1
|
Huang TK, Huang CH, Chen PA, Chen CH, Lu F, Yang WJ, Huang JYJ, Li BR. Development of a thermotaxis and rheotaxis microfluidic device for motile spermatozoa sorting. Biosens Bioelectron 2024; 258:116353. [PMID: 38696966 DOI: 10.1016/j.bios.2024.116353] [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: 01/24/2024] [Revised: 04/18/2024] [Accepted: 04/29/2024] [Indexed: 05/04/2024]
Abstract
Male infertility is a pervasive global reproductive challenge, primarily attributed to a decline in semen quality. Addressing this concern, there has been a growing focus on spermatozoa sorting in assisted reproductive technology. This study introduces a groundbreaking development in the form of a thermotaxis and rheotaxis microfluidic (TRMC) device designed for efficient motile spermatozoa sorting within a short 15-min timeframe. The TRMC device mimics the natural sperm sorting mechanism of the oviduct, selecting spermatozoa with superior motility and DNA integrity. The experimental outcomes demonstrate a remarkable enhancement in the percentage of progressive spermatozoa following sorting, soaring from 3.90% to an impressive 96.11% when subjected to a temperature decrease from 38 °C to 35 °C. Notably, sperm motility exhibited a substantial 69% improvement. The TRMC device exhibited a commendable recovery rate of 60.93%, surpassing current clinical requirements. Furthermore, the sorted spermatozoa displayed a notable reduction in the DNA fragmentation index to 6.94%, signifying a substantial 90% enhancement in DNA integrity. This remarkable advancement positions the TRMC device as highly suitable for applications in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), offering a promising solution to male infertility challenges.
Collapse
Affiliation(s)
- Teng-Kuan Huang
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chung-Hsien Huang
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Department of Electrical and Computer Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Pei-An Chen
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Department of Electrical and Computer Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Ching Hung Chen
- Taiwan IVF Group, Hsinchu, Taiwan; Ton Yen General Hospital, Hsinchu, Taiwan
| | - Farn Lu
- Taiwan IVF Group, Hsinchu, Taiwan; Ton Yen General Hospital, Hsinchu, Taiwan
| | - Wen-Ju Yang
- Taiwan IVF Group, Hsinchu, Taiwan; Ton Yen General Hospital, Hsinchu, Taiwan
| | - Jack Yu Jen Huang
- Taiwan IVF Group, Hsinchu, Taiwan; Ton Yen General Hospital, Hsinchu, Taiwan; Division of Reproductive Endocrinology & Infertility, The Department of Obstetrics and Gynecology at Stanford University, Stanford, CA, USA
| | - Bor-Ran Li
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Department of Electrical and Computer Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Center for Emergent Functional Matter Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Medical Device Innovation and Translation R&D Center, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
| |
Collapse
|
2
|
Geampana A, Perrotta M. Predicting Success in the Embryology Lab: The Use of Algorithmic Technologies in Knowledge Production. SCIENCE, TECHNOLOGY & HUMAN VALUES 2023; 48:212-233. [PMID: 36504522 PMCID: PMC9727110 DOI: 10.1177/01622439211057105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This article analyzes local algorithmic practices resulting from the increased use of time-lapse (TL) imaging in fertility treatment. The data produced by TL technologies are expected to help professionals pick the best embryo for implantation. The emergence of TL has been characterized by promissory discourses of deeper embryo knowledge and expanded selection standardization, despite professionals having no conclusive evidence that TL improves pregnancy rates. Our research explores the use of TL tools in embryology labs. We pay special attention to standardization efforts and knowledge-creation facilitated through TL and its incorporated algorithms. Using ethnographic data from five UK clinical sites, we argue that knowledge generated through TL is contingent upon complex human-machine interactions that produce local uncertainties. Thus, algorithms do not simply add medical knowledge. Rather, they rearrange professional practice and expertise. Firstly, we show how TL changes lab routines and training needs. Secondly, we show that the human input TL requires renders the algorithm itself an uncertain and situated practice. This, in turn, raises professional questions about the algorithm's authority in embryo selection. The article demonstrates the embedded nature of algorithmic knowledge production, thus pointing to the need for STS scholarship to further explore the locality of algorithms and AI.
Collapse
Affiliation(s)
- Alina Geampana
- Department of Sociology and Policy, School of Social Sciences and Humanities, Aston University, Birmingham, United Kingdom
| | - Manuela Perrotta
- Department of People and Organisations, School of Business and Management, Queen Mary University of London, United Kingdom
| |
Collapse
|
3
|
A novel role of follicle-stimulating hormone (FSH) in various regeneration-related functions of endometrial stem cells. Exp Mol Med 2022; 54:1524-1535. [PMID: 36117220 PMCID: PMC9534881 DOI: 10.1038/s12276-022-00858-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/07/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
Follicle-stimulating hormone (FSH) promotes the production and secretion of estrogen, which in turn stimulates the growth and maturation of ovarian follicles. Therefore, consecutive FSH treatment to induce ovarian hyperstimulation (superovulation) is still considered the most cost-effective option for the majority of assisted reproductive technologies (ARTs). However, a relatively high cancellation rate and subsequent low pregnancy outcomes (approximately 15%) are the most challenging aspects of this FSH-based ART. Currently, the main cause for this low implantation rate of FSH-based ART has not yet been revealed. Therefore, we hypothesized that these high cancellation rates with FSH-based superovulation protocols might be associated with the harmful effects of consecutive FSH treatment. Importantly, several recent studies have revealed that tissue-resident stem cell deficiency can significantly reduce cyclic endometrial regeneration and subsequently decrease the pregnancy outcome. In this context, we investigated whether FSH treatment could directly inhibit endometrial stem cell functions and consequently suppress endometrial regeneration. Consistent with our hypothesis, our results revealed for the first time that FSH could inhibit various regeneration-associated functions of endometrial stem cells, such as self-renewal, migration, and multilineage differentiation capacities, via the PI3K/Akt and ERK1/2 signaling pathways both in vitro and in vivo. Follicle-stimulating hormone (FSH) is commonly administered to treat female infertility by stimulating the ovaries, but FSH treatment can also inhibit key cellular and physiological processes required for successful pregnancy. In the light of pregnancy outcomes as low as 15 percent after FSH-based assisted reproduction technologies, In-Sun Hong at Gachon University, Incheon, South Korea, and colleagues investigated the effects of FSH. Working with cultured human stem cells from the lining of the uterus, they found that FSH could inhibit multiple cellular regenerative functions that normally maintain this lining. They also identified a specific molecular signaling pathway involved in mediating these inhibitory effects. Studies in mice supported the cell culture results. The findings could help improve infertility treatment strategies by guiding research into methods to alleviate the unwanted effects of FSH.
Collapse
|
4
|
Valera MÁ, Meseguer M. "Quality is not an act, it is a habit." Reflection on the role of the fertilization rate in the quality control strategies of assisted reproduction treatments. Fertil Steril 2021; 116:666-667. [PMID: 34462100 DOI: 10.1016/j.fertnstert.2021.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Affiliation(s)
- M Ángeles Valera
- In vitro fertilization laboratory, IVIRMA Valencia, Valencia, Spain; IVI Foundation, Valencia, Spain; Health Research Institute la Fe, Valencia, Spain
| | - Marcos Meseguer
- In vitro fertilization laboratory, IVIRMA Valencia, Valencia, Spain; IVI Foundation, Valencia, Spain; Health Research Institute la Fe, Valencia, Spain
| |
Collapse
|
5
|
Holmes R, Wirka KA, Catherino AB, Hayward B, Swain JE. Comparison of electronic versus manual witnessing of procedures within the in vitro fertilization laboratory: impact on timing and efficiency. F S Rep 2021; 2:181-188. [PMID: 34278352 PMCID: PMC8267391 DOI: 10.1016/j.xfre.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/09/2021] [Accepted: 04/21/2021] [Indexed: 11/28/2022] Open
Abstract
Objective To evaluate the impact of an electronic witnessing system (EWS) on witnessing standard operating procedures and to assess embryologist perceptions of the EWS. Design Prospective cohort study. Setting Private in vitro fertilization laboratory network. Patient(s) None. Intervention(s) None Main Outcome Measure(s) The time difference between manual and electronic double-witnessing procedures, and embryologist perceptions of the EWS. Result(s) From 342 witnessing times analyzed (114 EWS, 114 manual, and 114 interruptions to witnesses), the EWS reduced mean (SD) total witnessing time (in seconds) by 91.5 (23.6) for intracytoplasmic sperm injection, 62.0 (17.9) for Day 3 embryo assessment, 58.3 (18.9) for fresh embryo transfer, and 59.4 (13.3) for frozen embryo transfer. This time reduction significantly decreased the overall time required for double-witnessing by 3.1- to 5.2-fold. A survey with 50 embryologists within the laboratory network indicated that most embryologists considered the EWS to improve sample traceability (78.3%), reduce errors in labeling issues (80.4%), and reduce the risk of sample mismatch errors by minimizing disruptions (60.9%). Furthermore, 82.6% thought that visual completion of the EWS dashboard provided peace of mind when leaving work and 84.8% were more confident knowing that all procedures were completed according to the EWS. Conclusion(s) An EWS can improve laboratory efficiency by significantly decreasing the time required for witnessing procedures and by minimizing interruptions. The EWS was well perceived by embryologists and laboratory managers and enhanced their confidence and peace of mind with regard to witnessing compliance and safety/accuracy.
Collapse
Affiliation(s)
| | - Kelly Athayde Wirka
- EMD Serono, Inc. (a business of Merck KGaA, Darmstadt, Germany), Rockland, Massachusetts
| | | | - Brooke Hayward
- EMD Serono, Inc. (a business of Merck KGaA, Darmstadt, Germany), Rockland, Massachusetts
| | | |
Collapse
|
6
|
Lunenfeld B, Bilger W, Longobardi S, Kirsten J, D'Hooghe T, Sunkara SK. Decision points for individualized hormonal stimulation with recombinant gonadotropins for treatment of women with infertility. Gynecol Endocrinol 2019; 35:1027-1036. [PMID: 31392906 DOI: 10.1080/09513590.2019.1650345] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
It is essential that fertility treatment is individualized based on a thorough diagnostic work-up, with treatment tailored to the patients' requirements. This individualization should be kept in mind during the main decision points that occur before and during treatment. Treatment customization must include consideration of both the woman and her partner involved in the process together, including their collective treatment goals. Once treatment goals have been agreed and diagnostic evaluations performed, personalization based on patient characteristics, together with an understanding of treatment goals and patient preferences, enables the selection of appropriate treatments, protocols, products and their dosing. Following treatment initiation, monitoring and adaptation of product and dose can then ensure optimal outcomes. Currently, it is not possible to base treatment decisions on every characteristic of the patient and personalization is based on biomarkers that have been identified as the most relevant. However, in the future, the use of artificial intelligence coupled with continuous monitoring should enable greater individualization and improve outcomes. This review considers the current state-of-the-art related to decision points during individualized treatment of female infertility, before looking at future developments that might further assist in making individualized treatment decisions, including the use of computer-assisted decision making.
Collapse
Affiliation(s)
- Bruno Lunenfeld
- Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Wilma Bilger
- Medical Affairs Fertility, Endocrinology & General Medicine, Merck Serono GmbH, Darmstadt, Germany
| | | | - Jan Kirsten
- Business Franchise Fertility, Merck KGaA, Darmstadt, Germany
| | - Thomas D'Hooghe
- Global Medical Affairs Fertility, Merck KGaA, Darmstadt, Germany
- Department of Development and Regeneration, Organ Systems, Group Biomedical Sciences, KU Leuven (University of Leuven), Leuven, Belgium
- Department of Obstetrics and Gynecology, Yale University, New Haven, CT, USA
| | - Sesh K Sunkara
- Assisted Conception Unit, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
7
|
Hashimoto H, Miyachi H, Kataoka K, Maru Y, Togawa Y, Matsue H. Case of fertility treatment-induced Stevens-Johnson syndrome with a severe ocular complication. J Dermatol 2019; 46:1042-1045. [PMID: 31489686 DOI: 10.1111/1346-8138.15072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/08/2019] [Indexed: 12/22/2022]
Abstract
Pharmacological regimens with multiple medications are being used in fertility treatments. Herein, we report a case of a 40-year-old Japanese woman who developed Stevens-Johnson syndrome (SJS) with a severe ocular complication during fertility treatment. Despite early multimodal interventions, including methylprednisolone pulse therapy and plasma exchange, her ocular complications persisted for more than a year. The four drugs administered in this case (cabergoline, medroxyprogesterone acetate, clomiphene, and intravenous human chorionic gonadotropin) have never been reported to induce SJS. Based on this case, we suggest that obstetricians, gynecologists, and dermatologists should be aware of fertility treatment-induced severe drug eruptions.
Collapse
Affiliation(s)
- Hiroyo Hashimoto
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Division of Dermatology, Chiba Aoba Municipal Hospital, Chiba, Japan
| | - Hideaki Miyachi
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koki Kataoka
- Division of Dermatology, Chiba Aoba Municipal Hospital, Chiba, Japan
| | - Yugo Maru
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yaei Togawa
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroyuki Matsue
- Department of Dermatology, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
8
|
Victor AR, Griffin DK, Brake AJ, Tyndall JC, Murphy AE, Lepkowsky LT, Lal A, Zouves CG, Barnes FL, McCoy RC, Viotti M. Assessment of aneuploidy concordance between clinical trophectoderm biopsy and blastocyst. Hum Reprod 2019; 34:181-192. [PMID: 30418565 DOI: 10.1093/humrep/dey327] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/31/2018] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is a clinical trophectoderm (TE) biopsy a suitable predictor of chromosomal aneuploidy in blastocysts? SUMMARY ANSWER In the analyzed group of blastocysts, a clinical TE biopsy was an excellent representative of blastocyst karyotype in cases of whole chromosome aneuploidy, but in cases of only segmental (sub-chromosomal) aneuploidy, a TE biopsy was a poor representative of blastocyst karyotype. WHAT IS KNOWN ALREADY Due to the phenomenon of chromosomal mosaicism, concern has been expressed about the possibility of discarding blastocysts classified as aneuploid by preimplantation genetic testing for aneuploidy (PGT-A) that in fact contain a euploid inner cell mass (ICM). Previously published studies investigating karyotype concordance between TE and ICM have examined small sample sizes and/or have utilized chromosomal analysis technologies superseded by Next Generation Sequencing (NGS). It is also known that blastocysts classified as mosaic by PGT-A can result in healthy births. TE re-biopsy of embryos classified as aneuploid can potentially uncover new instances of mosaicism, but the frequency of such blastocysts is currently unknown. STUDY DESIGN, SIZE, DURATION For this study, 45 patients donated 100 blastocysts classified as uniform aneuploids (non-mosaic) using PGT-A by NGS (n = 93 whole chromosome aneuploids, n = 7 segmental aneuploids). In addition to the original clinical TE biopsy used for PGT-A, each blastocyst was subjected to an ICM biopsy as well as a second TE biopsy. All biopsies were processed for chromosomal analysis by NGS, and karyotypes were compared to the original TE biopsy. PARTICIPANTS/MATERIALS, SETTING, METHODS The setting for this study was a single IVF center with an in-house PGT-A program and associated research laboratory. MAIN RESULTS AND THE ROLE OF CHANCE When one or more whole chromosomes were aneuploid in the clinical TE biopsy, the corresponding ICM was aneuploid in 90 out of 93 blastocysts (96.8%). When the clinical TE biopsy contained only segmental (sub-chromosomal) aneuploidies, the ICM was aneuploid in three out of seven cases (42.9%). Blastocysts showing aneuploidy concordance between clinical TE biopsy and ICM were also aneuploid in a second TE biopsy in 86 out of 88 cases (97.7%). In blastocysts displaying clinical TE-ICM discordance, a second TE biopsy was aneuploid in only two out of six cases (33.3%). LIMITATIONS, REASONS FOR CAUTION All embryos in this study had an initial classification of 'aneuploid' and not 'euploid' or 'mosaic'. Therefore, the findings of this study refer specifically to a TE biopsy predicting aneuploidy in the remaining blastocyst, and cannot be extrapolated to deduce the ability of a TE biopsy to predict euploidy in the blastocyst. No conclusions should be drawn from this study about the ability of a mosaic TE biopsy to predict the karyotype of the corresponding blastocyst. Caution should be exercised in generalizing the findings of the sample group of this study to the general IVF blastocyst population. The segmental aneuploidy group only contained seven samples. WIDER IMPLICATIONS OF THE FINDINGS The high rate of intra-blastocyst concordance observed in this study concerning whole chromosome aneuploidy contributes experimental evidence to the validation of PGT-A at the blastocyst stage. Concomitantly, the results suggest potential clinical value in reassessing blastocysts deemed aneuploid by TE re-biopsy in select cases, particularly in instances of segmental aneuploidies. This could impact infertility treatment for patients who only have blastocysts classified as aneuploid by PGT-A available. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Zouves Foundation for Reproductive Medicine and Zouves Fertility Center. The authors have no competing interest to disclose. TRIAL REGISTRATION NUMBER Not applicable.
Collapse
Affiliation(s)
- Andrea R Victor
- Zouves Fertility Center, Foster City, CA, USA.,School of Biosciences, University of Kent, Canterbury, United Kingdom
| | - Darren K Griffin
- School of Biosciences, University of Kent, Canterbury, United Kingdom
| | | | | | | | | | - Archana Lal
- Zouves Fertility Center, Foster City, CA, USA
| | - Christo G Zouves
- Zouves Fertility Center, Foster City, CA, USA.,Zouves Foundation for Reproductive Medicine, Foster City, CA, USA
| | - Frank L Barnes
- Zouves Fertility Center, Foster City, CA, USA.,Zouves Foundation for Reproductive Medicine, Foster City, CA, USA
| | - Rajiv C McCoy
- Department of Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Manuel Viotti
- Zouves Fertility Center, Foster City, CA, USA.,Zouves Foundation for Reproductive Medicine, Foster City, CA, USA
| |
Collapse
|
9
|
Palmer GA, Kratka C, Szvetecz S, Fiser G, Fiser S, Sanders C, Tomkin G, Szvetecz MA, Cohen J. Comparison of 36 assisted reproduction laboratories monitoring environmental conditions and instrument parameters using the same quality-control application. Reprod Biomed Online 2019; 39:63-74. [DOI: 10.1016/j.rbmo.2019.03.204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/02/2019] [Accepted: 03/06/2019] [Indexed: 12/31/2022]
|
10
|
Griffin DK, Ogur C. Chromosomal analysis in IVF: just how useful is it? Reproduction 2018; 156:F29-F50. [PMID: 29945889 DOI: 10.1530/rep-17-0683] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/23/2018] [Indexed: 12/11/2022]
Abstract
Designed to minimize chances of genetically abnormal embryos, preimplantation genetic diagnosis (PGD) involves in vitro fertilization (IVF), embryo biopsy, diagnosis and selective embryo transfer. Preimplantation genetic testing for aneuploidy (PGT-A) aims to avoid miscarriage and live born trisomic offspring and to improve IVF success. Diagnostic approaches include fluorescence in situ hybridization (FISH) and more contemporary comprehensive chromosome screening (CCS) including array comparative genomic hybridization (aCGH), quantitative polymerase chain reaction (PCR), next-generation sequencing (NGS) and karyomapping. NGS has an improved dynamic range, and karyomapping can detect chromosomal and monogenic disorders simultaneously. Mosaicism (commonplace in human embryos) can arise by several mechanisms; those arising initially meiotically (but with a subsequent post-zygotic 'trisomy rescue' event) usually lead to adverse outcomes, whereas the extent to which mosaics that are initially chromosomally normal (but then arise purely post-zygotically) can lead to unaffected live births is uncertain. Polar body (PB) biopsy is the least common sampling method, having drawbacks including cost and inability to detect any paternal contribution. Historically, cleavage-stage (blastomere) biopsy has been the most popular; however, higher abnormality levels, mosaicism and potential for embryo damage have led to it being superseded by blastocyst (trophectoderm - TE) biopsy, which provides more cells for analysis. Improved biopsy, diagnosis and freeze-all strategies collectively have the potential to revolutionize PGT-A, and there is increasing evidence of their combined efficacy. Nonetheless, PGT-A continues to attract criticism, prompting questions of when we consider the evidence base sufficient to justify routine PGT-A? Basic biological research is essential to address unanswered questions concerning the chromosome complement of human embryos, and we thus entreat companies, governments and charities to fund more. This will benefit both IVF patients and prospective parents at risk of aneuploid offspring following natural conception. The aim of this review is to appraise the 'state of the art' in terms of PGT-A, including the controversial areas, and to suggest a practical 'way forward' in terms of future diagnosis and applied research.
Collapse
Affiliation(s)
- Darren K Griffin
- School of BiosciencesCentre for Interdisciplinary Studies of Reproduction, University of Kent, Canterbury, UK
| | - Cagri Ogur
- Bahceci Genetic Diagnosis Centerİstanbul, Turkey.,Department of BioengineeringYildiz Technical University, İstanbul, Turkey
| |
Collapse
|
11
|
Roque M, Valle M, Sampaio M, Geber S. Obstetric outcomes after fresh versus frozen-thawed embryo transfers: A systematic review and meta-analysis. JBRA Assist Reprod 2018; 22:253-260. [PMID: 29782139 PMCID: PMC6106638 DOI: 10.5935/1518-0557.20180049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective To evaluate if there are differences in the risks of obstetric outcomes in
IVF/ICSI singleton pregnancies when compared fresh to frozen-thawed embryo
transfers (FET). Methods This was a systematic review and meta-analysis evaluating the obstetric
outcomes in singleton pregnancies after FET and fresh embryo transfer. The
outcomes included in this study were pregnancy-induced hypertension (PIH),
pre-eclampsia, placenta previa, and placenta accreta. Results The search yielded 654 papers, 6 of which met the inclusion criteria and
reported on obstetric outcomes. When comparing pregnancies that arose from
FET or fresh embryo transfer, there was an increase in the risk of obstetric
complications in pregnancies resulting from FET when compared to those
emerging from fresh embryo transfers in PIH (aOR 1.82; 95% CI 1.24-2.68),
pre-eclampsia (aOR 1.32, 95% CI 1.07, 1.63), and placenta accreta (aOR 3.51,
95% CI 2.04-6.05). There were no significant differences in the risk between
the FET and fresh embryo transfer groups when evaluating placenta previa
(aOR 0.70; 95% CI 0.46-1.08). Conclusion The obstetric outcomes observed in pregnancies arising from ART may differ
among fresh and FET cycles. Thus, when evaluating to perform a fresh embryo
transfer or a freeze-all cycle, these differences found in obstetric
outcomes between fresh and FET should be taken into account. The adverse
obstetric outcomes after FET found in this study emphasize that the
freeze-all policy should not be offered to all the patients, but should be
offered to those with a clear indication of the benefit of this
strategy.
Collapse
Affiliation(s)
- Matheus Roque
- ORIGEN - Center for Reproductive Medicine, Rio de Janeiro, Brazil.,Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marcello Valle
- ORIGEN - Center for Reproductive Medicine, Rio de Janeiro, Brazil
| | - Marcos Sampaio
- ORIGEN - Center for Reproductive Medicine, Belo Horizonte, Brazil
| | - Selmo Geber
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,ORIGEN - Center for Reproductive Medicine, Belo Horizonte, Brazil
| |
Collapse
|
12
|
Osaikhuwuomwan J, Maduka R, Aziken M. The effect of bacterial colonization of the embryo transfer catheter on Outcome of In vitro Fertilization–Embryo transfer treatment. ACTA ACUST UNITED AC 2018. [DOI: 10.4103/ajmhs.ajmhs_54_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|