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Bartolacci A, Marzanati D, Barbagallo BM, Solano Narduche L, D’Alessandro G, Esposito S, Vanni VS, Masciangelo R, Gentilini D, Papaleo E, Pagliardini L. To Assess or Not to Assess: Reconsidering Day 3 Embryo Quality in Planned Freeze-All Blastocyst Cycles. J Pers Med 2024; 14:624. [PMID: 38929846 PMCID: PMC11204659 DOI: 10.3390/jpm14060624] [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: 05/07/2024] [Revised: 05/31/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Day 3 embryo quality is a predictor of in vitro fertilization (IVF) success rates in cleavage-stage embryo transfer. However, the association between day 3 embryo quality and clinical outcomes in blastocyst transfer policy is largely unknown. This retrospective study included 1074 frozen-thawed single day 5/6 blastocyst transfers between January 2019 and December 2022. Three groups were assessed depending on whether the transferred blastocyst derived from a top-quality, good-quality, or poor-quality embryo at day 3. The analysis was conducted independently for each blastocyst quality group (top, good, and poor) using multivariable logistic regression. We applied a Factorial Analysis of Mixed Data (FAMD) to reduce the potential collinearity between the covariates used in the model. All the blastocysts included in this study were obtained from the first ICSI freeze-all cycles. The cleavage and blastocysts stages were assessed between 67 ± 0.5 (day 3), 115 ± 0.5 (day 5), and 139 ± 0.5 (day 6) hours post-insemination (hpi), respectively. After adjusting for the day of transfer (day 5 or day 6) and FAMD dimensions, no statistical differences in a β-HCG, clinical pregnancy, and live birth were observed among the same-quality blastocysts derived from different day 3 embryo quality groups (top = A, good = B, and poor = C). Our findings showed that a day 3 embryo quality assessment may be unnecessary in planned freeze-all blastocyst cycles.
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Affiliation(s)
- Alessandro Bartolacci
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
| | - Daria Marzanati
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (D.M.); (D.G.)
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy;
| | - Beatrice Maria Barbagallo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
| | - Lisett Solano Narduche
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy;
| | - Giulia D’Alessandro
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
| | - Stefania Esposito
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
| | - Valeria Stella Vanni
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
| | - Rossella Masciangelo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
| | - Davide Gentilini
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (D.M.); (D.G.)
- Bioinformatics and Statistical Genomics Unit, Istituto Auxologico Italiano IRCCS, 20095 Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
| | - Luca Pagliardini
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy; (B.M.B.); (G.D.); (S.E.); (V.S.V.); (R.M.); (E.P.); (L.P.)
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (D.M.); (D.G.)
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy;
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Zhang W, Shi H, Niu W, Sun B, Zhang Y, Wang F. Morphological quality on Day 3 affects the pregnancy outcomes of low-quality euploid blastocysts: a retrospective cohort study. Hum Reprod 2024:deae123. [PMID: 38852063 DOI: 10.1093/humrep/deae123] [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: 05/03/2023] [Revised: 05/01/2024] [Indexed: 06/10/2024] Open
Abstract
STUDY QUESTION Does the morphological quality on Day 3 influence the pregnancy outcomes of euploid blastocysts? SUMMARY ANSWER The morphological quality on Day 3 affects the clinical pregnancy rate (CPR) and live birth rate (LBR) of low-quality euploid blastocysts. WHAT IS KNOWN ALREADY The morphological grading of Day 3 embryos affects the pregnancy outcome of cleavage-stage embryos and is an excellent indicator to predict embryo development potential. However, it is still unclear whether morphological quality on Day 3 is associated with pregnancy outcomes of the euploid blastocyst. STUDY DESIGN, SIZE, DURATION This retrospective cohort study comprised 1275 patients who received single euploid blastocyst transfer between January 2016 and August 2021 at a tertiary teaching hospital. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients were grouped into two groups according to the morphological grading on Day 3 of transferred blastocysts: high-quality (HQ, including Grades I and II) Day 3 embryos and low-quality (LQ, Grade III) Day 3 embryos. The primary outcomes were CPR and LBR. Interactions of development days (Day 5 and Day 6) and morphological quality (high- and low-quality) of blastocysts with morphological quality of Day 3 embryos on pregnancy outcomes were tested in the stratified analysis and logistic regression models. The multivariate logistic regression analysis was conducted to investigate the independent effect of the morphological quality of Day 3 embryos on pregnancy outcomes after adjusting for potentially confounding factors. MAIN RESULTS AND THE ROLE OF CHANCE The CPR and LBR of the HQ Day 3 embryos group were statistically higher than those of the LQ Day 3 embryos group (CPR: 59.73% versus 49.70%, respectively, P = 0.015; LBR: 49.73% versus 41.21%, respectively, P = 0.041). The development days of blastocysts did not exhibit a multiplicative interaction with the morphological quality of Day 3 embryos on the CPR (P for interaction = 0.648) and LBR (P for interaction = 0.925). The morphological quality of blastocysts exhibits a multiplicative interaction with the morphological quality of Day 3 embryos on the CPR (P for interaction = 0.020) and LBR (P for interaction = 0.012). After adjusting for potential confounders, the HQ Day 3 embryo group was positively associated with the CPR (adjusted odds ratio (aOR): 2.10, 95% CI: 1.31-3.36, P = 0.002) and LBR (aOR: 1.97, 95% CI: 1.20-3.25, P = 0.008) of LQ blastocysts. However, the morphological quality on Day 3 was not significantly associated with the CPR (aOR: 0.95, 95% CI: 0.58-1.55, P = 0.835) and LBR (aOR: 0.86, 95% CI: 0.53-1.40, P = 0.550) of HQ blastocysts. LIMITATIONS, REASONS FOR CAUTION Selection and confounding bias introduced by the retrospective design cannot be completely eliminated in this study, although multivariable logistic analysis was conducted to adjust for potential confounders. Also, some subgroups had small sample sizes, which may reduce statistical power. Moreover, participants in our study only received single euploid blastocyst transfer, and whether the results could apply to blastocysts with unknown ploidy status is unclear. WIDER IMPLICATIONS OF THE FINDINGS This study found that the morphological quality on Day 3 was significantly associated with the CPR and LBR of LQ blastocysts; Therefore, when only LQ euploid blastocysts are available for transfer, blastocysts derived from HQ Day 3 embryos are recommended. STUDY FUNDING/COMPETING INTEREST(S) No external funding was obtained. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Wanjun Zhang
- Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hao Shi
- Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenbin Niu
- Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Sun
- Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yile Zhang
- Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fang Wang
- Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Zhou H, Ye L, Zhang H, Zheng Y, Jin W. Should we should consider day 3 blastomere number during single vitrified-warmed blastocyst transfer cycle? A retrospective study. Eur J Obstet Gynecol Reprod Biol 2024; 297:209-213. [PMID: 38688135 DOI: 10.1016/j.ejogrb.2024.04.021] [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: 01/02/2024] [Revised: 03/18/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
The present study investigated whether day 3 blastomere number has an effect on the clinical outcomes during single vitrified-warmed blastocyst transfer cycles. A total of 3294 vitrified-warmed single day 5 blastocyst transferred cycles were analyzed in this retrospective study from January 2018 to December 2021. The cycles were divided into ≥ 7 and < 7 blastomere groups depending on the day 3 embryo blastomere number. The clinical outcomes were compared between the two groups, moreover multivariate logistic regression analysis was conducted to investigate the correlation between the number of day 3 blastomeres and clinical outcomes. The chi-square test demonstrated that the rates of clinical pregnancy and live birth were significantly higher in the ≥ 7 blastomere group compared to the < 7 blastomere group with respect to single high-quality blastocyst transfer cycles. Conversely, these rates were similar in the two groups with respect to single low-quality blastocyst transfer cycles. These results were confirmed by multivariate logistic regression analysis. However, the miscarriage rate was higher in the < 7 blastomere group than in ≥ 7 group during low-quality blastocyst transfer cycles. These results suggested that day 3 blastomere number should be considered during single vitrified-warmed blastocyst transfer cycles. Thus, blastocsyts derived from ≥ 7 blastomere embryos are preferred when choosing the same quality blastocysts.
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Affiliation(s)
- Haisu Zhou
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Lianmin Ye
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Huan Zhang
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Yi Zheng
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Wumin Jin
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
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Liu Z, Cai J, Liu L, Ouyang L, Chen J, Yang C, Chen K, Yang X, Ren J, Jiang X. Does cleavage stage morphology increase the discriminatory power of prediction in blastocyst transfer outcome? J Assist Reprod Genet 2024; 41:347-358. [PMID: 38040894 PMCID: PMC10894791 DOI: 10.1007/s10815-023-02997-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023] Open
Abstract
PURPOSE To evaluate the contribution of the cleavage stage morphological parameters to the prediction of blastocyst transfer outcomes. METHODS A retrospective study was conducted on 8383 single-blastocyst transfer cycles including 2246 fresh and 6137 vitrified-warmed cycles. XGboost, LASSO, and GLM algorithms were employed to establish models for assessing the predictive value of the cleavage stage morphological parameters in transfer outcomes. Four models were developed using each algorithm: all-in model with or without day 3 morphology and embryo quality-only model with or without day 3 morphology. RESULTS The live birth rate was 48.04% in the overall cohort. The AUCs of the models with the algorithm of XGboost were 0.83, 0.82, 0.63, and 0.60; with LASSO were 0.66, 0.66, 0.61, and 0.60; and with GLM were 0.66, 0.66, 0.61, and 0.60 respectively. In models 1 and 2, female age, basal FSH, peak E2, endometrial thickness, and female BMI were the top five critical features for predicting live birth; In models 3 and 4, the most crucial factor was blastocyst formation on D5 rather than D6. In model 3, incorporating cleavage stage morphology, including early cleavage, D3 cell number, and fragmentation, was significantly associated with successful live birth. Additionally, the live birth rates for blastocysts derived from on-time, slow, and fast D3 embryos were 49.7%, 39.5%, and 52%, respectively. CONCLUSIONS The value of cleavage stage morphological parameters in predicting the live birth outcome of single blastocyst transfer is limited.
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Affiliation(s)
- Zhenfang Liu
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
| | - Jiali Cai
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
- School of Medicine, Xiamen University, Xiamen, 361005, Fujian, China
| | - Lanlan Liu
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
- School of Medicine, Xiamen University, Xiamen, 361005, Fujian, China
| | - Ling Ouyang
- Medical Quality Management Department, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
| | - Jinghua Chen
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
| | - Chao Yang
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
| | - Kaijie Chen
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
| | - Xiaolian Yang
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
| | - Jianzhi Ren
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China
| | - Xiaoming Jiang
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China.
- School of Medicine, Xiamen University, Xiamen, 361005, Fujian, China.
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Qiu J, Du T, Guo H, Mol BW, Lin J, Zhao D, Wang Y, Kuang Y, Li W. Does Day 3 embryo status matter to reproductive outcomes of single blastocyst transfer cycles? A cohort study. BJOG 2023; 130:1669-1676. [PMID: 37308804 DOI: 10.1111/1471-0528.17559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/05/2023] [Accepted: 05/14/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate whether Day 3 (D3) embryo status matter to reproductive outcomes of blastocyst transfer cycles. DESIGN Retrospective cohort study. SETTING Assisted Reproduction Department of Shanghai Ninth People's Hospital, Shanghai, China. POPULATION A total of 6906 vitrified-thawed single blastocyst transfer cycles in 6502 women were included. METHODS Generalised estimated equation regression models were used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between embryo status and pregnancy outcomes. MAIN OUTCOME MEASURES Biochemical pregnancy, miscarriage, live birth. RESULTS High-quality blastocysts derived from poor-grade D3 embryos had comparable pregnancy outcomes to those derived from high-grade D3 embryos (40.0% versus 43.2%, aOR 1.00, 95% CI 0.85-1.17 for live birth rate; 8.3% versus 9.5%, aOR 0.82, 95% CI 0.63-1.07 for miscarriage rate). Cycles with low D3 cell number (five cells or fewer) had significantly higher miscarriage rate (9.2% versus 7.6%, aOR 1.33, 95% CI 1.02-1.75) compared with cycles with eight cells on D3. CONCLUSIONS Poor-quality cleavage embryos should be cultivated to the blastocyst stage because high-quality blastocysts derived from poor-grade D3 embryos had acceptable pregnancy outcomes. When the blastocyst grade is identical, choosing embryos with higher D3 cell number (eight or more cells) for transfer could reduce the risk of early miscarriage.
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Affiliation(s)
- Jiaxin Qiu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Du
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Guo
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, The School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Jiaying Lin
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Zhao
- Department of Obstetrics and Gynaecology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanping Kuang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wentao Li
- Department of Obstetrics and Gynaecology, The School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- JC School of Public Health and Primary Care The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
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Pons MC, Carrasco B, Rives N, Delgado A, Martínez-Moro A, Martínez-Granados L, Rodriguez I, Cairó O, Cuevas-Saiz I. Predicting the likelihood of live birth: an objective and user-friendly blastocyst grading system. Reprod Biomed Online 2023; 47:103243. [PMID: 37473718 DOI: 10.1016/j.rbmo.2023.05.015] [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: 02/07/2023] [Revised: 05/10/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023]
Abstract
RESEARCH QUESTION Can day-5 blastocysts be ranked according to their likelihood of live birth using an objective and user-friendly grading system? DESIGN A retrospective multicentre study conducted between 2017 and 2019, including 1044 day-5 blastocysts. Blastocyst expansion degree, trophectoderm and inner cell mass quality were assessed morphologically and morphometrically. Several analyses were conducted: the association between the qualitative and quantitative assessment for the blastocyst expansion degree and the number of trophectoderm cells; the effect of the embryo quality on day 3 and the contribution of the three blastocyst parameters to live birth, with logistic regression; and a decision tree with the most significant variables to create the new scoring system. RESULTS Cut-off points were found to discriminate between expanding and expanded blastocysts (165 µm for blastocyst diameter) and between trophectoderm grades (A: ≥14 cells; B: 11-13 cells; C: ≤10 cells). When the embryos reached the blastocyst stage, their quality on day 3 did not add predictive value for implantation and live birth. In the logistic regression analysis, the only parameter capable of significantly predicting the live birth likelihood was the trophectoderm grade: A versus C (OR 1.95, 95% CI 1.26 to 3.0); B versus C (OR 1.71, 95% CI 1.22 to 2.4). The decision tree supported the finding that the trophectoderm grade had the highest predictive value for a live birth, followed by the blastocyst expansion degree in a second step. CONCLUSIONS This new method makes objective blastocyst assessment feasible, allowing for standardization and exportation to other laboratories worldwide.
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Affiliation(s)
- Maria Carme Pons
- Dexeus Mujer- Hospital Universitari Dexeus, Reproductive Medicine Service, Gran, Via Carles III, 71-75. 08028 Barcelona, Spain.
| | - Beatriz Carrasco
- Dexeus Mujer- Hospital Universitari Dexeus, Reproductive Medicine Service, Gran, Via Carles III, 71-75. 08028 Barcelona, Spain
| | - Natalia Rives
- Barcelona IVF, Escoles Pies, 103. 08017 Barcelona, Spain
| | - Arantza Delgado
- Institut Universitari IVI Valencia, Plaza Policía local, 3. 46015 Valencia, Spain
| | - Alvaro Martínez-Moro
- IVF Spain Madrid, Calle Manuel de Falla, 6-8. 28036 Madrid, Spain; Animal Reproduction Department, INIA-CSIC, Avda. Puerta del Hierro, 18. 28040, Madrid, Spain
| | - Luís Martínez-Granados
- Hospital Universitario Príncipe de Asturias, Unidad de Reproducción Humana, Carretera de Alcalá-Meco s/n. 28805 Alcalá de Henares, Spain
| | - Ignacio Rodriguez
- Dexeus Mujer- Hospital Universitari Dexeus, Reproductive Medicine Service, Gran, Via Carles III, 71-75. 08028 Barcelona, Spain
| | - Olga Cairó
- Centro de Infertilidad y Reproducción Humana (CIRH), Plaza Eguilaz, 14 bajos. 08017 Barcelona, Spain
| | - Irene Cuevas-Saiz
- Hospital General Universitario de Valencia, Unidad de Medicina Reproductiva, Avenida Tres Cruces, 2. 46014 Valencia, Spain
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Zhu J, Wu L, Liu J, Liang Y, Zou J, Hao X, Huang G, Han W. External validation of a model for selecting day 3 embryos for transfer based upon deep learning and time-lapse imaging. Reprod Biomed Online 2023; 47:103242. [PMID: 37429765 DOI: 10.1016/j.rbmo.2023.05.014] [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: 10/18/2022] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 07/12/2023]
Abstract
RESEARCH QUESTION Could objective embryo assessment using iDAScore Version 2.0 perform as well as conventional morphological assessment? DESIGN A retrospective cohort study of fresh day 3 embryo transfer cycles was conducted at a large reproductive medicine centre. In total, 7786 embryos from 4328 cycles with known implantation data were cultured in a time-lapse incubator and included in the study. Fetal heartbeat (FHB) rate was analysed retrospectively using iDAScore Version 2.0 and conventional morphological assessment associated with the transferred embryos. The pregnancy-prediction performance of the two assessment methods was compared using area under the curve (AUC) values for predicting FHB. RESULTS AUC values were significantly higher for iDAScore compared with morphological assessment for all cycles (0.62 versus 0.60; P = 0.005), single-embryo transfer cycles (0.63 versus 0.60; P = 0.043) and double-embryo transfer cycles (0.61 versus 0.59; P = 0.012). For the age subgroups, AUC values were significantly higher for iDAScore compared with morphological assessment in the <35 years subgroup (0.62 versus 0.60; P = 0.009); however, no significant difference was found in the ≥35 years subgroup. In terms of the number of blastomeres, AUC values were significantly higher for iDAScore compared with morphological assessment for both the <8c subgroup (0.67 versus 0.56; P < 0.001) and the ≥8c subgroup (0.58 versus 0.55; P = 0.012). CONCLUSIONS iDAScore Version 2.0 performed as well as, or better than, conventional morphological assessment in fresh day 3 embryo transfer cycles. iDAScore Version 2.0 may therefore constitute a promising tool for selecting embryos with the highest likelihood of implantation.
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Affiliation(s)
- Jiahong Zhu
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lihong Wu
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Junxia Liu
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yanfeng Liang
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jiayi Zou
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiangwei Hao
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Guoning Huang
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
| | - Wei Han
- Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing Health Centre for Women and Children, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering, Centre for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
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Liu L, Zhou H, Hu J, Sun X, Liu D, Huang G. Association between duration of progesterone supplementation and clinical outcomes in artificial frozen-thawed embryo transfer cycles. Front Endocrinol (Lausanne) 2023; 14:1193826. [PMID: 37576967 PMCID: PMC10415160 DOI: 10.3389/fendo.2023.1193826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/22/2023] [Indexed: 08/15/2023] Open
Abstract
Objective The administration of progesterone before transfer in hormone replacement treatment (HRT) is crucial for the clinical outcomes of frozen-thawed embryo transfer (FET), but the optimal duration of progesterone remains controversial. This study aimed to investigate the effect of the duration of progesterone administration on the clinical outcomes of FET cycles. Methods This prospective cohort study included 353 artificial FET cycles conducted at a reproductive medicine center between April and October 2021. The FET cycles were stratified into four groups based on the duration of progesterone supplementation before the procedure and the embryonic development stage: group P3 (73 patients) received intramuscular progesterone for 3 days and group P4 (87 patients) for 4 days before Day 3 frozen embryo transfer, group P5 (70 patients) for 5 days and group P6 (123 patients) for 6 days before frozen blastocyst transfer. This trial was performed using one or two vitrified embryo(s) when the endometrial thickness reached 7 mm after estrogen supplementation in an artificial cycle. The primary outcome was clinical pregnancy, and secondary outcomes included biochemical pregnancy, implantation, early pregnancy loss, and live births. Results There were no significant differences in the demographic and clinical characteristics between the groups. No significant difference was observed in the clinical pregnancy rates between groups: 23/73 (31.5%) in group P3 vs 28/87 (32.2%) in group P4 (P = 0.927). Compared to group P5 (41/70, 58.6%), the clinical pregnancy rate was not significantly different in group P6 (77/123, 62.6%, P = 0.753). There was no significant difference in the implantation rates between groups: 33/136 (24.3%) in group P3 vs 34/166 (20.5%) in group P4 (P = 0.431), and 62/133 (46.6%) in group P5 vs 107/231 (46.3%) in group P6 (P = 0.956). The duration of progesterone supplementation (mean: 3.5 ± 0.5 days; range:3-4 days) before Day 3 frozen embryo transfer did not impact clinical pregnancy (odds ratio [OR] 1.048; 95% confidence interval [CI], 0.518-2.119). The duration of progesterone administration (mean: 5.6 ± 0.5 days; range:5-6 days) before frozen blastocyst transfer may not affect clinical pregnancy (OR 1.339; 95% CI, 0.717-2.497). Conclusion There may be no significant correlation between the duration of progesterone supplementation and pregnancy outcomes in artificial FET cycles, although the clinical pregnancy rate was higher when progesterone supplementation was extended for one day before FET.
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Affiliation(s)
- Ling Liu
- Reproductive Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hongyan Zhou
- Reproductive Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jie Hu
- Reproductive Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xingyu Sun
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Doudou Liu
- Reproductive Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Guiying Huang
- Reproductive Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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9
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Zhang GL, Sun TY, Li S, Jiang MX, Guo L. The pregnancy outcomes of day-5 poor-quality and day-6 high-quality blastocysts in single blastocyst transfer cycles. Clin Exp Reprod Med 2023; 50:63-68. [PMID: 36935413 PMCID: PMC10030202 DOI: 10.5653/cerm.2022.05540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/24/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE This study compared the outcomes of single blastocyst transfer cycles, using day- 5 poor-quality blastocysts and day-6 high-quality blastocysts. METHODS We analyzed 462 frozen-thawed embryo transfer (FET) cycles performed at our center from January 2014 to December 2019. The cycles were divided into two groups: a day-5 poor-quality blastocyst transfer group (group A) and a day-6 high-quality blastocyst transfer group (group B). The clinical outcomes were tested. RESULTS In groups A and B, respectively, the clinical pregnancy rate (CPR; 61.65% vs. 67.17%, p=0.258), implantation rate (IR; 61.65% vs. 67.17%, p=0.258), and live birth rate (LBR; 69.51% vs. 77.83%, p=0.134) showed no significant differences. Moreover, when day-3 embryo quality was considered, the CPR, IR, and LBR were also similar in group A and group B (p>0.05). CONCLUSION The clinical outcomes of day-5 poor-quality blastocysts and day-6 high-quality blastocysts were similar, suggesting that the developmental speed of the embryo might be more important than embryo quality for the clinical outcomes of single blastocyst transfer in FET cycles.
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Affiliation(s)
- Guang-Li Zhang
- Center for Reproductive Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Tian-Yi Sun
- Center for Reproductive Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Sen Li
- Center for Reproductive Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Man-Xi Jiang
- Center for Reproductive Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Lei Guo
- Center for Reproductive Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
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10
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Geng L, Lin X, Liu R, Wu J, Luo Y, Sun H, Hou Z, Zhang Q, Xu C, Li X, Cao C, Wang T, Xia X. Clinical Outcome of Day-3 Cleavage Slow-Growing Embryos at Different Cleavage Rates after Overnight Culture: A Cohort Retrospective Study. J Clin Med 2022; 11:4417. [PMID: 35956032 PMCID: PMC9369477 DOI: 10.3390/jcm11154417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION We explored the association between clinical outcomes and the cleavage rate of day-3 cleavage slow-growing embryos after overnight culture. METHODS The data collected from 303 frozen embryo transfer (FET) cycles with 606 4-cell or 5-cell embryos cultured overnight (18-22 h) after thawing were analyzed. Based on the growth rate after the overnight culture, the embryos were divided into three groups: no embryo reaching eight cells (Group I), either one of the two embryos reaching eight cells (Group II), and both two embryos reaching eight cells or more (Group III). A statistical analysis of the different clinical outcomes from the three groups was performed. RESULTS Biochemical pregnancy rate (OR 3.22; p = 0.001), implantation rate (OR 2.44; p = 0.002), clinical pregnancy rate (OR 3.04; p = 0.001), ongoing pregnancy rate (OR 3.14; p = 0.001), and live birth rate (OR 2.78; p = 0.004) were significantly higher in Group III as compared to Group I. Group II had a significantly higher biochemical pregnancy rate (OR 2.02; p = 0.013) and implantation rate (OR 1.77; p = 0.019) than Group I. CONCLUSIONS The capability of day-3 cleavage slow-growing embryos to reach eight cells, especially that of two embryos reaching eight cells by overnight culture, appear to result in a better pregnancy outcome.
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Affiliation(s)
- Lan Geng
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Xinran Lin
- Medical College, Shantou University Medical College, Shantou 515063, China
| | - Rang Liu
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Jiahui Wu
- Department of Gynecology, Shenzhen Maternity &
- Child Healthcare Hospital, Shenzhen 518000, China
| | - Yongsheng Luo
- Quality Control Department, The Second People’s Hospital of Futian District, Shenzhen 518000, China
| | - Hongmei Sun
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Zhenhui Hou
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Qiuju Zhang
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Chang Xu
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Xiao Li
- Shenzhen Health Capacity Building and Continuing Education Center, Shenzhen 518000, China
| | - Canhui Cao
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Tianren Wang
- Center for Reproductive Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
| | - Xi Xia
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
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11
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Liu Y, Tilleman K, Vlaeminck B, Gervais R, Chouinard PY, De Sutter P, Fievez V. The fatty acid composition in follicles is related to the developmental potential of oocytes up to the blastocyst stage: a single-centre cohort study. Reprod Biol Endocrinol 2022; 20:107. [PMID: 35879714 PMCID: PMC9310456 DOI: 10.1186/s12958-022-00974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advanced maternal age and obesity are associated with impaired female fertility. Moreover, fatty acids (FA) in follicular fluid (FF) play important roles in oocyte maturation and embryo development. However, the effects of body mass index (BMI), age, and FF FA composition on embryo development between days 3 and 5 and blastocyst stage on day 5 are still unclear. METHODS This study included 138 patients undergoing assisted reproductive technology (ART), which were divided into three BMI groups (18.5-24.9 kg/m2 vs. 25.0-29.9 kg/m2 vs. ≥ 30.0 kg/m2) and three age-related groups (20-30 years vs. 31-34 years vs. ≥ 35 years) which were compared for ART outcomes. Further, observations were divided into quartiles based on either of three parameters related to embryo outcome, i.e. (i) embryos developing between days 3 and 5 (ED3-5) and (ii) expanded blastocysts on day 5 (EB5), both expressed proportionally to the number of oocytes with two pronuclei (2PN), as well as (iii) the embryo utilization rate (EUR). Proportions of FF FA were then compared between Q1 and Q4, representing the quartile with the worst vs. the best embryo outcome, respectively. Finally, regression models were created to assess the relationships between BMI, age, FF total FA (TFA) concentration, relative proportions of specific FA and embryo outcome. RESULTS Patients of Q1 had higher proportions of FF C20:5n-3, C22:6n-3 and total n-3 PUFA than Q4 patients. Furthermore, Q4 patients tended to be younger than Q1 patients. Within the whole cohort, the proportion of C20:5n-3 negatively correlated with ED3-5/2PN and EUR, while EB5/2PN tended to be negatively correlated with age. Regression models within the overweight and obese group confirmed the negative relation between C20:5n-3 and ED3-5/2PN, but also indicated additional associations: C18:1n-9 and C20:4n-6 were positively associated with ED3-5/2PN and EUR, respectively while the proportion of C18:0 was negatively associated with EUR. CONCLUSION The proportions of n-3 PUFA, particularly C20:5n-3 and C22:6n-3 were reduced in the patients' quartile with the best embryo outcome. This group of patients was also younger. However, the embryo quality parameters of overweight/obese patients were not associated with age but were positively associated with FF C18:1n-9 and negatively with the proportions of C18:0 or C20:5n-3. TRIAL REGISTRATION This study' registration number was B670201627735.
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Affiliation(s)
- Yujie Liu
- Department of Animal Sciences and Aquatic Ecology, Ghent University, Coupure Links 653, 9000, Ghent, Belgium
| | - Kelly Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Bruno Vlaeminck
- Department of Biology, Ghent University, Krijgslaan 281, S8, 9000, Ghent, Belgium
| | - Rachel Gervais
- Department of Animal Sciences, Laval University, 2425, rue de l'Agriculture, Québec, Québec, G1V 0A6, Canada
| | - P Yvan Chouinard
- Department of Animal Sciences, Laval University, 2425, rue de l'Agriculture, Québec, Québec, G1V 0A6, Canada
| | - Petra De Sutter
- Department for Reproductive Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Veerle Fievez
- Department of Animal Sciences and Aquatic Ecology, Ghent University, Coupure Links 653, 9000, Ghent, Belgium.
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12
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Xiong F, Sun Q, Wang S, Yao Z, Chen P, Wan C, Zhong H, Zeng Y. A nomogram to assist blastocyst selection in vitrified‐warmed embryo transfer cycles. J Obstet Gynaecol Res 2022; 48:1816-1828. [PMID: 35373468 DOI: 10.1111/jog.15138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/14/2021] [Accepted: 12/14/2021] [Indexed: 01/21/2023]
Affiliation(s)
- Feng Xiong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
| | - Qing Sun
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
| | - Sisi Wang
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
| | - Zhihong Yao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
| | - Peilin Chen
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
| | - Caiyun Wan
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
| | - Huixian Zhong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
| | - Yong Zeng
- Shenzhen Key Laboratory of Reproductive Immunology for Peri‐implantation Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital Shenzhen Guangdong People's Republic of China
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13
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Mi Z, Liu Z, Zhang Y, Zhu J, Yao Y, Zhou Y, Huang Y, Li Q, Ma Y. Number of Blastomeres in Day-2 Embryos Affect the Rates of Blastocyst Formation and Clinical Pregnancy During In Vitro Fertilization Cycles. Reprod Sci 2021; 28:3397-3405. [PMID: 34664219 DOI: 10.1007/s43032-021-00774-1] [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: 12/08/2020] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
In the current in vitro fertilization and embryo transfer protocol, the 8 blastomeres in the day-3 embryo are selected for transfer because these embryos can produce high rates of blastocyst formation and clinical pregnancy. However, the relationship between the blastomere number in day-2 embryos and the rate of blastocyst formation or clinical pregnancy remains unclear. The purpose of this retrospective study is to explore the relationship between the blastomere number in day-2 embryos and the rate of blastocyst formation or clinical pregnancy. From January 2015 to April 2020, we collected 8126 day-3 embryos (8 blastomeres) from 2282 patients. These embryos were classified into 8 groups (1 blastomere, 2 blastomeres, 3 blastomeres, 4 blastomeres, 5 blastomeres, 6 blastomeres, 7 blastomeres, and 8 blastomeres) based on their blastomeres number on day 2 after insemination. Of these groups, the 4 blastomeres group accounted for the largest proportion (74.44%). The 1 blastomere group accounted for the smallest proportion (0.22%). A total of 3554 day-3 embryos (8 blastomeres) from 1648 patients developed into blastocysts. The rate of blastocyst formation from the 4 blastomeres group was the highest (94.06%). Finally, 800 patients received single day-3 embryos (8 blastomeres) transfer. The rate of clinical pregnancy from 4 blastomeres group was the highest (51.98%). In conclusion, our data provide evidence that the number of blastomeres in day-2 embryos affects the rate of blastocyst formation and clinical pregnancy.
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Affiliation(s)
- Zuxia Mi
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China
| | - Zheng Liu
- College of Medical Laboratory Science, Guilin Medical University, Guilin, Guangxi, China
| | - Yu Zhang
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China
| | - Juan Zhu
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China
| | - Yufei Yao
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China
| | - Yao Zhou
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China
| | - Yuanhua Huang
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China
| | - Qi Li
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China
| | - Yanlin Ma
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Reproductive Medical Center, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, 3 Longhua Road, Haikou, 570102, Hainan, China.
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, Hainan, China.
- Hainan Provincial Clinical Research Center for Thalassemia, the First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China.
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14
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Wu J, Zhang J, Kuang Y, Chen Q, Wang Y. The effect of Day 3 cell number on pregnancy outcomes in vitrified-thawed single blastocyst transfer cycles. Hum Reprod 2021; 35:2478-2487. [PMID: 32944763 DOI: 10.1093/humrep/deaa209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/18/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does cell number on Day 3 have an impact on pregnancy outcomes in vitrified-thawed single blastocyst transfer cycles? SUMMARY ANSWER A low Day 3 cell number (≤5 cells) was independently associated with decreased live birth rate (LBR) during single blastocyst transfer cycles in young women. WHAT IS KNOWN ALREADY Day 3 cell number is an effective predictor of IVF success rates when transferring cleavage stage embryos. However, the association between Day 3 blastomere number and pregnancy outcomes after blastocyst transfer is still unknown. STUDY DESIGN, SIZE, DURATION A retrospective cohort study of 3543 patients who underwent frozen-thawed single blastocyst transfers from January 2013 to June 2018 at a tertiary-care academic medical center. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients were grouped into six groups according to the Day 3 cell number: ≤4 cells, 5 cells, 6 cells, 7 cells, 8 cells and >8 cells. The primary outcome measure was LBR. A logistic regression analysis was performed to explore the independent association between Day 3 blastomere number and LBR after adjustment for some potential confounders. MAIN RESULTS AND THE ROLE OF CHANCE In women <35 years old, the LBR varied significantly according to Day 3 cell number, with the rate of 31.2%, 34.4%, 41.9%, 45.1%, 48.1% and 48.2% for the ≤4-cell, 5-cell, 6-cell, 7-cell, 8-cell and >8-cell groups, respectively (P < 0.001). This significant difference was also observed in the high- and low-quality blastocyst subgroups of young women. However, for women ≥35 years old, the rate of live birth was similar between groups. Furthermore, after accounting for confounding factors, the LBR was significantly decreased in the ≤4-cell (adjusted odds ratio (aOR): 0.62, 95% CI: 0.48-0.80, P < 0.001) and 5-cell (aOR: 0.73, 95% CI: 0.57-0.92, P = 0.009) groups as compared to the 8-cell group. Likewise, the blastocysts arising from ≤4-cell (aOR: 0.73, 95% CI: 0.57-0.93, P = 0.010) or 5-cell (aOR: 0.77, 95% CI: 0.61-0.97, P = 0.024) embryos were associated with lower clinical pregnancy rate than those from 8-cell embryos. No significant differences were observed in biochemical pregnancy rate and miscarriage rate. LIMITATIONS, REASONS FOR CAUTION A limitation of the current study was its retrospective design. Future prospective studies are needed to confirm our findings. WIDER IMPLICATIONS OF THE FINDINGS Our observations suggested that a low Day 3 cell number was related to decreased LBR after blastocyst transfer in young women, which provided vital information for clinicians in selecting blastocyst during IVF treatment. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the National Natural Science Foundation of China (NSFC) (31770989 to Y.W.; 81671520 to Q.C.) and the Shanghai Ninth People's Hospital Foundation of China (JYLJ030 to Y.W.). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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15
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He Y, Wang Y, Zhang H, Zhang Y, Quan F. Alpha-lipoic acid improves the maturation and the developmental potential of goat oocytes in vitro. Reprod Domest Anim 2021; 56:545-554. [PMID: 33423332 DOI: 10.1111/rda.13892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 01/07/2021] [Indexed: 12/30/2022]
Abstract
Oxidative stress inevitably occurs during oocyte maturation in vitro. α-lipoic acid (α-LA) has a strong antioxidant capacity, but the effect of α-LA on parthenogenetic activation of oocytes was rarely reported. This study aims to investigate the effect of supplementing α-LA to in vitro maturation medium on the subsequent developmental ability of goat parthenogenetic embryos during oocytes maturation. In the study, the goat cumulus-oocyte complex was divided into the experimental (with 25 μmol/L α-LA) and the control (without α-LA) groups. Oxidase expression was measured using RT-qPCR. After 18-22 hr of maturation, the oocytes were then parthenogenetic activated. The total antioxidant capacity of embryos was measured after 0, 24, 48, 72 and 96 hr of culture. Rates of oocyte maturation and the rates of development for parthenogenetic embryos in the α-LA group were significantly improved by 7.88% (p < .05) and 5.41% (p < .05) compared with those in the control group, respectively. After 24 hr, the difference in total antioxidant capacity was extremely significant in both groups. An evident decrease in the control group and a minor decrease in the α-LA group were observed (p < .01). The ratio of inner cell mass cells to the total cell number of blastocysts in the α-LA group increased compared with that in the control group (p < .05) on day 8. α-LA significantly promoted the expression of SOD and GPX4 of parthenogenetic blastocysts and maturated oocytes. α-LA (25 μmol/L) improved the maturation rate and the developmental competence of the parthenogenetic activation of oocytes, which might be mediated by maintaining the total antioxidant ability of oocytes during the culture period.
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Affiliation(s)
- Yuanyuan He
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Yile Wang
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Hengde Zhang
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Yong Zhang
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Fusheng Quan
- Key Laboratory of Animal Biotechnology of the Ministry of Agriculture, College of Veterinary Medicine, Northwest A&F University, Yangling, China
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Kemper JM, Liu Y, Afnan M, Hammond ER, Morbeck DE, Mol BWJ. Should we look for a low-grade threshold for blastocyst transfer? A scoping review. Reprod Biomed Online 2021; 42:709-716. [PMID: 33632655 DOI: 10.1016/j.rbmo.2021.01.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/02/2021] [Accepted: 01/28/2021] [Indexed: 11/18/2022]
Abstract
Embryo quality is a key determinant of the success of IVF. Although the focus has been on selecting the best embryo for transfer, the classification of low-grade blastocysts (LGB) in existing scoring systems has received less attention. This is worrisome; embryo freezing allows optimal use of all created embryos, thus maximizing the cumulative live birth rate, which is arguably the most important outcome for infertile couples. A PubMed search was conducted in August 2020, using '((('poor-quality' OR 'poor quality') OR ('low-grade' OR 'low grade')) AND ('embryo' OR 'blastocyst')) AND ('pregnancy' OR 'live birth')'. This scoping review shows that LGB have similar euploidy and pregnancy success rates after implantation and have no adverse effects on pregnancy or perinatal outcomes. Evidence for pregnancy outcomes is lacking for different grades of LGB, with most studies clustering all LQB as one to compare with optimal blastocysts.
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Affiliation(s)
- James M Kemper
- Monash Women's, Monash Health, 246 Clayton Road Clayton 3168, Australia; Department of Obstetrics and Gynaecology, Monash University Clayton, Australia.
| | - Yanhe Liu
- Monash IVF Queensland, Southport, Australia; School of Human Sciences, University of Western Australia, Crawly, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | | | | | - Dean E Morbeck
- Fertility Associates Auckland, New Zealand; Department of Obstetrics and Gynaecology, University of Auckland, New Zealand
| | - Ben W J Mol
- Monash Women's, Monash Health, 246 Clayton Road Clayton 3168, Australia; Department of Obstetrics and Gynaecology, Monash University Clayton, Australia; Aberdeen Centre for Women's Health Research, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen Aberdeen, UK
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17
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Shen X, Long H, Gao H, Guo W, Xie Y, Chen D, Cong Y, Wang Y, Li D, Si J, Zhao L, Lyu Q, Kuang Y, Wang L. The Valuable Reference of Live Birth Rate in the Single Vitrified-Warmed BB/BC/CB Blastocyst Transfer: The Cleavage-Stage Embryo Quality and Embryo Development Speed. Front Physiol 2020; 11:1102. [PMID: 33013471 PMCID: PMC7511572 DOI: 10.3389/fphys.2020.01102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022] Open
Abstract
Background It is unclear whether we should focus attention on cleavage-stage embryo quality and embryo development speed when transferring single particular grade vitrified-warmed blastocysts, especially poor-quality blastocysts (grade “C”). Method This retrospective study considered 3386 single vitrified-warmed blastocyst transfer cycles from January 2010 to December 2017. They were divided into group 1 (AA/AB/BA, n = 374), group 2 (BB, n = 1789), group 3 (BC, n = 901), and group 4 (CB, n = 322). The effects of cleavage-stage embryo quality and embryo development speed were measured in terms of clinical pregnancy and live birth rates in each group. Results Pregnancy outcomes showed a worsening trend from groups 1 to 4; the proportion of embryos with better cleavage-stage quality and faster development speed decreased. In group 1, only the blastocyst expansion degree 3 was a negative factor in the clinical pregnancy rate (odds ratio (OR) [95% confidence interval (CI)]: 0.233 [0.091–0.595]) and live birth rate (0.280 [0.093–0.884]). In the other groups (BB, BC, and CB), blastocysts frozen on day 5 had significantly better clinical pregnancy outcomes than those frozen on day 6: 1.373 [1.095–1.722] for group 2, 1.523 [1.055–2.197] for group 3, and 3.627 [1.715–7.671] for group 4. The live birth rate was 1.342 [1.060–1.700] for group 2, 1.544 [1.058–2.253] in group 3, and 3.202 [1.509–6.795] in group 4, all Ps < 0.05). The degree of blastocoel expansion three for clinical pregnancy rate in group 2 (0.350 [0.135–0.906], P < 0.05) and day 3 blastomere number (>7) for live birth rate in group 4 (2.455 [1.190–5.063], P < 0.05) were two important factors. Conclusion We should consider choosing BB/BC/CB grade blastocysts frozen on day 5, CB grade blastocysts with day 3 blastomere numbers (>7), and AA/AB/BA grade blastocysts with degrees of expansion (≥4) to obtain better pregnancy outcomes.
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Affiliation(s)
- Xi Shen
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Long
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyuan Gao
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenya Guo
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yating Xie
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Chen
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanyan Cong
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongying Li
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiqiang Si
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Leiwen Zhao
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qifeng Lyu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanping Kuang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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18
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Xia L, Zhao S, Xu H, Wu X, Zhang A, Niu Z. Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos. Front Endocrinol (Lausanne) 2020; 11:561085. [PMID: 33042021 PMCID: PMC7525122 DOI: 10.3389/fendo.2020.561085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/17/2020] [Indexed: 11/30/2022] Open
Abstract
Embryos with low morphological scores can still develop to the blastocyst stage and result in good clinical outcomes. However, no studies have reported the possible effects of transferring cryopreserved blastocysts developed from poor-quality cleavage stage embryos on pregnancy and perinatal outcomes. In this retrospective study, the clinical value of transferring blastocysts derived from day 3 poor-quality cleavage stage embryos during in vitro fertilization and embryo transfer procedures was evaluated. According to the quality of embryos on day 3 from which the transferred blastocyst originated, patients were divided into three groups: poor-quality (111 cycles, group A), good-quality (235 cycles, group B), and top-quality (119 cycles, group C). Group A experienced the highest miscarriage rate (30.2%) which was increased when compared to group C (12.5%) (P = 0.03). The clinical pregnancy rates and live birth rates were not significantly different among the three groups. However, good blastocyst originating from top day 3 embryos resulted in higher live birth rate. Of the 218 live births, no differences in obstetric and perinatal outcomes were noted among the three groups. The results showed that extended culture of poor-quality cleavage stage embryos could resulted in favorable clinical pregnancy rates but at a higher incidence of miscarriages. Meanwhile, the risk of adverse perinatal outcomes was not increased.
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Herbemont C, Chekroune S, Bonan S, Cedrin-Durnerin I, Vivot A, Sonigo C, Boujenah J, Grynberg M, Sifer C. Impact of post-warming culture duration on clinical outcomes of vitrified good-quality blastocyst transfers: a prospective randomized study. Fertil Steril 2019; 110:1290-1297. [PMID: 30503128 DOI: 10.1016/j.fertnstert.2018.07.1153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/23/2018] [Accepted: 07/30/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine whether post-warming culture duration (1 hour vs. 18 hours) influences implantation rates (IRs) of good-quality blastocysts (GQB) in a good-prognosis population. DESIGN Prospective interventional randomized study. SETTING University hospital. PATIENT(S) One hundred sixty-two GQB transfers. INTERVENTION(S) Patients' vitrified blastocysts were randomly allocated to group A, warming on the day before transfer (n = 81), or B, warming on the day of transfer (n = 81). MAIN OUTCOME MEASURE(S) IR, live birth rate, reexpansion degree, and quality after warming and immediately before transfer. RESULT(S) Quality of the warmed and transferred blastocysts was similar (respectively, 39.1% and 32.7% top quality [≥B4AA/AB/BA] in group A vs. 41.7 and 42.2% in group B). In group A, 14 of 102 blastocysts (12.2%) appeared to be unsuitable for transfer, versus only 1 of 103 (0.9%) in group B, thus leading to an additional warming. As expected, reexpansion degree just before transfer was higher in group A (0.90 vs. 0.70). Likewise, the proportion of hatched blastocysts before transfer was higher after a longer culture period (38.6% in group A vs. 12.7% in group B). IRs were similar (38.0% in group A vs. 36% in group B), as were live birth rates (35.8% in group A vs. 34.6% in group B). CONCLUSION(S) IRs were not different, whatever the duration of post-warming culture of GQB. Both warming strategies could be applied to good-prognosis patients to optimize the laboratory workflow without any detrimental effect.
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Affiliation(s)
- Charlène Herbemont
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France; Université, Paris XIII, Bobigny, France
| | - Sarah Chekroune
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France
| | - Sarah Bonan
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France
| | - Isabelle Cedrin-Durnerin
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France
| | - Alexandre Vivot
- AP-HP, Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Paris, France; INSERM, UMR1153, Université Paris Descartes, Paris, France
| | - Charlotte Sonigo
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France; INSERM, U1185, Université Paris-Sud, Le Kremlin-Bicetre, France
| | - Jeremy Boujenah
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France; Service de Gynécologie-Obstétrique, Hôpital Jean Verdier, Bondy, France
| | - Michael Grynberg
- Université, Paris XIII, Bobigny, France; AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy, France; INSERM, U1133, Université, Paris-Diderot, Paris, France
| | - Christophe Sifer
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction-CECOS, Hôpital Jean Verdier, Bondy, France; Université, Paris XIII, Bobigny, France.
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20
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Li M, Wang Y, Shi J. Do day-3 embryo grade predict day-5 blastocyst transfer outcomes in patients with good prognosis? Gynecol Endocrinol 2019; 35:36-39. [PMID: 30241445 DOI: 10.1080/09513590.2018.1484444] [Citation(s) in RCA: 2] [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: 10/28/2022] Open
Abstract
The main aim was to investigate whether or not day-3 embryo grade could predict day-5 blastocyst transfer outcomes in patients with good prognosis. This study included 233 elective single blastocyst transfers (eSBT) by D5 selection with conventional morphology (CM) and 121 elective single blastocyst transfers (eSBT) by D5 selection with time-lapse monitoring system (TL) from October 2016 to October 2017. All the patients were submitted to controlled ovarian stimulation (COS) with long-term protocol and transferred for the first time. The main outcome measures were clinical pregnancy rates (CPR) and ongoing pregnancy (OPR). Our results suggested that CPR (58.04 versus 57.89 versus 55.56%; p = .957) and OPR (66.07 versus 65.79 versus 64.44%; p = .981) were comparable among day 3 grades I, grades II, and grades III groups. We also observed that the TL group showed a slightly better CPR and OPR than CM group (p > .05). Our findings suggested that good or poor embryos at day-3 were not predictive of the outcomes of good-quality blastocysts in a good-prognosis population. It needed to be emphasized that time-lapse monitoring might be useful for elective single blastocyst transfer.
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Affiliation(s)
- Mingzhao Li
- a The ART center , Northwest Women's and Children's Hospital , Xi'an , China
| | - Yingjin Wang
- b Medical Ultrasound Center , Northwest Women's and Children's Hospital , Xi'an , China
| | - Juanzi Shi
- a The ART center , Northwest Women's and Children's Hospital , Xi'an , China
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21
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Biochemical pregnancy loss after frozen embryo transfer seems independent of embryo developmental stage and chromosomal status. Reprod Biomed Online 2018; 37:349-357. [DOI: 10.1016/j.rbmo.2018.05.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/04/2018] [Accepted: 05/11/2018] [Indexed: 11/19/2022]
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Rocafort E, Enciso M, Leza A, Sarasa J, Aizpurua J. Euploid embryos selected by an automated time-lapse system have superior SET outcomes than selected solely by conventional morphology assessment. J Assist Reprod Genet 2018; 35:1573-1583. [PMID: 30030710 PMCID: PMC6133820 DOI: 10.1007/s10815-018-1265-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE We investigated if automated TLI selection may be a valuable strategy to identify those euploid embryos with the best chances of success. METHODS This is a unicentric and retrospective study involving 244 patients undergoing preimplantational genetic screening (PGS) cycles with autologous oocytes or oocyte donation (OD) with single euploid embryo transferred. We examined euploid embryos selected for transfer based on morphology evaluation alone (PGS-only; control group) or by assessment using an automated TLI system (Eeva™; PGS-TLI group). RESULTS In both, autologous oocytes and OD patients, significantly better implantation and clinical and ongoing pregnancy rates were obtained in the PGS-TLI group when euploid embryos with high implantation potential as predicted by the automated TLI System (Eeva™) were transferred compared with the PGS-only group. This improvement was also observed when only transfers of good morphological quality embryos were compared. TLI categories showed significant differences on blastocyst formation and euploidy rate. CONCLUSIONS Automated TLI combined with PGS is a useful prognostic tool to identify euploid embryos with the highest potential for implantation and pregnancy. Further, these results provide evidence that a healthy pregnancy does not only depend upon normal chromosomal status.
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Affiliation(s)
- E. Rocafort
- IVF Laboratory, IVF Spain, 13 Ansaldo Avenue, 03540 Alicante, Spain
- Present Address: Barcelona, Spain
| | - M. Enciso
- Genetics Department, iGLS, 7 Britania Street, 03540 Alicante, Spain
| | - A. Leza
- IVF Laboratory, IVF Spain, 13 Ansaldo Avenue, 03540 Alicante, Spain
| | - J. Sarasa
- Genetics Department, iGLS, 7 Britania Street, 03540 Alicante, Spain
| | - J. Aizpurua
- Reproductive Medicine, IVF Spain, 13 Ansaldo Avenue, 03540 Alicante, Spain
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