. During this study period, 27 patients have already underwent FET with the clinical pregnancy rate was 66.7% (18/27). After 1:2 PSM, 24 patients in the biopsy on vitrification-warming embryo group and 48 patients in the control group were compared, the clinical pregnancy rate (68.8% vs. 70.8%, p = 0.86), miscarriage rate (18.2% vs. 11.8%, p = 0.86), or live birth rate (52.1% vs. 62.5%, p = 0.40) had no significant difference. And the transferable blastocyst rate or the clinical pregnancy rate in the vitrification-warming cleavage-stage embryo group was not significantly different from those in the vitrification-warming blastocyst group. In addition, the PGT clinical outcomes of biopsy on vitrification-warming embryos had no significant difference between IVF-fertilized embryos and ICSI-fertilized embryos. CONCLUSION Biopsy on the vitrification-warming embryos with a dual vitrified cryopreservation does not affect the embryo quality or the PGT clinical outcomes.
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Affiliation(s)
- Min Ding
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhenyu Diao
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Jianjun Zhou
- Reproductive Medicine Centre, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.,Reproductive Medicine Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
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Van Heertum K, Lam L, Richardson B, Cartwright MJ, Mesiano SA, Cameron MJ, Weinerman R. Blastocyst Vitrification and Trophectoderm Biopsy Cumulatively Alter Embryonic Gene Expression in a Mouse Model. Reprod Sci 2021; 28:2961-2971. [PMID: 33826099 DOI: 10.1007/s43032-021-00560-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
Although embryo vitrification has been used extensively in human assisted reproductive technology (ART) and animal models, epidemiologic evidence and randomized controlled trials suggest differences in pregnancy/perinatal outcomes (birthweight, risk for preterm birth, and pre-eclampsia) between babies born from fresh versus frozen embryo transfers. To address the uncertainty surrounding the effects of laboratory manipulations of embryos on clinical outcomes, we subjected mouse blastocysts to increasing levels of manipulation for transcriptome analysis. Blastocysts were randomly divided into four groups: no manipulation (control), single vitrification/thaw (1 vit), double vitrification/thaw (2 vit), and single vitrification/thaw plus trophectoderm biopsy and again vitrified/thawed (2 vit + bx). Three sets of 15 blastocysts in each group were pooled for RNA sequencing, and differentially expressed genes (DEGs) and pathways were determined by statistical analysis. Blastocysts were also stained for ZO-1 and F-actin to assess cytoskeletal integrity. Freeze/thaw and biopsy manipulation affected multiple biological pathways. The most significant differences were detected in genes related to innate immunity, apoptosis, and mitochondrial function, with the magnitude of change proportional to the extent to manipulation. Significant disruptions were also seen in cytoskeletal staining, with greater disruptions seen with greater of manipulation. Our data suggests that embryo vitrification and biopsy affect embryo gene transcription, with several identified DEGs that may have plausible mechanisms for the clinical outcomes seen in human offspring following ART. Further study is required to determine whether these alterations in gene expression are associated with clinical differences seen in children born from fresh or frozen embryo transfer.
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Affiliation(s)
- Kristin Van Heertum
- University Hospitals Fertility Center/Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Lisa Lam
- CCRM New York Fertility, New York, NY, 10019, USA
| | - Brian Richardson
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Michael J Cartwright
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Sam A Mesiano
- Department of Reproductive Biology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Mark J Cameron
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Rachel Weinerman
- University Hospitals Fertility Center/Case Western Reserve University, Cleveland, OH, 44106, USA.
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Hu X, Ding C, Zhang D, Zhou W, Wang J, Zeng Y, Lv J, Xu YW, Zhou CQ. Embryo pooling: a promising strategy for managing insufficient number of embryos in preimplantation genetic diagnosis. Gynecol Endocrinol 2017; 33:867-871. [PMID: 28682646 DOI: 10.1080/09513590.2017.1347778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
This retrospective study evaluated the embryo pooling strategy for managing insufficient number of embryos in preimplantation genetic diagnosis (PGD) through serial vitrification of cleavage-stage embryos from consecutive cycles, and simultaneous blastocysts biopsy in combination with blastocysts obtained in ultimate fresh cycle. A retrospective analysis of the cumulative pregnancy rate of 68 patients underwent cleavage-stage embryos accumulation (Embryo Pooling Group) and 94 patients underwent one stimulation cycle (Control Group) over a 2-year period were conducted. The blastocyst formation rate was comparable between the consecutive cycles and the ultimate cycle in embryo pooling group (56.0 versus 62.0%, p = .078). No significant difference existed between twice-vitrified and once-vitrified warmed blastocysts with respect to implantation rate (50.8 versus 46.3%, p = .658). The implantation rate and cumulative pregnancy rate of embryo pooling group were 49.0 and 67.6%, respectively, which were statistically comparable to the corresponding values of 48.9 and 73.4% obtained in control group. Our study suggests that in patients undergoing ICSI-PGD who do not reach enough embryos in a single stimulation cycle, pooling embryos from consecutive ovarian stimulation cycles is a promising strategy, which can render a cumulative pregnancy rate comparable to those patients who only require one stimulation cycle.
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Affiliation(s)
- Xiaokun Hu
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
- b Key Laboratory for Reproductive Medicine of Guangdong , Guangzhou , PR China
| | - Chenhui Ding
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
- b Key Laboratory for Reproductive Medicine of Guangdong , Guangzhou , PR China
| | - Duoduo Zhang
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
| | - Wen Zhou
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
- b Key Laboratory for Reproductive Medicine of Guangdong , Guangzhou , PR China
| | - Jing Wang
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
- b Key Laboratory for Reproductive Medicine of Guangdong , Guangzhou , PR China
| | - Yanhong Zeng
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
- b Key Laboratory for Reproductive Medicine of Guangdong , Guangzhou , PR China
| | - Jie Lv
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
| | - Yan-Wen Xu
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
- b Key Laboratory for Reproductive Medicine of Guangdong , Guangzhou , PR China
| | - Can-Quan Zhou
- a Center for Reproductive Medicine and Department of Gynecology & Obstetrics , The First Affiliated Hospital of Sun Yat-Sen University , Guangzhou , PR China
- b Key Laboratory for Reproductive Medicine of Guangdong , Guangzhou , PR China
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Liu M, Su Y, Wang WH. Assessment of clinical application of preimplantation genetic screening on cryopreserved human blastocysts. Reprod Biol Endocrinol 2016; 14:16. [PMID: 27059821 PMCID: PMC4826494 DOI: 10.1186/s12958-016-0155-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/05/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Recent advancement in both human embryology and preimplantation genetic screening has created a completely new situation for human assisted reproduction. Embryos, typically at blastocyst stage, are biopsied and screened by DNA microarray or next-generation sequencing before cryopreservation, and then euploid embryos are warmed for transfer. Increased embryo implantation rates have been reported after transfer of euploid embryos screened for all chromosomes. However, some patients may have frozen their embryos without doing embryo biopsy and screening, thus embryo biopsy and screening may be required after cryopreservation and warming. Such procedures have not been performed routinely in clinics and the efficiency is still unknown. Therefore, in this study, we investigated embryo implantation after blastocysts were cryopreserved/warmed, and then biopsied and screened by DNA microarray for all chromosomes. RESULTS Two hundred and thirty four cryopreserved blastocysts from 35 women were warmed, and 224 (95.7 %) survived and were biopsied for aneuploidy screening. After analysis, 221 samples (98.7 %) had diagnostic results and 3 (1.3 %) samples did not have results due to DNA quality and quantity. Out of the samples with diagnostic results, 59.3 % were normal euploid and 40.7 % had abnormal chromosomes including aneuploidy, partial chromosome deletion and/or duplication. Most (65.6 %) samples had single chromosome anomalies, and 34.4 % of the samples had multiple chromosome anomalies. Chromosomal errors were observed in most chromosomes but chromosomes 21 and 22 had the most frequent chromosome anomalies. Transfer of 61 normal euploid blastocysts in 34 patients resulted in a 52.9 % clinical pregnancy rate and a 42.6 % implantation rate, and 41.2 % of the patients delivered normal babies or had ongoing pregnancy. CONCLUSIONS Frozen blastocysts can be warmed and biopsied for aneuploidy screening. These results may suggest that cryopreserved blastocysts can be warmed, biopsied and screened the day before embryo transfer, and such procedures may benefit patients who had previous implantation failures, or patients who did not have embryo screening before cryopreservation due to lack of embryo screening technology or other reasons.
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Affiliation(s)
- Min Liu
- Center for Reproductive Medicine, Changsha Hospital for Maternal and Child Health Care, No.416, Chengnan East Road, Changsha City, Hunan, China
| | - Yu Su
- Center for Reproductive Medicine, Changsha Hospital for Maternal and Child Health Care, No.416, Chengnan East Road, Changsha City, Hunan, China
| | - Wei-Hua Wang
- Houston Fertility Laboratory, 2500 Fondren Rd., Suite 350, Houston, TX, 77063, USA.
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Outcomes of blastocysts biopsied and vitrified once versus those cryopreserved twice for euploid blastocyst transfer. Reprod Biomed Online 2014; 29:59-64. [DOI: 10.1016/j.rbmo.2014.03.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 03/01/2014] [Accepted: 03/05/2014] [Indexed: 11/23/2022]
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Vitrification of human embryos previously cryostored by either slow freezing or vitrification results in high pregnancy rates. Reprod Biomed Online 2012; 24:314-20. [DOI: 10.1016/j.rbmo.2011.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 11/07/2011] [Accepted: 11/15/2011] [Indexed: 11/22/2022]
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