Clinical and biological parameters influencing implantation: score to determine number of embryos to transfer

Influence of air quality on the results of in vitro fertilization attempts: A retrospective study

OBJECTIVE

To assess the influence of air quality on the results of IVF.

STUDY DESIGN

We performed a retrospective study on 292 patients who have undergone an IVF attempt from April 2012 to December 2015 in our French university hospital. Patients were included in the study if data on the air quality at home and at work were available and if they haven't been gone for more than 4days in a month. Data were recorded during the 3 months before oocyte collection and 1 month after embryo transfer. Air quality measurements were obtained from the Observatoire Régional de l'Air en Midi-Pyrénées (ORAMIP) and concerned the levels of nitrogen dioxide (NO₂), ozone (O₃), particulate matter PM10 and SO₂ measured every day.

RESULTS

Acute exposures to high levels NO₂ or PM10 were associated with lower results of IVF (ovarian response to stimulation, number of top embryos) while these parameters were enhanced when patients were exposed to high levels of O₃ during the first 2 months of folliculogenesis. These effects were found even for a short exposure (1day).

CONCLUSIONS

Air quality has an impact on global health and also on the reproductive function and public and authorities must be aware of environmental protection.

Fitting the data from embryo implantation prediction: Learning from label proportions

Machine learning techniques have been previously used to assist clinicians to select embryos for human-assisted reproduction. This work aims to show how an appropriate modeling of the problem can contribute to improve machine learning techniques for embryo selection. In this study, a dataset of 330 consecutive cycles (and associated embryos) carried out by the Unit of Assisted Reproduction of the Hospital Donostia (Spain) throughout 18 months has been analyzed. The problem of the embryo selection has been modeled by a novel weakly supervised paradigm, learning from label proportions, which considers all the available data, including embryos whose fate cannot be certainly established. Furthermore, all the collected features, describing cycles and embryos, have been considered in a multi-variate data analysis. Our integral solution has been successfully tested. Experimental results show that the proposed technique consistently outperforms an equivalent approach based on standard supervised classification. Embryos in this study were selected for transference according to the criteria of the Spanish Association for Reproduction Biology Studies. Obtained classification models outperform these criteria, specifically reordering medium-quality embryos.

Loss of genomic imprinting in mouse embryos with fast rates of preimplantation development in culture

Currently, the stage of embryo development has been proposed as one of many criteria for identifying healthy embryos in infertility clinics with the fastest embryos being highlighted as the healthiest. However the validity of this as an accurate criterion with respect to genomic imprinting is unknown. Given that embryo development in culture generally requires an extra day compared to in vivo development, we hypothesized that loss of imprinting correlates with slower rates of embryonic development. To evaluate this, embryos were recovered at the 2-cell stage, separated into four groups based on morphological stage at two predetermined time points, and cultured to blastocysts. We examined cell number, embryo volume, embryo sex, imprinted Snrpn and H19 methylation, imprinted Snrpn, H19, and Cdkn1c expression, and expression of genes involved in embryo metabolism-Atp1a1, Slc2a1, and Mapk14-all within the same individual embryo. Contrary to our hypothesis, we observed that faster developing embryos exhibited greater cell numbers and embryo volumes as well as greater perturbations in genomic imprinting and metabolic marker expression. Embryos with slower rates of preimplantation development were most similar to in vivo derived embryos, displaying similar cell numbers, embryo volumes, Snrpn and H19 imprinted methylation, H19 imprinted expression, and Atp1a1 and Slc2a1 expression. We conclude that faster development rates in vitro are correlated with loss of genomic imprinting and aberrant metabolic marker expression. Importantly, we identified a subset of in vitro cultured embryos that, according to the parameters evaluated, are very similar to in vivo derived embryos and thus are likely most suitable for embryo transfer.

Soluble HLA-G in IVF/ICSI embryo culture supernatants does not always predict implantation success: a multicentre study

Several reports have described an association between the presence of soluble human leukocyte antigen G (sHLA-G) in human embryo culture supernatants (ES) and implantation success. However, not all studies agree with these findings. To further document this debate, a multicentre blinded study was performed to investigate, on a large number of IVF ES and ICSI ES, whether sHLA-G is a useful criterion for embryo selection before transfer. A total of 1405 ES from 355 patients were collected from three assisted reproductive technique (ART) centres and evaluated for their sHLA-G content in a single laboratory, using a chemiluminescence enzyme-linked immunosorbent assay. In only one centre was a significant association between sHLA-G-positive ES and successful implantation established (P = 0.0379), whereas no such association was observed in the other centres. It was found that the percentages and concentrations of sHLA-G-positive ES varied between centres, depending on culture media and ART conditions. The percentage of sHLA-G-positive ES was significantly higher in IVF ES than ICSI ES (P < 0.001 and P < 0.01 for two centres). These data demonstrate that substantial variations of sHLA-G content in ES occur between different ART centres, highlighting the influence of several technical parameters that differ from one centre to another.

The Impact of Leukemia Inhibitory Factor in Uterine Flushing on the Reproductive Potential of Infertile Women ? A Prospective Study

PROBLEM

To determine the value of leukemia inhibitory factor (LIF) assessment for predicting the reproductive outcome.

METHOD OF STUDY

Two phase study. Phase I: assessment of LIF in uterine flushing. Phase II: 1,5 years after examining the last patient, a questionnaire was sent to all participants of the phase I. Phase I: Uterine flushing and endometrial samples were collected during implantation window from infertile patients with stage I/II endometriosis (n = 14), patients with idiopathic infertility (n = 27), luteal phase deficiency (n = 13), and fertile control (n = 21). LIF was assessed in uterine flushings in all patients by ELISA. In endometrium, semiquantitative RT-PCR was performed for LIF mRNA expression. Phase II: questionnaire has been sent to all infertile women taking part in the first phase of the experiment, regarding their reproductive outcome.

RESULTS

65.4% patients who had returned the questionnaire did get pregnant. LIF concentration at a cut-off point of 2.31 pg/ml had a 95.7% sensitivity and 81.8% specificity in predicting the reproductive outcome.

CONCLUSION

This prospective study for the first time in literature indicates that the LIF assessment can be used as a predictor of reproductive success.