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Yao Y, Wang M, Liu M, Zhang Y, Mi Z, Mao J, Chen H, Huang Y, Huang Y, Liu Z, Ma Y. Micronuclei in 2-cell embryos show higher blastocyst formation rates on human embryonic development. Eur J Obstet Gynecol Reprod Biol 2024; 302:26-32. [PMID: 39213952 DOI: 10.1016/j.ejogrb.2024.08.039] [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: 12/19/2023] [Revised: 07/14/2024] [Accepted: 08/25/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Multinucleated blastomeres at the two-cell stage (2MNB) represent a frequently observed nuclear abnormality in early human embryos. This abnormality has been reported to significantly impact on the embryo's developmental potential to reach the blastocyst stage. However, our understanding of the embryo's developmental potential and the morphokinetics of 2MNB remains limited. This study investigates the influence of 2MNB and its subtypes on the blastocyst formation. STUDY DESIGN A non-interventional retrospective study was performed in the Reproductive Medical Center of the First Affiliated Hospital of Hainan Medical University, using a time-lapse incubator. The study involved the evaluation of 4416 embryos, including 628 multinucleated embryos, from 1521 intracytoplasmic sperm injection (ICSI) cycles conducted between October 2019 and October 2021. The morphokinetic characteristics of multinucleated embryos were analyzed. RESULTS The results show multinucleation was the most common abnormal mitotic event during embryo development (14.22 %) in 4416 embryos. A control group of 3210 developmentally normal embryos was used in the study. The multinucleated blastomeres caused a lower blastocyst rate (52.48 % VS 64.02 %) compared to the control group. Whereas, 2MNBcause a higher blastocyst rate thanthemat the 4-cell stage (4MNB) (58.89 % VS 43.64 %). 2MNB can be further be further divided into 2MNB1/2cell and 2MNB2/2cell based on one multinucleated blastomere or two multinucleated blastomere appeared. Time to pronuclei fading (tPNf) is significantly longer in 2MNB2/2cell compared to 2MNB1/2cell. Furthermore, the 2MNB1/2cell embryos were divided into four subgroups (Bi-: two nuclei with almost the same size, Micro-: two nuclei with varying sizes, Poly-: more than two nuclei with almost the same size, and Cluster-: more than two nuclei with varying sizes) based on the number of nuclei and relative size. The results show that the Bi- and Micro- groups had a significantly increased blastocyst rate. The Cluster-, and Poly- groups showed significantly delayed embryonic development compared to normal controls. Bi-group has significant delays at t3, t5, and t8 and the Micro-group had a significant delay only at t8. CONCLUSION 2MNB cause higher blastocyst rate than them at 4MNB. 2MNB1/2cell shows shorter tPNf compared to 2MNB2/2cell. Moreover, the Micro-, Bi- groups had a significantly increased blastocyst rate and different kinetic parameters compared to Cluster-, Poly-groups, suggesting that it is necessary to distinguish the nucleus status within 2MNB to increase the blastocyst rate. When selecting embryos for transformation from the 2MNB1/2cell, Micro- is the best choice.
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Affiliation(s)
- Yufei Yao
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Mingkun Wang
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Mian Liu
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Yu Zhang
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Zuxia Mi
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Jilong Mao
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Huaye Chen
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Yanhua Huang
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Yuanhua Huang
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Zheng Liu
- College of Medical Laboratory Science, Guilin Medical University, Guilin 541004, Guangxi, China.
| | - Yanlin Ma
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Provincial Clinical Research Center for Thalassemia, National Center for International Research, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China; Haikou Key Laboratory for Preservation of Human Genetic Resource, The Key Laboratory of Tropical Translational Medicine of Ministry of Education, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.
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Nuñez-Calonge R, Santamaria N, Rubio T, Manuel Moreno J. Making and Selecting the Best Embryo in In vitro Fertilization. Arch Med Res 2024; 55:103068. [PMID: 39191078 DOI: 10.1016/j.arcmed.2024.103068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/27/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024]
Abstract
Currently, most assisted reproduction units transfer a single embryo to avoid multiple pregnancies. Embryologists must select the embryo to be transferred from a cohort produced by a couple during a cycle. This selection process should be accurate, non-invasive, inexpensive, reproducible, and available to in vitro fertilization (IVF) laboratories worldwide. Embryo selection has evolved from static and morphological criteria to the use of morphokinetic embryonic characteristics using time-lapse systems and artificial intelligence, as well as the genetic study of embryos, both invasive with preimplantation genetic testing for aneuploidies (PGT-A) and non-invasive (niPGT-A). However, despite these advances in embryo selection methods, the overall success rate of IVF techniques remains between 25 and 30%. This review summarizes the different methods and evolution of embryo selection, their strengths and limitations, as well as future technologies that can improve patient outcomes in the shortest possible time. These methodologies are based on procedures that are applied at different stages of embryo development, from the oocyte to the cleavage and blastocyst stages, and can be used in laboratory routine.
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De Martin H, Bonetti TCS, Nissel CAZ, Gomes AP, Fujii MG, Monteleone PAA. Association of early cleavage, morula compaction and blastocysts ploidy of IVF embryos cultured in a time-lapse system and biopsied for genetic test for aneuploidy. Sci Rep 2024; 14:739. [PMID: 38185698 PMCID: PMC10772106 DOI: 10.1038/s41598-023-51087-z] [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: 06/01/2023] [Accepted: 12/30/2023] [Indexed: 01/09/2024] Open
Abstract
IVF embryos have historically been evaluated by morphological characteristics. The time-lapse system (TLS) has become a promising tool, providing an uninterrupted evaluation of morphological and dynamic parameters of embryo development. Furthermore, TLS sheds light on unknown phenomena such as direct cleavage and incomplete morula compaction. We retrospectively analyzed the morphology (Gardner Score) and morphokinetics (KIDScore) of 835 blastocysts grown in a TLS incubator (Embryoscope+), which were biopsied for preimplantation genetic testing for aneuploidy (PGT-A). Only the embryos that reached the blastocyst stage were included in this study and time-lapse videos were retrospectively reanalysed. According to the pattern of initial cleavages and morula compaction, the embryos were classified as: normal (NC) or abnormal (AC) cleavage, and fully (FCM) or partially compacted (PCM) morulae. No difference was found in early cleavage types or morula compaction patterns between female age groups (< 38, 38-40 and > 40 yo). Most of NC embryos resulted in FCM (≅ 60%), while no embryos with AC resulted in FCM. Aneuploidy rate of AC-PCM group did not differ from that of NC-FCM group in women < 38 yo, but aneuploidy was significantly higher in AC-PCM compared to NC-FCM of women > 40 yo. However, the quality of embryos was lower in AC-PCM blastocysts in women of all age ranges. Morphological and morphokinetic scores declined with increasing age, in the NC-PCM and AC-PCM groups, compared to the NC-FCM. Similar aneuploidy rates among NC-FCM and AC-PCM groups support the hypothesis that PCM in anomalous-cleaved embryos can represent a potential correction mechanism, even though lower morphological/morphokinetic scores are seen on AC-PCM. Therefore, both morphological and morphokinetic assessment should consider these embryonic development phenomena.
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Affiliation(s)
- H De Martin
- Centro de Reprodução Humana Monteleone, Rua Lima Barros, 61 Jardim Paulista, São Paulo, SP, CEP 04503-030, Brazil.
- Disciplina de Ginecologia-Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 255-10 Andar-Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil.
| | - T C S Bonetti
- Centro de Reprodução Humana Monteleone, Rua Lima Barros, 61 Jardim Paulista, São Paulo, SP, CEP 04503-030, Brazil
- Departamento de Ginecologia, Escola Paulista de Medicina - Universidade Federal de São Paulo, Rua Pedro de Toledo, 781. 4º andar. Vila Clementino, São Paulo, SP, 04039030, Brazil
| | - C A Z Nissel
- Centro de Reprodução Humana Monteleone, Rua Lima Barros, 61 Jardim Paulista, São Paulo, SP, CEP 04503-030, Brazil
- Disciplina de Ginecologia-Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 255-10 Andar-Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil
| | - A P Gomes
- Centro de Reprodução Humana Monteleone, Rua Lima Barros, 61 Jardim Paulista, São Paulo, SP, CEP 04503-030, Brazil
| | - M G Fujii
- Centro de Reprodução Humana Monteleone, Rua Lima Barros, 61 Jardim Paulista, São Paulo, SP, CEP 04503-030, Brazil
| | - P A A Monteleone
- Centro de Reprodução Humana Monteleone, Rua Lima Barros, 61 Jardim Paulista, São Paulo, SP, CEP 04503-030, Brazil
- Disciplina de Ginecologia-Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 255-10 Andar-Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil
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Garcia-Belda A, Cairó O, Martínez-Moro Á, Cuadros M, Pons MC, de Mendoza MVH, Delgado A, Rives N, Carrasco B, Cabello Y, Figueroa MJ, Cascales-Romero L, González-Soto B, Cuevas-Saiz I. Considerations for future modification of The Association for the Study of Reproductive Biology embryo grading system incorporating time-lapse observations. Reprod Biomed Online 2024; 48:103570. [PMID: 37952277 DOI: 10.1016/j.rbmo.2023.103570] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 11/14/2023]
Abstract
The Association for the Study of Reproductive Biology (ASEBIR) Interest Group in Embryology (in Spanish 'Grupo de Interés de Embriología') reviewed key morphokinetic parameters to assess the contribution of time-lapse technology (TLT) to the ASEBIR grading system. Embryo grading based on morphological characteristics is the most widely used method in human assisted reproduction laboratories. The introduction and implementation of TLT has provided a large amount of information that can be used as a complementary tool for morphological embryo evaluation and selection. As part of IVF treatments, embryologists grade embryos to decide which embryos to transfer or freeze. At the present, the embryo grading system developed by ASEBIR does not consider dynamic events observed through TLT. Laboratories that are using TLT consider those parameters as complementary data for embryo selection. The aim of this review was to evaluate review time-specific morphological changes during embryo development that are not included in the ASEBIR scoring system, and to consider them as candidates to add to the scoring system.
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Affiliation(s)
| | | | - Álvaro Martínez-Moro
- IVF Spain Madrid, Madrid, Spain.; Animal Reproduction Department, INIA-CSIC, Madrid, Spain
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Alhelou Y, Hamdan M, Razali N, Adenan N, Ali J. Novel image analyser-assisted morphometric methodology offer unique opportunity for selection of embryos with potential for implantation. BMC Pregnancy Childbirth 2023; 23:698. [PMID: 37770819 PMCID: PMC10538025 DOI: 10.1186/s12884-023-06025-2] [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: 03/23/2023] [Accepted: 09/23/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Previous studies looked into the connections between pregnancy and the Zona Pellucida (ZP) thickness and Zona Pellucida Thickness Variation (ZPTV), as well as the embryo's radius, circumference, perimeter and global symmetry. However, no research has linked embryo implantation and pregnancy to the percentage of ZP thinning, the reduction in ooplasm volume, and the increase in perivitelline space (PVS) volume. Our objective is to correlate the percentage of ZP thinning, the percentage of ooplasm volume shrinkage and the percentage of PVS increase to the implantation. These data will be used for embryo selection as well as it can be put into a software that will assist embryo selection. MATERIALS AND METHODS Retrospective study included 281 patients, all of them had 2 embryos transferred, 149 patients got pregnant with two gestation sacs and 132 patients did not get pregnant. All of the transferred embryos had the ZP thickness measured several times from time of ICSI till Embryo Transfer (ET), the ooplasm volume was calculated from time of ICSI till two Pronuclei (2PN) fading and the PVS was calculated from the ICSI time till the 2PN fading. RESULTS The first characteristic is the change in the average ZP thickness that decreased by 32.7% + 5.3% at 70 h for the implanted embryos (Group 1) versus 23.6% + 4.8% for non-implanted embryos (Group 2) p = 0.000. The second characteristic is the average reduction in the volume of the ooplasm which is 20.5% + 4.3% in Group 1 versus 15.1% + 5.2% in Group 2, p = 0.000. The third characteristic is the increase in the volume of the PVS which was 38.1% + 7.6% in Group 1 versus 31.6% + 9.7% in Group 2 p = 0.000. CONCLUSION The implanted embryos showed higher percent of ZP thinning, higher percent of ooplasm reduction and higher percent of PVS increase.
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Affiliation(s)
- Y Alhelou
- FAKIH IVF, Sh Haza Bin Zayed st, Abu Dhabi, United Arab Emirates.
- Department of Obstetrics and Gynaecology, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - M Hamdan
- Department of Obstetrics and Gynaecology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - N Razali
- Department of Obstetrics and Gynaecology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nam Adenan
- Department of Obstetrics and Gynaecology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - J Ali
- Department of Obstetrics and Gynaecology, Universiti Malaya, Kuala Lumpur, Malaysia
- IVF Department, Maternity and Children Hospital, Dammam, Saudi Arabia
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Herbert SL, Staib C, Wallner T, Löb S, Curtaz C, Schwab M, Wöckel A, Häusler S. Morphokinetic analysis of early human embryonic development and its relationship to endometriosis resection: a retrospective time-lapse study using the KIDScore™ D3 and D5 implantation data algorithm. Arch Gynecol Obstet 2023; 308:587-597. [PMID: 37179499 PMCID: PMC10293388 DOI: 10.1007/s00404-023-07008-6] [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: 09/01/2022] [Accepted: 03/13/2023] [Indexed: 05/15/2023]
Abstract
RESEARCH QUESTION Does complete resection of endometriosis improve embryo quality as assessed by morphokinetic parameters using time-lapse microscopy? DESIGN For this retrospective study we analysed 237 fertilised, cultured and transferred embryos from 128 fresh IVF and/ or ICSI transfer cycles. Endometriosis was confirmed or excluded by laparoscopy. Patients were stimulated with recombinant FSH using GnRH agonist and antagonist protocols. After fertilisation, a time-lapse incubation system was used for observation. Embryo quality was assessed using the KIDScore™ D3 and D5 implantation data algorithm. RESULTS The analysis showed a median KIDScore™ D5 of 2.6 (on a scale of 1 to 9.9) for embryos from patients with endometriosis without complete resection. The control group without endometriosis achieved a score of 6.8 (p = 0.003). The median score for embryos from endometriosis patients with complete resection was 7.2, which was a significant increase compared to embryos from patients without complete resection (p = 0.002). We observed an effect size of r = 0.4 for complete resection versus no resection of endometriosis using the KIDScore™ D5. There were no differences in KIDScore™ D3 between the three patient groups. Pregnancy and miscarriage rates showed the same clinical trends. In three of our four case series of patients who underwent IVF/ ICSI cycles before and after complete resection, we found a marked improvement in embryo quality after complete resection. CONCLUSIONS Complete resection of endometriosis could significantly improve the otherwise poor embryo quality of patients undergoing IVF-procedures. The data, therefore, strongly support recommending surgery to patients with endometriosis prior to assisted reproduction.
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Affiliation(s)
- Saskia-Laureen Herbert
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany.
| | - Claudia Staib
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Theresa Wallner
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Sanja Löb
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Carolin Curtaz
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Michael Schwab
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Sebastian Häusler
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
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Rauchfuss LK, Zhao Y, Walker D, Galantis T, Fredrickson J, Barud K, Shenoy C. Optimal Embryo Selection: The Irreplaceable Role of the Embryologist in an Age of Advancing Technology. J Hum Reprod Sci 2023; 16:227-232. [PMID: 38045503 PMCID: PMC10688284 DOI: 10.4103/jhrs.jhrs_98_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/26/2023] [Accepted: 09/07/2023] [Indexed: 12/05/2023] Open
Abstract
Background Time-lapse incubators allow for ongoing evaluation of embryos without culture condition disruption. The use of time-lapse incubation has been shown to improve outcomes either by improving overall conditions or providing additional information to aid in embryo selection for transfer. Time-lapse incubators can also utilise morphokinetic models to rank embryos based on morphokinetic parameters. We sought to compare a morphokinetic model for embryo comparison to traditional morphologic evaluation. Aims The aim of the study is to compare a morphokinetic model for embryo comparison to traditional morphologic evaluation. Settings and Design This is a retrospective cohort design. Materials and Methods Embryos cultured in a time-lapse culture system that had traditional morphologic evaluation, morphokinetic modelling and known live birth outcomes were included in this study. Embryos with unknown competence were excluded, including when two embryos were transferred with a single live birth resulted. Statistical Analysis Used Receiver operating characteristic (ROC) curves were determined for both the morphologic analysis and the morphokinetic model on culture day 3 and day 5. Using the ROC-determined cutoff that optimised both sensitivity and specificity, a binary outcome for each test was analysed using agreement statistics to determine if one method of embryo evaluation was superior to the other. Results Morphological and morphokinetic grading were both predictive of embryo competence on days 3 and 5. However, on day 3, morphologic grading was superior to morphokinetic grading with area under the curve (AUC) of 0.66 (P < 0.001) and 0.58 (P = 0.009), respectively. Contrarily, on day 5, the morphokinetic model had a higher AUC of 0.65 (P = 0.03) compared to the morphologic grading, AUC 0.56 (P = 0.02). Conclusion Traditional morphology was noted to be a better diagnostic tool (higher AUC) on culture day 3 while a morphokinetic model was superior on day 5.
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Al Smadi MA, Hammadeh ME, Batiha O, Al Sharu E, Altalib MM, Jahmani MY, Mahdy A, Amor H. Elevated seminal protein carbonyl concentration is correlated with asthenozoospermia and affects adversely the laboratory intracytoplasmic sperm injection (ICSI) outcomes. Andrologia 2021; 53:e14232. [PMID: 34449913 DOI: 10.1111/and.14232] [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: 04/14/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/27/2022] Open
Abstract
Elevated concentrations of reactive oxygen species (ROS) in the semen can lead to oxidative protein damage as they react with the amino acids' side chains in the protein, leading to the generation of carbonyl groups. This study aimed to investigate the effect of protein carbonyl (PC) concentration on sperm motility and the laboratory intracytoplasmic sperm injection (ICSI) outcomes. A total of 150 couples from the ICSI cycle were enrolled in this study and were divided into three groups (G) according to the PC concentration as following, G1 included samples with PC concentrations <0.65 nmol/mg, G2 included samples with 0.65≤PC≤2.23 nmol/mg and G3 included samples with PC>2.23 (nmol/mg). PC concentrations were measured in all semen samples, and the laboratory ICSI outcomes were evaluated for all injected oocytes. The Kruskal-Wallis p-values for the differences in the medians of sperm motility, fertilisation rate, embryo cleavage score and embryo quality score were <0.05. Furthermore, Dunn's post hoc test showed a significant difference between all groups, p-values <0.05, except for the medians of embryo quality score between G2 and G3. In conclusion, our results showed that sperm motility and laboratory ICSI outcomes are affected negatively by higher concentrations of PC in the semen.
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Affiliation(s)
- Mohammad A Al Smadi
- Department of Obstetrics & Gynecology, Reproductive Medicine Unit, Saarland University, Homburg, Germany
| | - Mohamad Eid Hammadeh
- Department of Obstetrics & Gynecology, Reproductive Medicine Unit, Saarland University, Homburg, Germany
| | - Osamah Batiha
- Department of Biotechnology & Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Emad Al Sharu
- Reproductive Endocrinology and IVF Unit, King Hussein Medical Center, Amman, Jordan
| | | | | | - Ahmed Mahdy
- Department of Internal Medicine V, Pneumology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany
| | - Houda Amor
- Department of Obstetrics & Gynecology, Reproductive Medicine Unit, Saarland University, Homburg, Germany
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Firmin J, Maître JL. Morphogenesis of the human preimplantation embryo: bringing mechanics to the clinics. Semin Cell Dev Biol 2021; 120:22-31. [PMID: 34253437 DOI: 10.1016/j.semcdb.2021.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/15/2021] [Accepted: 07/01/2021] [Indexed: 12/19/2022]
Abstract
During preimplantation development, the human embryo forms the blastocyst, the structure enabling uterine implantation. The blastocyst consists of an epithelial envelope, the trophectoderm, encompassing a fluid-filled lumen, the blastocoel, and a cluster of pluripotent stem cells, the inner cell mass. This specific architecture is crucial for the implantation and further development of the human embryo. Furthermore, the morphology of the human embryo is a prime determinant for clinicians to assess the implantation potential of in vitro fertilized human embryos, which constitutes a key aspect of assisted reproduction technology. Therefore, it is crucial to understand how the human embryo builds the blastocyst. As any material, the human embryo changes shape under the action of forces. Here, we review recent advances in our understanding of the mechanical forces shaping the blastocyst. We discuss the cellular processes responsible for generating morphogenetic forces that were studied mostly in the mouse and review the literature on human embryos to see which of them may be conserved. Based on the specific morphological defects commonly observed in clinics during human preimplantation development, we discuss how mechanical forces and their underlying cellular processes may be affected. Together, we propose that bringing tissue mechanics to the clinics will advance our understanding of human preimplantation development, as well as our ability to help infertile couples to have babies.
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Affiliation(s)
- Julie Firmin
- Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR3215, INSERM, U934 Paris, France
| | - Jean-Léon Maître
- Institut Curie, PSL Research University, Sorbonne Université, CNRS UMR3215, INSERM, U934 Paris, France.
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Zhang Q, Ji H, Shi J, Wang L, Ding L, Jiang Y, Huang X, Qiu P, Li P. Digital PCR Detection of mtDNA/gDNA Ratio in Embryo Culture Medium for Prediction of Embryo Development Potential. Pharmgenomics Pers Med 2021; 14:521-531. [PMID: 33958889 PMCID: PMC8096441 DOI: 10.2147/pgpm.s304747] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/06/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The ratio of mitochondrial DNA to genomic DNA (mtDNA/gDNA) in embryo culture medium as a predictor of embryonic development is a new method of noninvasive embryo screening. However, current tests based on this concept have proven inconsistent. The aim of this study was to define the predictive value of the ratio of mtDNA/gDNA for embryonic developmental potential. MATERIALS AND METHODS We used digital PCR to measure mtDNA/gDNA ratios in day 3 culture media of 223 embryos from 56 patients. We compared the relationship between the predictive value of mtDNA/gDNA ratio and each of embryo fragmentation, embryo morphological grade, and blastocyst formation. RESULTS mtDNA/gDNA ratio decreased significantly with a decrease in embryo rating: 22.54 (44.66); 31.25 (36.97) and 46.33 (57.11); Grades A vs C, P = 0.006; B vs C, P = 0.015. mtDNA/gDNA ratio increased overall with an increase in embryo fragment content but did not differ significantly between high-, -medium, and poor-quality embryos. Interestingly, this trend differed from that of the unformed blastocysts. mtDNA/gDNA ratio of cleavage stage embryos forming blastocysts was lower (P=0.005). Trends of mtDNA/gDNA ratio differed according to inner cell mass (ICM) and trophectoderm (TE) levels, but not significantly. mtDNA/gDNA ratio in day 3 culture medium was not significantly improved over morphological scores. CONCLUSION We hereby show the correlation of mtDNA/gDNA ratio in the culture medium of developing embryos. The correlation between the mtDNA/gDNA ratio and early embryonic development was controversial. Furthermore, an increase in mtDNA/gDNA ratio might indicate reduced development potential, but the difference remains insufficient for application as a clinical predictor.
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Affiliation(s)
- Qing Zhang
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Hong Ji
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Jian Shi
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Longmei Wang
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Lu Ding
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Yufei Jiang
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Xianjing Huang
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Pingping Qiu
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
| | - Ping Li
- Department of Reproductive Medicine, Women and Children’s Hospital Affiliated to Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, People’s Republic of China
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11
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Shang YL, Zhu FX, Yan J, Chen L, Tang WH, Xiao S, Mo WK, Zhang ZG, He XJ, Qiao J, Cao YX, Li W. Novel DPY19L2 variants in globozoospermic patients and the overcoming this male infertility. Asian J Androl 2020; 21:183-189. [PMID: 30333325 PMCID: PMC6413555 DOI: 10.4103/aja.aja_79_18] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Globozoospermia has been reported to be a rare but severe causation of male infertility, which results from the failure of acrosome biogenesis and sperm head shaping. Variants of dpy-19-like 2 (DPY19L2) are highly related to globozoospermia, but related investigations have been mainly performed in patients from Western countries. Here, we performed a screening of DPY19L2 variants in a cohort of Chinese globozoospermic patients and found that five of nine patients carried DPY19L2 deletions and the other four patients contained novel DPY19L2 point mutations, as revealed by whole-exome sequencing. Patient 3 (P3) contained a heterozygous variant (c.2126+5G>A), P6 contained a homozygous nonsense mutation (c.1720C>T, p.Arg574*), P8 contained compound heterozygous variants (c.1182-1184delATC, p.Leu394_Ser395delinsPhe; c.368A>T, p.His123Arg), and P9 contained a heterozygous variant (c.1182-1184delATCTT, frameshift). We also reported intracytoplasmic sperm injection (ICSI) outcomes in the related patients, finding that ICSI followed by assisted oocyte activation (AOA) with calcium ionophore achieved high rates of live births. In summary, the infertility of these patients results from DPY19L2 dysfunction and can be treated by ICSI together with AOA.
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Affiliation(s)
- Yong-Liang Shang
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Fu-Xi Zhu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei 230022, China
| | - Jie Yan
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Liang Chen
- Medical Center of Reproductive and Genetics, Peking University First Hospital, Beijing 100034, China
| | - Wen-Hao Tang
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Sai Xiao
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Wei-Ke Mo
- Digital China Health Technologies Co., Ltd., Beijing 100080, China
| | - Zhi-Guo Zhang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei 230022, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei 230022, China
| | - Xiao-Jin He
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei 230022, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei 230022, China
| | - Jie Qiao
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Yun-Xia Cao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei 230022, China
| | - Wei Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
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12
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Abreu CM, Thomas V, Knaggs P, Bunkheila A, Cruz A, Teixeira SR, Alpuim P, Francis LW, Gebril A, Ibrahim A, Margarit L, Gonzalez D, Freitas PP, Conlan RS, Mendes Pinto I. Non-invasive molecular assessment of human embryo development and implantation potential. Biosens Bioelectron 2020; 157:112144. [PMID: 32250927 DOI: 10.1016/j.bios.2020.112144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 12/25/2022]
Abstract
In vitro fertilization (IVF) is the most common assisted reproductive technology used to treat infertility. Embryo selection for transfer in IVF cycles relies on the morphological evaluation by embryologists, either by conventional microscopic assessment or more recently by time-lapse imaging systems. Despite the introduction of time-lapse imaging improvements in IVF success rates have failed to materialize, therefore alternative approaches are needed. Recent studies have shown that embryos resulting in successful pregnancy differ in their secretome and metabolism compared to embryos that fail to implant, suggesting that molecular analysis of embryo culture medium could assist in non-invasive single embryo selection. However, this approach has yet to be adopted clinically due to the lack of appropriate highly sensitive screening technologies needed to assess volume-limited samples. Here we report the detection of hCGβ, IL-8 and TNFα from conditioned culture media of single human embryos using electrochemical impedance spectroscopy. The impedimetric immunosensors revealed that morphologically non-viable embryos produce higher levels of IL-8 and TNFα, associated with abnormal cell division and cell death, respectively. More importantly, hCGβ detection was able to discriminate apparently morphologically identical viable embryos. This work brings an objective dimension to embryo selection, which could overcome the major limitations of morphology-based embryo selection for implantation. Future work should include the validation of these biomarkers in a large patient cohort.
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Affiliation(s)
- Catarina M Abreu
- International Iberian Nanotechnology Laboratory (INL), Avenida Mestre José Veiga, 4715-330, Braga, Portugal; Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, UK; Centre for NanoHealth, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Victoria Thomas
- Wales Fertility Institute Neath, Neath Port Talbot Hospital, Swansea Bay University Health Board, Port Talbot, SA12 7BX, UK
| | - Paul Knaggs
- Wales Fertility Institute Neath, Neath Port Talbot Hospital, Swansea Bay University Health Board, Port Talbot, SA12 7BX, UK
| | - Adnan Bunkheila
- Singleton Hospital, Swansea Bay University Health Board, Sketty Lane, Swansea, SA2 8QA, UK
| | - Andrea Cruz
- International Iberian Nanotechnology Laboratory (INL), Avenida Mestre José Veiga, 4715-330, Braga, Portugal
| | - Sofia R Teixeira
- International Iberian Nanotechnology Laboratory (INL), Avenida Mestre José Veiga, 4715-330, Braga, Portugal; Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, UK; Centre for NanoHealth, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Pedro Alpuim
- International Iberian Nanotechnology Laboratory (INL), Avenida Mestre José Veiga, 4715-330, Braga, Portugal
| | - Lewis W Francis
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, UK; Centre for NanoHealth, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Amr Gebril
- Wales Fertility Institute Neath, Neath Port Talbot Hospital, Swansea Bay University Health Board, Port Talbot, SA12 7BX, UK
| | - Ahmed Ibrahim
- Wales Fertility Institute Neath, Neath Port Talbot Hospital, Swansea Bay University Health Board, Port Talbot, SA12 7BX, UK
| | - Lavinia Margarit
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, UK; Princess of Wales Hospital, Cwm Taf Morgannwg University Health Board, Coity Road, Bridgend, CF31 1RQ, UK
| | - Deyarina Gonzalez
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, UK; Centre for NanoHealth, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Paulo P Freitas
- International Iberian Nanotechnology Laboratory (INL), Avenida Mestre José Veiga, 4715-330, Braga, Portugal
| | - R Steven Conlan
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, UK; Centre for NanoHealth, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Inês Mendes Pinto
- International Iberian Nanotechnology Laboratory (INL), Avenida Mestre José Veiga, 4715-330, Braga, Portugal.
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13
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Vuong LN, Pham TD, Huynh BG, Nguyen QN, Ho TM, Norman RJ, Mol BW. Live Birth Rate After Transfer of Fresh or Frozen Poor Quality Day-3 Embryos Only. FERTILITY & REPRODUCTION 2019. [DOI: 10.1142/s266131821950018x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Embryo quality is an important predictor of successful outcome in in vitro fertilization (IVF). However, current knowledge on the live birth rate after transfer of poor quality embryos is limited. This study investigated the live birth rate after transfer of only poor quality day-3 embryos in women undergoing IVF. Methods: This retrospective study included 153 couples who underwent IVF at IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam between June 2014 and January 2017 and had only poor quality day-3 embryos available for fresh (n [Formula: see text] 102) or frozen (n [Formula: see text] 51) transfer. The control group included patients who had transfer of one good embryo (n [Formula: see text] 64). Embryos were rated using the Istanbul criteria. Results: In the poor quality embryo group, the mean number of oocytes retrieved and number of embryos were 7.5 ± 4.4 and 1.8 ± 0.9, respectively. Mean number of embryos transferred was 1.6 ± 0.5 in the fresh transfer group and 2.0 ± 0.2 in the freeze-only group. Live births did occur after transfer of poor quality embryos, but the implantation, clinical pregnancy and live birth rates were significantly lower than after fresh or frozen transfer of a single good quality embryo (9.5 vs. 26.6%, p < 0.001; 13.7 vs. 26.6%, p < 0.001; and 7.2 vs. 18.8%, p [Formula: see text] 0.02, respectively). Conclusions: Live birth was achieved after transfer of only poor quality embryos in women undergoing IVF. This suggests that transfer of poor quality embryos could be an option when higher grade embryos are not available, after the chances of live birth have been discussed with the patient.
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Affiliation(s)
- Lan N. Vuong
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Toan D. Pham
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Bao G. Huynh
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | | | - Tuong M. Ho
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | | | - Ben W. Mol
- Department of Obstetrics and Gynaecology, School of Medicine, Monash University, Melbourne, Australia
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14
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Magata F, Ideta A, Okubo H, Matsuda F, Urakawa M, Oono Y. Growth potential of bovine embryos presenting abnormal cleavage observed through time lapse cinematography. Theriogenology 2019; 133:119-124. [PMID: 31085381 DOI: 10.1016/j.theriogenology.2019.04.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/01/2019] [Accepted: 04/26/2019] [Indexed: 12/01/2022]
Abstract
Time-lapse monitoring (TLM) has emerged as a novel technology for the continuous and noninvasive evaluation of embryos. TLM has revealed the prevalence of specific dysmorphisms such as abnormal development during the early-cleavage stage of embryos. However, little information is available on the prevalence and consequences of abnormal cleavage in bovine embryos. Hence, this study aimed to investigate growth potential of bovine embryos presenting abnormal cleavage, such as reverse cleavage (RC), direct cleavage (DC), and irregular and unsmooth ruffling of the oolema membrane (ruffling). Bovine embryos derived through in vitro fertilization (IVF) were cultured in the microwell culture dishes, and the kinetics of in vitro development were observed through TLM at 20-min intervals for 10 d. Approximately 36% of embryos that developed into a blastocyst presented abnormal cleavage. Morphokinetic evaluations revealed that RC, DC, and ruffling embryos showed slower development compared to embryos with normal cleavage (P < 0.01). Embryos with RC and DC, but not ruffling, revealed impaired hatchability (P < 0.05) with increased collapses of the blastocyst cavity until hatching (P < 0.0001). Moreover, the RC and DC embryos presented increased chromosomal aneuploidy (P < 0.05). These results suggest a compromised viability of embryos with RC and DC. This is the first report that clarified the effect of abnormal cleavage on the morphokinetics and growth potential of bovine IVF embryos. Results indicate that the kinetic evaluation of bovine embryos using the time-lapse imaging system will be beneficial for selecting embryos with a high viability.
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Affiliation(s)
- F Magata
- Research and Development Group, Zen-noh Embryo Transfer Center, Kamishihoro, Hokkaido, Japan; Department of Veterinary Medical Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - A Ideta
- Research and Development Group, Zen-noh Embryo Transfer Center, Kamishihoro, Hokkaido, Japan
| | - H Okubo
- Research and Development Group, Zen-noh Embryo Transfer Center, Kamishihoro, Hokkaido, Japan
| | - F Matsuda
- Department of Veterinary Medical Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - M Urakawa
- Research and Development Group, Zen-noh Embryo Transfer Center, Kamishihoro, Hokkaido, Japan
| | - Y Oono
- Research and Development Group, Zen-noh Embryo Transfer Center, Kamishihoro, Hokkaido, Japan
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15
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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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16
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Simopoulou M, Sfakianoudis K, Antoniou N, Maziotis E, Rapani A, Bakas P, Anifandis G, Kalampokas T, Bolaris S, Pantou A, Pantos K, Koutsilieris M. Making IVF more effective through the evolution of prediction models: is prognosis the missing piece of the puzzle? Syst Biol Reprod Med 2018; 64:305-323. [PMID: 30088950 DOI: 10.1080/19396368.2018.1504347] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Assisted reproductive technology has evolved tremendously since the emergence of in vitro fertilization (IVF). In the course of the recent decade, there have been significant efforts in order to minimize multiple gestations, while improving percentages of singleton pregnancies and offering individualized services in IVF, in line with the trend of personalized medicine. Patients as well as clinicians and the entire IVF team benefit majorly from 'knowing what to expect' from an IVF cycle. Hereby, the question that has emerged is to what extent prognosis could facilitate toward the achievement of the above goal. In the current review, we present prediction models based on patients' characteristics and IVF data, as well as models based on embryo morphology and biomarkers during culture shaping a complication free and cost-effective personalized treatment. The starting point for the implementation of prediction models was initiated by the aspiration of moving toward optimal practice. Thus, prediction models could serve as useful tools that could safely set the expectations involved during this journey guiding and making IVF treatment more effective. The aim and scope of this review is to thoroughly present the evolution and contribution of prediction models toward an efficient IVF treatment. ABBREVIATIONS IVF: In vitro fertilization; ART: assisted reproduction techniques; BMI: body mass index; OHSS: ovarian hyperstimulation syndrome; eSET: elective single embryo transfer; ESHRE: European Society of Human Reproduction and Embryology; mtDNA: mitochondrial DNA; nDNA: nuclear DNA; ICSI: intracytoplasmic sperm injection; MBR: multiple birth rates; LBR: live birth rates; SART: Society for Assisted Reproductive Technology Clinic Outcome Reporting System; AFC: antral follicle count; GnRH: gonadotrophin releasing hormone; FSH: follicle stimulating hormone; LH: luteinizing hormone; AMH: anti-Müllerian hormone; DHEA: dehydroepiandrosterone; PCOS: polycystic ovarian syndrome; NPCOS: non-polycystic ovarian syndrome; CE: cost-effectiveness; CC: clomiphene citrate; ORT: ovarian reserve test; EU: embryo-uterus; DET: double embryo transfer; CES: Cumulative Embryo Score; GES: Graduated Embryo Score; CSS: Combined Scoring System; MSEQ: Mean Score of Embryo Quality; IMC: integrated morphology cleavage; EFNB2: ephrin-B2; CAMK1D: calcium/calmodulin-dependent protein kinase 1D; GSTA4: glutathione S-transferase alpha 4; GSR: glutathione reductase; PGR: progesterone receptor; AMHR2: anti-Müllerian hormone receptor 2; LIF: leukemia inhibitory factor; sHLA-G: soluble human leukocyte antigen G.
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Affiliation(s)
- Mara Simopoulou
- a Department of Physiology , Medical School, National and Kapodistrian University of Athens , Athens , Greece.,b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | | | - Nikolaos Antoniou
- a Department of Physiology , Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Evangelos Maziotis
- a Department of Physiology , Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Anna Rapani
- a Department of Physiology , Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Panagiotis Bakas
- b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - George Anifandis
- d Department of Histology and Embryology, Faculty of Medicine , University of Thessaly , Larissa , Greece
| | - Theodoros Kalampokas
- b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Stamatis Bolaris
- e Department fo Obsterics and Gynaecology , Assisted Conception Unit, General-Maternity District Hospital "Elena Venizelou" , Athens , Greece
| | - Agni Pantou
- c Department of Assisted Conception , Human Reproduction Genesis Athens Clinic , Athens , Greece
| | - Konstantinos Pantos
- c Department of Assisted Conception , Human Reproduction Genesis Athens Clinic , Athens , Greece
| | - Michael Koutsilieris
- a Department of Physiology , Medical School, National and Kapodistrian University of Athens , Athens , Greece
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17
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Viñals Gonzalez X, Odia R, Cawood S, Gaunt M, Saab W, Seshadri S, Serhal P. Contraction behaviour reduces embryo competence in high-quality euploid blastocysts. J Assist Reprod Genet 2018; 35:1509-1517. [PMID: 29980895 DOI: 10.1007/s10815-018-1246-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/20/2018] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of the study is to investigate how blastocyst contraction behaviour affects the reproductive competence in high-quality euploid embryos. METHODS Eight hundred ninety-six high-quality blastocysts derived from 190 patients (mean age 38.05 (SD = 2.9) years) who underwent preimplantation genetic testing for aneuploidies (PGT-A) from January 2016 to October 2017 were included in this study. PGT-A results were reported as euploid or aneuploid. Aneuploid embryos were sub-classified into three categories: monosomy, trisomy and complex aneuploid. Retrospective studies of time-lapse monitoring (TLM) of those embryos were analysed and reproductive outcome of transferred embryos was collected. RESULTS A total of 234/896 were euploid (26.1%) whilst 662/896 (73.9%) blastocysts were proven to be aneuploid from which 116 (17.6%) presented monosomies, 136 (20.5%) trisomies and 410 (61.9%) were complex aneuploid. The most frequent chromosomal complements were trisomies affecting chromosome 21 and monosomies involving chromosomes 16 and 22. Data analysis showed a statistical difference in the number of contractions being reported greater in aneuploid when compared to euploid embryos (0.6 vs 1.57; p < 0.001). Analysis of the aneuploid embryos showed that monosomies present less number of contractions when compared to embryos affected with trisomies or complex aneuploidies (1.23 vs 1.53 and 1.40; p < 0.05). No difference was observed when comparing the latter two groups. Euploid embryos presenting at least one contraction resulted in lower implantation and clinical pregnancy rates when compared to blastocysts that do not display this event (47.6 vs 78.5% and 40.0 vs 59.0% respectively). CONCLUSIONS Most aneuploid blastocysts diagnosed by PGT-A have complex aneuploidies, showing that aneuploid embryos can develop after genomic activation and reaching high morphological scores. It becomes clear that embryo contraction, despite being a physiological feature during blastulation, is conditioned by the ploidy status of the embryo. Furthermore, the presence of contractions may compromise implantation rates.
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Affiliation(s)
- Xavier Viñals Gonzalez
- Embryology Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St., London, W1W 5QS, UK.
| | - Rabi Odia
- Embryology Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St., London, W1W 5QS, UK
| | - Suzanne Cawood
- Embryology Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St., London, W1W 5QS, UK
| | - Matthew Gaunt
- Embryology Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St., London, W1W 5QS, UK
| | - Wael Saab
- Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St., London, W1W 5QS, UK
| | - Svidrya Seshadri
- Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St., London, W1W 5QS, UK
| | - Paul Serhal
- Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St., London, W1W 5QS, UK
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Goto K, Kumasako Y, Koike M, Kanda A, Kido K, Nagaki M, Otsu E, Kawabe F, Kai Y, Utsunomiya T. Prediction of the in vitro developmental competence of early-cleavage-stage human embryos with time-lapse imaging and oxygen consumption rate measurement. Reprod Med Biol 2018; 17:289-296. [PMID: 30013431 PMCID: PMC6046524 DOI: 10.1002/rmb2.12104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/27/2018] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To assess an embryo's ability to develop into a good-quality blastocyst during the early-cleavage stage using time-lapse imaging and the oxygen consumption rate. METHODS In total, 942 zygotes had their oxygen consumption rates measured. In total, 282 zygotes were assessed by using time-lapse imaging. In total, 121 zygotes were examined by using both their oxygen consumption rate and time-lapse imaging. RESULTS The embryos with moderate respiration rates of between 0.41 and 0.61 (×1014/mol s-1) on day 3 had a 22.1% chance of becoming good-quality blastocysts; those outside that range had a 14.3% chance. With the time-lapse system, when the first division was within 24 hours, 22.3% of the embryos grew to good blastocysts. After 24 hours, the rate dropped to 8.6%. The intervals between two consecutive cleavages were calculated and the duration of the second cell cycle was defined. When the time was between nine hours and 13 hours, there was a higher rate of good blastocysts. Regarding both criteria, when the embryos had progressed in the optimal range, a high percentage of them had become good blastocysts; it was 8.0% outside of that range. CONCLUSION Individual embryos with the potential to develop into good-quality blastocysts could be selected at day 3 of culture using these systems.
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Setti AS, Figueira RCS, Braga DPDAF, Iaconelli A, Borges E. Blastomere nucleation: Predictive factors and influence of blastomere with no apparent nuclei on blastocyst development and implantation. JBRA Assist Reprod 2018; 22:102-107. [PMID: 29701942 PMCID: PMC5982554 DOI: 10.5935/1518-0557.20180028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To investigate whether embryos presenting blastomere(s) with no apparent nucleus (BNAN) on days 2 and 3 are more likely to fail to develop into blastocysts, hatch and implant. METHODS A total of 5705 zygotes obtained from 743 intracytoplasmic sperm injection (ICSI) cycles were analyzed. The presence and incidence of BNAN on days 2 and 3 of embryo development were recorded and then associated with ICSI outcomes. RESULTS The occurrence of BNAN on day 2 of embryo development was determinant to the decreased odds of blastocyst formation (OR: 0.57, CI: 0.50-0.65), quality (OR: 0.56, CI: 0.43-0.73) and hatching status (OR: 0.66, CI: 0.50-0.87). The presence of BNAN on day 3 of embryo development was determinant to the decreased odds of blastocyst formation (OR: 0.67, CI: 0.58-0.78) and hatching status (OR: 0.61, CI: 0.45-0.83). The occurrence of BNAN on day 2 of embryo development was determinant to the decreased odds of blastocyst implantation (OR: 0.50, CI: 0.27-0.94). CONCLUSION The presence of BNAN on day 2 or day 3 reduces development to blastocyst stage, hatching and implantation. Careful nuclear observation, taking into account the absence of blastomere nucleus, should be part of the strategies used for embryo selection.
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Affiliation(s)
- Amanda Souza Setti
- Fertility Medical Group, São Paulo - SP, Brazil.,Instituto Sapientiae- Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo - SP, Brazil
| | | | - Daniela Paes de Almeida Ferreira Braga
- Fertility Medical Group, São Paulo - SP, Brazil.,Instituto Sapientiae- Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo - SP, Brazil
| | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo - SP, Brazil.,Instituto Sapientiae- Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo - SP, Brazil
| | - Edson Borges
- Fertility Medical Group, São Paulo - SP, Brazil.,Instituto Sapientiae- Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo - SP, Brazil
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20
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Alhelou Y, Mat Adenan NA, Ali J. Embryo culture conditions are significantly improved during uninterrupted incubation: A randomized controlled trial. Reprod Biol 2017; 18:40-45. [PMID: 29279181 DOI: 10.1016/j.repbio.2017.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
A parallel group superiority prospective randomised controlled trial was devised to compare the culture characteristics of human pre-implantation stage embryos during uninterrupted culture in a time lapse incubator (TLI) versus the conventional model of interrupted culture in a standard incubator (SI) under low oxygen tension using a single step medium. 221 patients aged 35-and-under, 124 patients aged between 36 and 39 and 86 patients aged 40-and-over years were randomised and cultured either in a SI or in a TLI. Patients in the three age groups were distributed between the TLI and SI in a 1:1 ratio. The development of embryos on days 2, 3 and 5, and the clinical pregnancy and implantation rates were recorded. The fertilisation rate, development of day 2 and clinical pregnancy rates were similar in both treatments but the 8-cell development rate in all age groups combined (p = 0.016), blastocyst development rate (p = 0.0022) and the implantation rate (p = 0.0022) was significantly higher for the uninterrupted culture. These findings demonstrated significant differences between the two incubation groups. It also indicated less efficacious embryonic development with age in both treatments which appeared more pronounced in the conventional incubator. In conclusion uninterrupted culture is superior compared to the interrupted incubation culture system.
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Affiliation(s)
- Yousef Alhelou
- Fakih IVF, Sh Haza Bin Zayed st, Abu Dhabi, United Arab Emirates; IVF Lab, Deparment of Obstetrics and Gynaecology, KKWK, UMMC, Faculty of Medicine, University of Malaya, K. Lumpur, Malaysia
| | - Noor Azmi Mat Adenan
- IVF Lab, Deparment of Obstetrics and Gynaecology, KKWK, UMMC, Faculty of Medicine, University of Malaya, K. Lumpur, Malaysia
| | - Jaffar Ali
- IVF Lab, Deparment of Obstetrics and Gynaecology, KKWK, UMMC, Faculty of Medicine, University of Malaya, K. Lumpur, Malaysia.
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21
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Pribenszky C, Nilselid AM, Montag M. Time-lapse culture with morphokinetic embryo selection improves pregnancy and live birth chances and reduces early pregnancy loss: a meta-analysis. Reprod Biomed Online 2017; 35:511-520. [DOI: 10.1016/j.rbmo.2017.06.022] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/30/2017] [Accepted: 06/30/2017] [Indexed: 11/30/2022]
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22
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Carrasco B, Arroyo G, Gil Y, Gómez MJ, Rodríguez I, Barri PN, Veiga A, Boada M. Selecting embryos with the highest implantation potential using data mining and decision tree based on classical embryo morphology and morphokinetics. J Assist Reprod Genet 2017; 34:983-990. [PMID: 28573526 DOI: 10.1007/s10815-017-0955-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/15/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The objective of this work was to determine which embryonic morphokinetic parameters up to D3 of in vitro development have predictive value for implantation for the selection of embryos for transfer in clinical practice based upon information generated from embryo transfers with known implantation data (KID). METHODS A total of 800 KID embryos (100% implantation rate (IR) per transfer and 0% IR per transfer) cultured in an incubator with Time-Lapse system were retrospectively analysed. Of them, 140 embryos implanted, whereas 660 did not. RESULTS The analysis of morphokinetic parameters, together with the embryo morphology assessment on D3, enabled us to develop a hierarchical model that places the classical morphological score, the t4 and t8 morphokinetic values, as the variables with the best prognosis of implantation. CONCLUSION In our decision tree, the classical morphological score is the most predictive parameter. Among embryos with better morphological scores, morphokinetics permits deselection of embryos with the lowest implantation potential.
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Affiliation(s)
- Beatriz Carrasco
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain.
| | - Gemma Arroyo
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain
| | - Yolanda Gil
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain
| | - Mª José Gómez
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain
| | - Ignacio Rodríguez
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain
| | - Pedro N Barri
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain
| | - Anna Veiga
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain
- Banc de Línies Cel.lulars, Centre de Medicina Regenerativa de Barcelona CMR[B], Dr. Aiguader, 22, 08003, Barcelona, Spain
| | - Montserrat Boada
- Department of Obstetrics, Gynaecology and Reproduction, Instituto Universitario Dexeus, Gran Vía Carles III, 71-75, 08028, Barcelona, Spain
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23
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Gatimel N, Ladj M, Teston C, Lesourd F, Fajau C, Cohade C, Parinaud J, Léandri RD. How many embryos should be transferred? A validated score to predict ongoing implantation rate. Eur J Obstet Gynecol Reprod Biol 2017; 212:30-36. [DOI: 10.1016/j.ejogrb.2017.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 11/23/2016] [Accepted: 03/07/2017] [Indexed: 10/20/2022]
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24
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Kirkegaard K, Dyrlund TF, Ingerslev HJ. Clinical Application of Methods to Select In VitroFertilized Embryos. Hum Reprod 2016. [DOI: 10.1002/9781118849613.ch7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kirstine Kirkegaard
- Department of Medical Biochemistry; Aarhus University Hospital; Aarhus Denmark
| | - Thomas F. Dyrlund
- Department of Molecular Biology and Genetics; Aarhus University; Aarhus Denmark
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25
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Schatten H, Sun QY. Cytoskeletal Functions, Defects, and Dysfunctions Affecting Human Fertilization and Embryo Development. Hum Reprod 2016. [DOI: 10.1002/9781118849613.ch10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Heide Schatten
- Department of Veterinary Pathobiology; University of Missouri; Columbia MO USA
| | - Qing-Yuan Sun
- State Key Laboratory of Reproductive Biology, Institute of Zoology; Chinese Academy of Sciences; Beijing China
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26
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Aparicio-Ruiz B, Basile N, Pérez Albalá S, Bronet F, Remohí J, Meseguer M. Automatic time-lapse instrument is superior to single-point morphology observation for selecting viable embryos: retrospective study in oocyte donation. Fertil Steril 2016; 106:1379-1385.e10. [DOI: 10.1016/j.fertnstert.2016.07.1117] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/18/2016] [Accepted: 07/26/2016] [Indexed: 01/23/2023]
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Petersen BM, Boel M, Montag M, Gardner DK. Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on Day 3. Hum Reprod 2016; 31:2231-44. [PMID: 27609980 PMCID: PMC5027927 DOI: 10.1093/humrep/dew188] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 06/29/2016] [Indexed: 12/19/2022] Open
Abstract
STUDY QUESTION Can a generally applicable morphokinetic algorithm suitable for Day 3 transfers of time-lapse monitored embryos originating from different culture conditions and fertilization methods be developed for the purpose of supporting the embryologist's decision on which embryo to transfer back to the patient in assisted reproduction? SUMMARY ANSWER The algorithm presented here can be used independently of culture conditions and fertilization method and provides predictive power not surpassed by other published algorithms for ranking embryos according to their blastocyst formation potential. WHAT IS KNOWN ALREADY Generally applicable algorithms have so far been developed only for predicting blastocyst formation. A number of clinics have reported validated implantation prediction algorithms, which have been developed based on clinic-specific culture conditions and clinical environment. However, a generally applicable embryo evaluation algorithm based on actual implantation outcome has not yet been reported. STUDY DESIGN, SIZE, DURATION Retrospective evaluation of data extracted from a database of known implantation data (KID) originating from 3275 embryos transferred on Day 3 conducted in 24 clinics between 2009 and 2014. The data represented different culture conditions (reduced and ambient oxygen with various culture medium strategies) and fertilization methods (IVF, ICSI). The capability to predict blastocyst formation was evaluated on an independent set of morphokinetic data from 11 218 embryos which had been cultured to Day 5. PARTICIPANTS/MATERIALS, SETTING, METHODS The algorithm was developed by applying automated recursive partitioning to a large number of annotation types and derived equations, progressing to a five-fold cross-validation test of the complete data set and a validation test of different incubation conditions and fertilization methods. The results were expressed as receiver operating characteristics curves using the area under the curve (AUC) to establish the predictive strength of the algorithm. MAIN RESULTS AND THE ROLE OF CHANCE By applying the here developed algorithm (KIDScore), which was based on six annotations (the number of pronuclei equals 2 at the 1-cell stage, time from insemination to pronuclei fading at the 1-cell stage, time from insemination to the 2-cell stage, time from insemination to the 3-cell stage, time from insemination to the 5-cell stage and time from insemination to the 8-cell stage) and ranking the embryos in five groups, the implantation potential of the embryos was predicted with an AUC of 0.650. On Day 3 the KIDScore algorithm was capable of predicting blastocyst development with an AUC of 0.745 and blastocyst quality with an AUC of 0.679. In a comparison of blastocyst prediction including six other published algorithms and KIDScore, only KIDScore and one more algorithm surpassed an algorithm constructed on conventional Alpha/ESHRE consensus timings in terms of predictive power. LIMITATIONS, REASONS FOR CAUTION Some morphological assessments were not available and consequently three of the algorithms in the comparison were not used in full and may therefore have been put at a disadvantage. Algorithms based on implantation data from Day 3 embryo transfers require adjustments to be capable of predicting the implantation potential of Day 5 embryo transfers. The current study is restricted by its retrospective nature and absence of live birth information. Prospective Randomized Controlled Trials should be used in future studies to establish the value of time-lapse technology and morphokinetic evaluation. WIDER IMPLICATIONS OF THE FINDINGS Algorithms applicable to different culture conditions can be developed if based on large data sets of heterogeneous origin. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Vitrolife A/S, Denmark and Vitrolife AB, Sweden. B.M.P.’s company BMP Analytics is performing consultancy for Vitrolife A/S. M.B. is employed at Vitrolife A/S. M.M.’s company ilabcomm GmbH received honorarium for consultancy from Vitrolife AB. D.K.G. received research support from Vitrolife AB.
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Affiliation(s)
- Bjørn Molt Petersen
- Bjørn Molt Petersen BMP Analytics, Vilhelm Becks Vej 20, 8260 Viby J, Denmark
| | - Mikkel Boel
- Vitrolife A/S, Jens Juuls Vej 20, 8260 Viby J, Denmark
| | - Markus Montag
- ilabcomm GmbH, Eisenachstr. 34, 53757 St. Augustin, Germany
| | - David K Gardner
- School of BioSciences, University of Melbourne, Parkville, Melbourne, Victoria 3010, Australia
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Gardner DK, Balaban B. Assessment of human embryo development using morphological criteria in an era of time-lapse, algorithms and 'OMICS': is looking good still important? Mol Hum Reprod 2016; 22:704-718. [PMID: 27578774 DOI: 10.1093/molehr/gaw057] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 08/24/2016] [Indexed: 02/07/2023] Open
Abstract
With the worldwide move towards single embryo transfer there has been a renewed focus on the requirement for reliable means of assessing embryo viability. In an era of 'OMICS' technologies, and algorithms created through the use of time-lapse microscopy, the actual appearance of the human embryo as it progresses through each successive developmental stage to the blastocyst appears to have been somewhat neglected in recent years. Here we review the key features of the human preimplantation embryo and consider the relationship between morphological characteristics and developmental potential. Further, the impact of the culture environment on morphological traits, how key morphological qualities reflect aspects of embryo physiology, and how computer-assisted analysis of embryo morphology may facilitate a more quantitative approach to selection are discussed. The clinical introduction of time-lapse systems has reopened our eyes and given us a new vantage point from which to view the beauty of the initial stages of human life. Rather than a future in which the morphology of the embryo is deemed irrelevant, we propose that key features, such as multinucleation, cell size and blastocyst differentiation should be included in future iterations of selection/deselection algorithms.
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Affiliation(s)
- David K Gardner
- School of BioSciences, University of Melbourne, Victoria 3010, Australia
| | - Basak Balaban
- VKF American Hospital Assisted Reproduction Unit, Guzelbahce St. No. 20, Istanbul, Turkey
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Huang B, Jiang C, Chen A, Cui Y, Xie J, Shen J, Chen J, Cai L, Liao T, Ning S, Jiang SW, Fan G, Qin L, Liu J. Establishment of human-embryonic-stem-cell line from mosaic trisomy 9 embryo. Taiwan J Obstet Gynecol 2016; 54:505-11. [PMID: 26522100 DOI: 10.1016/j.tjog.2015.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Human-embryonic-stem-cell (hESC) lines derived from chromosomally or genetically abnormal embryos obtained following preimplantation genetic diagnosis are valuable in investigating genetic disorders. MATERIALS AND METHODS In this study, a new hESC line, Center of Clinical Reproductive Medicine 8 (CCRM8) was established by isolation, culture, and passaging of the inner cell mass of mosaic trisomy 9 embryos. RESULTS A karyotype analysis showed that the hESC line possessed a euploid (46 chromosomes). The undifferentiated hESCs exhibited long-term proliferation capacity and expressed typical markers of OCT4, TRA-1-60, and TRA-1-81. In vitro embryoid-body (EB) formation, differentiation, and in vivo teratoma production confirmed the pluripotency of the hESC line. The data represented here are the first detailed report on the characterization and differentiation of one Chinese hESC line generated from mosaic trisomy 9 embryos. CONCLUSION Our study showed that chromosomally aberrant embryos could generate a normal hESC line, which would be useful in investigating gene function and embryo development.
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Affiliation(s)
- Boxian Huang
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China; School of Life Science and Technology, China Pharmaceutical University, Nanjing 210038, China
| | - Chunyan Jiang
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Aiqin Chen
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Yugui Cui
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Jiazi Xie
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Jiandong Shen
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Juan Chen
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Lingbo Cai
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Tingting Liao
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Song Ning
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Shi-Wen Jiang
- Department of Biomedical Science, Mercer University School of Medicine, Savannah, GA 31404, USA
| | - Guoping Fan
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Lianju Qin
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
| | - Jiayin Liu
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China; School of Life Science and Technology, China Pharmaceutical University, Nanjing 210038, China.
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30
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Younis JS, Yazdi V, Izhaki I, Ben-Ami M. The association between multinucleated blastomeres and poor ovarian response under the Bologna criteria. J Assist Reprod Genet 2016; 33:885-92. [PMID: 27169602 DOI: 10.1007/s10815-016-0731-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 05/03/2016] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate the occurrence of multinucleated blastomeres (MNB) in poor ovarian response (POR) women defined under the Bologna criteria. METHODS This observational study was designed in a prospective controlled manner. Among 380 cases evaluated for eligibility, 102 women were found suitable and recruited; 51 with POR in accordance with the Bologna criteria defined as the study group and 51 with normal ovarian response defined as the control group. RESULTS Among the 51 women in each group, 8 and 2 did not achieve embryos in the study and control group, respectively (P < 0.05). The percentage of women that had at least one embryo with one MNB was significantly higher in the study as compared to the control group, corresponding to 49 and 29 %, respectively. The total number of embryos evaluated was 416; 167 in the study and 249 in the control groups. Among these embryos, the MNB rate was significantly higher in the study as compared to the control group, corresponding to 19 and 8 %, respectively. CONCLUSIONS Blastomere multinuclearity is significantly more common in women and embryos of POR cases, defined under the Bologna criteria. Future studies are warranted to substantiate our observation that has the potential to be clinically implemented in this sub-group of women undergoing assisted reproductive technologies (ART) treatment.
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Affiliation(s)
- Johnny S Younis
- Reproductive Medicine Unit, Department of Obstetrics & Gynecology, Poriya Medical Center, Tiberias, 15208, Israel.
- Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel.
| | - Vicky Yazdi
- Reproductive Medicine Unit, Department of Obstetrics & Gynecology, Poriya Medical Center, Tiberias, 15208, Israel
| | - Ido Izhaki
- Department of Evolutionary and Environmental Biology, University of Haifa, Haifa, Israel
| | - Moshe Ben-Ami
- Reproductive Medicine Unit, Department of Obstetrics & Gynecology, Poriya Medical Center, Tiberias, 15208, Israel
- Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel
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Yin BL, Hao HY, Zhang YN, Wei D, Zhang CL. Good quality blastocyst from non-/mono-pronuclear zygote may be used for transfer during IVF. Syst Biol Reprod Med 2016; 62:139-45. [PMID: 26901373 DOI: 10.3109/19396368.2015.1137993] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Bao-Li Yin
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Hao-Ying Hao
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Ya-Nan Zhang
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Duo Wei
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Cui-Lian Zhang
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
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Abnormally cleaving embryos are able to produce live births: a time-lapse study. J Assist Reprod Genet 2016; 33:379-385. [PMID: 26749387 DOI: 10.1007/s10815-015-0632-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE This study investigated the prevalence of abnormally cleaved embryos and determined which types of abnormally cleaved embryos (1-3c, 2-4c, 3-5c, 4-6c), might be suitable for transfer based on live birth data. METHODS One hundred seventy-one women (whose transferred embryos were confirmed to be either fully implanted or fully unimplanted) provided 1256 embryos, which were analyzed. RESULTS Of these embryos, 320 embryos were transferred, of these transferred embryos, 291 embryos were normal and 29 embryos were abnormal, which five embryos were not analyzed because each one was presented one abnormal cleavage type. These 24 embryos were divided into four groups. Inclusion criteria were as follows: women under 37 years of age undergoing first fresh in vitro fertilization (IVF) treatment with a basal antral follicle count of 5-15, body mass index (BMI) of 18-25 kg/m(2), number of retrieved oocytes between 5 and 20, and tubal factors as the cause of infertility. Time-lapse imaging analysis software was used to compare temporal parameters of normal cleavage and abnormal cleavage groups (there were four abnormal groups, based on the prevalence of abnormal cleavage embryos). Cleavage times were analyzed before the abnormal cleavage occurred, and time intervals were analyzed after the abnormal cleavage based upon the types of abnormal cleavage. In addition, the time intervals of t4-t3 and t8-t5 were also analyzed; corresponding time parameters were measured in the normal group as well. Implantation rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate were also measured in the normally cleaved and abnormally cleaved embryos. The prevalence of abnormal cleavage was 15.92% (200/1256). T8-t5 was the most important parameter in the prediction of potential development (production of a live-born baby) of abnormally cleaving embryos. CONCLUSIONS Abnormally cleaving embryos were able to produced live births with T8-t5 the best parameter to predict the developmental potential of abnormally cleaving embryos.
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Zhang Q, Guo XM, Li Y. Optimal polar bodies angle for higher subsequent embryo viability: a pilot study. Fertil Steril 2015; 105:670-675.e2. [PMID: 26632209 DOI: 10.1016/j.fertnstert.2015.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the optimal polar bodies (PB) angle for higher subsequent embryo implantation potential. DESIGN Prospective study. SETTING Academic fertility center. PATIENT(S) From January to July 2015, 116 patients were recruited in their first IVF-ET cycles. INTERVENTION(S) At the pronuclear stage, PB angle was measured with the use of E-ruler 1.1. MAIN OUTCOME MEASURE(S) The primary outcome measure was good-quality embryo rate. Secondary measures were clinical pregnancy rate (CPR) and embryo implantation rate (IR). RESULT(S) A total of 1,103 oocytes were retrieved. PB angle was measured in 454 zygotes, and 164 of their subsequent embryos were transferred into the uterus. All-or-none implantation took place in 129 embryos, and 89 patients accepted fresh embryo(s) transfer with known PB angle. By means of receiver operating characteristic analysis, the optimal PB angle for subsequent embryo implantation was 24.25°. Based on this cutoff value, 454 zygotes were divided into two groups: small-angle and large-angle. A higher percentage of small-angle zygotes developed into good-quality embryos (70.97% vs. 58.58%). CPR and IR both decreased progressively from purely small-angle embryos to mixed embryos to purely large-angle embryos (CPR: 72.41% vs. 38.46% vs. 26.47%, respectively; IR: 63.27% vs. 26.92% vs. 16.67%, respectively). CONCLUSION(S) Noninvasive assessment of PB angle is a viable technique for zygote selection and should be included in embryo selection parameters. CLINICAL TRIAL REGISTRATION NUMBER CLINICAL TRIAL REGISTRATION NUMBER ChiCTR-OOC-15005882.
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Affiliation(s)
- Qiong Zhang
- Center for Reproductive Medicine, Xiang-Ya Hospital, Central South University, Hunan, People's Republic of China
| | - Xiaoyue M Guo
- Yale University School of Medicine, New Haven, Connecticut
| | - Yanping Li
- Center for Reproductive Medicine, Xiang-Ya Hospital, Central South University, Hunan, People's Republic of China.
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Egashira A, Yamauchi N, Tanaka K, Mine C, Otsubo H, Murakami M, Islam MR, Ohtsuka M, Yoshioka N, Kuramoto T. Developmental capacity and implantation potential of the embryos with multinucleated blastomeres. J Reprod Dev 2015; 61:595-600. [PMID: 26346255 PMCID: PMC4685227 DOI: 10.1262/jrd.2015-052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The presence of multinucleated blastomeres (MNBs) in embryos is associated with poor developmental
competence in assisted reproductive technologies. This phenomenon is observed not only in humans but also in
other animal species. The purpose of the present study was to investigate the characteristics of embryos with
MNBs (MNB embryos) that could be utilized in embryo transfer. The developmental rate of MNB embryos to the
blastocyst stage (50.8%) was significantly lower than that of normal embryos (73.3%) (P < 0.05). The
clinical pregnancy rates of fresh embryo transfer (ET) using day 2 or day 3 embryos were significantly lower
in MNB embryos (5.1%) compared with normal embryos (24.0%) (P < 0.05). In the case of frozen-thawed ET
using a single vitrified/warmed blastocyst, however, the clinical pregnancy rate of MNB embryos was close to
that of normal embryos (59.1% vs. 52.8%). Thus, the findings of the present study suggest
that the frozen-thawed ET of MNB embryos might improve the potential for implantation followed by successful
pregnancy.
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Perkel KJ, Tscherner A, Merrill C, Lamarre J, Madan P. The ART of selecting the best embryo: A review of early embryonic mortality and bovine embryo viability assessment methods. Mol Reprod Dev 2015; 82:822-38. [PMID: 26184077 DOI: 10.1002/mrd.22525] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 07/10/2015] [Indexed: 12/14/2022]
Abstract
Animal reproductive biotechnology is continually evolving. Significant advances have been made in our understanding of early embryonic mortality and embryo development in domestic animals, which has improved the selection and success of in vitro technologies. Yet our knowledge is still relatively limited such that identifying a single embryo with the highest chance of survival and development for transfer remains challenging. While invasive methods such as embryo biopsy can provide useful information regarding the genetic status of the embryos, morphological assessment remains the most common evaluation. A recent shift, however, favors alternative, adjunct approaches for non-invasive assessment of an embryo's viability and developmental potential. Various analytical techniques have facilitated the evaluation of cellular health through the metabolome, the assessment of end products of cellular metabolism, or by analyzing spent media for small RNAs. This review discusses the application of noninvasive approaches for ascertaining the health and viability of in vitro-produced bovine embryos. A comparative analysis of noninvasive techniques for embryo assessment currently being investigated in cattle and humans is also discussed.
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Affiliation(s)
- Kayla J Perkel
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Allison Tscherner
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Casandra Merrill
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jonathan Lamarre
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Pavneesh Madan
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Chaplia OV, Gontar JV, Bilko NM. Preimplantation development of human embryos with numerical chromosome abnormalities in vitro. CYTOL GENET+ 2015. [DOI: 10.3103/s0095452715040039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Perinatal outcomes of patients who achieved pregnancy with a morphologically poor embryo via assisted reproductive technology. Arch Gynecol Obstet 2015. [PMID: 26202135 DOI: 10.1007/s00404-015-3815-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To learn more about the perinatal outcomes of conception via the use of low-grade embryos, we evaluated the relationship between the status of transferred embryos and the resultant perinatal outcomes. METHODS A total of 340 patients who achieved pregnancy via ART treatment and consequently delivered in our clinic between April 2009 and March 2014 were recruited for this study. Patients were divided into two groups according to a morphological assessment of the transferred embryos, which relegated 79 patients into a poor-embryo group with the remainders (n = 261) placed into a good-embryo group. RESULTS The mean maternal age for the poor-embryo group was 36.0 years, which was similar to the good-embryo group (36.8). In both groups, the percentages of fresh ET cycles were similar. The values for the mean birth weight and birth height of infants in the poor-embryo group were 3055 g and 50.3 cm, respectively, and there were no significant differences with the good-embryo group. The umbilical blood gas analysis in the poor-quality group was similar to that in the good-embryo group. There were no obvious major anomalies among the infants of either group. CONCLUSIONS The perinatal outcomes of the poor-embryo group were comparable to those of the good-embryo group. Based on these results, we can provide qualified assurance for a normal perinatal outcome to patients who had no choice but to undergo embryo transfer with a poor-quality embryo.
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Gui B, Yao Z, Huang Y, Mei L, Li Y, Liu D, Liu N, Xia Y, Liang D, Wu L. Morphometric analysis and developmental comparison of embryos from carriers with balanced chromosomal rearrangements in preimplantation genetic diagnosis cycles. Reprod Fertil Dev 2015; 28:1953-1963. [PMID: 26118930 DOI: 10.1071/rd15093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/28/2015] [Indexed: 11/23/2022] Open
Abstract
The morphological parameters of embryos from 22 carriers with balanced chromosomal rearrangements (CRs) were quantified and evaluated to determine their possible link to chromosomal composition. The morphometric characteristics of 168 embryos diagnosed by fluorescence in situ hybridisation were measured using an imaging tool and then analysed retrospectively. The mean zygotic diameter of normal-balanced embryos was significantly smaller compared with that of abnormal embryos (P=0.015). In addition, the reduction in total cytoplasmic volume for Day-3 embryos was significantly lower in normal or balanced embryos than in abnormal embryos (P=0.027). Moreover, the pronuclear volumes of embryos that failed to reach the blastocyst stage were significantly smaller compared with those of blastocysts (P=0.016). These findings indicate that morphometric characteristics are correlated with developmental outcomes as well as with chromosomal composition in embryos from balanced CR carriers. However, an effective indicator of developmental outcomes may not accurately reflect chromosomal composition. Combining morphometric and traditional qualitative assessment may increase the precision and standardisation of embryo evaluation as well as contributing to improved efficiency of preimplantation genetic diagnosis by selecting embryos with high developmental potential and preferentially testing embryos predicted to have a low risk of chromosomal imbalance.
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Affiliation(s)
- Baoheng Gui
- The State Key Laboratory of Medical Genetics of China, Central South University, No. 110, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Zhongyuan Yao
- The State Key Laboratory of Medical Genetics of China, Central South University, No. 110, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Yanru Huang
- The State Key Laboratory of Medical Genetics of China, Central South University, No. 110, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Libin Mei
- The State Key Laboratory of Medical Genetics of China, Central South University, No. 110, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Yanping Li
- The Reproductive Medical Center of Xiangya Hospital, Central South University, No. 87, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Donge Liu
- The Reproductive Medical Center of Xiangya Hospital, Central South University, No. 87, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Nenghui Liu
- The Reproductive Medical Center of Xiangya Hospital, Central South University, No. 87, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Yan Xia
- The State Key Laboratory of Medical Genetics of China, Central South University, No. 110, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Desheng Liang
- The State Key Laboratory of Medical Genetics of China, Central South University, No. 110, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
| | - Lingqian Wu
- The State Key Laboratory of Medical Genetics of China, Central South University, No. 110, Xiangya Rd, Changsha, Hunan, 410008, P. R. China
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Hammond ER, Stewart B, Peek JC, Shelling AN, Cree LM. Assessing embryo quality by combining non-invasive markers: early time-lapse parameters reflect gene expression in associated cumulus cells. Hum Reprod 2015; 30:1850-60. [PMID: 26040474 DOI: 10.1093/humrep/dev121] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 05/01/2015] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Are there associations between early time-lapse parameters, expression of candidate embryo viability genes in cumulus cells and embryo quality on Day 5? SUMMARY ANSWER Early time-lapse parameters correlate to the expression levels of candidate embryo viability genes in cumulus cells but a combined analysis including both time-lapse and candidate gene expression did not identify significant predictors of embryo quality on Day 5. WHAT IS KNOWN ALREADY Recent evidence suggests that early time-lapse parameters are predictive of blastocyst development. Similarly, a number of candidate genes in cumulus cells have been identified as potential markers of embryo viability. Relationships between time-lapse parameters and candidate gene expression in cumulus cells have not been investigated, and a combined analysis of these markers has not been attempted in relation to embryo quality. STUDY DESIGN, SIZE, DURATION A total of 78 embryos obtained by ICSI from 22 patients were studied by time-lapse and measurement of cumulus cell gene expression of known markers of embryo viability. Time-lapse and cumulus cell gene expression data were assessed in relation to embryo quality on Day 5. PARTICIPANTS/MATERIALS, SETTING, METHODS All women, aged 32-40 years, underwent ICSI treatment for male infertility. Embryos with annotatable time to pronuclear breakdown (tPNB), division to two cells (t2C), three cells (t3C), four cells (t4C) and five cells (t5C) were included in the study. Expression levels of 27 candidate genes for embryo viability were measured in 78 associated cumulus cell masses using quantitative real-time PCR. MAIN RESULTS AND THE ROLE OF CHANCE Cumulus cell expression of 11 candidate genes involved in energy metabolism (ATPase, H+ transporting, lysosomal 70 kDa, V1 subunit A (ATP6V1A), NADH dehydrogenase (ubiquinone) 1 alpha subcomplex, 1, 7.5 kDa (NDUFA1), lactate dehydrogenase A (LDHA), phosphofructokinase platelet (PFKP) and solute carrier family 2 member 4 (SLC2A4), mitochondrial biogenesis (DNA directed RNA polymerase, mitochondrial (POLRMT) and transcription factor A, mitochondrial (TFAM), signalling (prostaglandin-endoperoxide synthase 2), steroidogenesis (cytochrome P450, family 11, subfamily A, polypeptide 1 (CYP11A1) and cell stress (heat shock 70 kDa protein 5 (HSPA5) and peroxiredoxin 3 (PRDX3)) correlated to time-lapse parameters of the developing embryo, largely for t3C onwards (all P < 0.05). Expression of ATP synthase, H+ transporting, mitochondrial Fo complex, subunit E (ATP51), HSPA5, PFKP, PRDX3 and versican (VCAN) and the parameter t4C were also related to embryo quality on Day 5 (all P < 0.05). Ordinal logistic regression, where gene expression and time-lapse parameters were combined, did not identify any significant predictors of embryo quality on Day 5. LIMITATIONS AND REASON FOR CAUTION Data are from a preliminary study, limited by a small sample size and using more than one ovarian stimulation protocol. A possible limitation is that each follicle was treated as an independent observation, although a considerable fraction of embryos were from the same patient. WIDER IMPLICATIONS OF THE FINDINGS Results presented in this study suggest that some of the variation of time-lapse parameters may be related to cumulus cell gene expression and thus the ovarian microenvironment in which the oocyte developed. Although the current study did not identify significant predictors of embryo quality on Day 5, investigation in a larger cohort may determine whether cumulus cell gene expression and time-lapse parameters can be combined to predict embryo quality. STUDY FUNDING/COMPETING INTERESTS Funding was provided by Fertility Associates Ltd, the Auckland Medical Research Foundation and the University of Auckland. J.C.P. has a 0.5% shareholding in Fertility Associates. All other authors of this manuscript have nothing to declare and no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
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Affiliation(s)
- Elizabeth R Hammond
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Bert Stewart
- Fertility Associates, Greenlane, Auckland 1051, New Zealand
| | - John C Peek
- Fertility Associates, Greenlane, Auckland 1051, New Zealand
| | - Andrew N Shelling
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Lynsey M Cree
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand Fertility Associates, Greenlane, Auckland 1051, New Zealand
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What does morphokinetics add to embryo selection and in-vitro fertilization outcomes? Curr Opin Obstet Gynecol 2015; 27:193-200. [DOI: 10.1097/gco.0000000000000166] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Is the presence of a non-cleaved embryo on day 3 associated with poorer quality of the remaining embryos in the cohort? J Assist Reprod Genet 2015; 32:677-83. [PMID: 25772647 DOI: 10.1007/s10815-015-0455-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/24/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Morphological evaluation is currently considered the single most important predictive measure for assessing embryo quality. The aim of this study was to investigate whether cycles with at least one non-cleaved embryo (i.e., a 1-cell embryo on day 3) have different outcomes compared with cycles in which all embryos had cleaved by day 3. METHODS All autologous IVF/ICSI cycles with a fresh day 3 transfer and without using a gestational carrier performed at our center between 1/1/2010 and 12/31/2011 were analyzed retrospectively. Those cycles with at least one non-cleaved embryo on day 3 were compared with all other autologous cycles that had 100% cleaved embryos performed during the study period. RESULTS Eight hundred and forty two cycles were included. Of them, 144 cycles comprised the non-cleaved group, and 698 cycles comprised the cleaved group. Cycles in the non-cleaved group had more oocytes retrieved (15.4 ± 7.1 vs. 12.5 ± 7.1, p < 0.001), more zygotes obtained (10.0 ± 5.3 vs. 7.9 ± 5.2, p = <0.001), but the embryos exhibited lower cleavage rates and higher rates of fragmentation and asymmetry compared with controls (p < 0.001). However, spontaneous abortion rates, ectopic pregnancies rates as well as delivery rates were similar between the two groups. CONCLUSIONS Our results show that the presence of a non-cleaved embryo on day 3 is associated with a more exuberant response to controlled ovarian stimulation as reflected by more oocytes retrieved. Despite the significant decrease in quality of the whole cohort in the non-cleaved group, implantation, delivery rates and number of embryos frozen were not adversely affected by the presence of a non-cleaved embryo.
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Aragona C, Linari A, Micara G, Tranquilli D, Gambaro AML, Bezerra Espinola MS. Term pregnancy and live birth subsequent to immediate uterine transfer of sperm microinjected oocyte in a natural cycle. Gynecol Endocrinol 2015; 31:599-600. [PMID: 26036715 DOI: 10.3109/09513590.2015.1031105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It has been reported that it is possible to achieve a pregnancy after immediate uterine transfer of oocyte and sperm, before fertilization and cleavage were known to have occurred; there is an enormous amount of work about the optimal timing of embryo transfer, with no conclusive evidence of a gold standard satisfying patient age, endometrial receptivity, hormonal levels and embryological parameters. We hereby report a case of one 35-year-old nulligravid woman with longstanding tubal factor infertility and 3 previous failed ICSI cycles, treated with ICSI and immediate transfer of the oocyte microinjected with a spermatozoon in a natural cycle. A single oocyte was retrieved, injected with a spermatozoon and transferred 40 min after injection, resulting in an uneventful pregnancy and delivery of a healthy female infant weighing 3320 g at 40 weeks' estimated gestational age. This case, certainly novel, should be interpreted with caution. Whether confirmed for efficacy and safeness in appropriate controlled clinical trials, our present observation could offer a simple, practical and cost-effective approach in ART programs in selected patients.
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Affiliation(s)
- Cesare Aragona
- a Division of Sterility and Assisted Reproduction, Department of Gynecological-Obstetric Sciences and Urologic Sciences, Umberto I Policlinic of Rome, Sapienza , University of Rome , Roma , Italy
| | - Antonella Linari
- a Division of Sterility and Assisted Reproduction, Department of Gynecological-Obstetric Sciences and Urologic Sciences, Umberto I Policlinic of Rome, Sapienza , University of Rome , Roma , Italy
| | - Giulietta Micara
- a Division of Sterility and Assisted Reproduction, Department of Gynecological-Obstetric Sciences and Urologic Sciences, Umberto I Policlinic of Rome, Sapienza , University of Rome , Roma , Italy
| | - Daniela Tranquilli
- a Division of Sterility and Assisted Reproduction, Department of Gynecological-Obstetric Sciences and Urologic Sciences, Umberto I Policlinic of Rome, Sapienza , University of Rome , Roma , Italy
| | - Agnese Maria Lourdes Gambaro
- a Division of Sterility and Assisted Reproduction, Department of Gynecological-Obstetric Sciences and Urologic Sciences, Umberto I Policlinic of Rome, Sapienza , University of Rome , Roma , Italy
| | - Maria Salome Bezerra Espinola
- a Division of Sterility and Assisted Reproduction, Department of Gynecological-Obstetric Sciences and Urologic Sciences, Umberto I Policlinic of Rome, Sapienza , University of Rome , Roma , Italy
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Kirkegaard K, Ahlström A, Ingerslev HJ, Hardarson T. Choosing the best embryo by time lapse versus standard morphology. Fertil Steril 2014; 103:323-32. [PMID: 25527231 DOI: 10.1016/j.fertnstert.2014.11.003] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/03/2014] [Accepted: 11/04/2014] [Indexed: 01/05/2023]
Abstract
Within the past few years the morphological evaluation of in vitro fertilized embryos has been extended to include continuous surveillance, enabled by the introduction of time-lapse incubators developed specifically for IVF treatment. As a result time-lapse monitoring has been implemented in many clinics worldwide. The proposed benefits compared with culture in a standard incubator and fixed time-point evaluation are uninterrupted culture, a flexible workflow in the laboratory, and improved embryo selection. The latter is based on the reasonable assumption that more frequent observations will provide substantially more information on the relationship between development, timing, and embryo viability. Several retrospective studies have confirmed a relationship between time-lapse parameters and embryo viability evaluated by developmental competence, aneuploidy, and clinical pregnancy. Furthermore a much anticipated randomized study has shown improved pregnancy rates (PRs) after culture in a time-lapse incubator combined with selection using a hierarchical time-lapse selection model. At present this is the only randomized study on possible benefits of time lapse in human embryology. Strict evidence may still seem too weak to introduce time lapse in routine clinical setting. This aim of this review is therefore to perform a balanced discussion of the evidence for time-lapse monitoring.
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Affiliation(s)
- Kirstine Kirkegaard
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
| | - Aishling Ahlström
- IVF Lab, Reproductive Medicine, Sahlsgrenska University Hospital, Gothenberg, Sweden
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No evidence of association between blastocyst aneuploidy and morphokinetic assessment in a selected population of poor-prognosis patients: a longitudinal cohort study. Reprod Biomed Online 2014; 30:57-66. [PMID: 25458852 DOI: 10.1016/j.rbmo.2014.09.012] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 09/08/2014] [Accepted: 09/11/2014] [Indexed: 12/17/2022]
Abstract
Recent studies involving a limited number of patients have indicated a correlation between aneuploidy and various morphokinetic parameters during preimplantation development. The results among different groups, however, have been inconsistent in identifying the parameters that are able to predict chromosomal abnormalities. The aim of this study was to investigate whether aneuploidy of human blastocysts was detectable by specific morphokinetic parameters in patients at increased risk of aneuploidy because of advanced maternal age, history of unsuccessful IVF treatments, or both. A longitudinal cohort study was conducted using 455 blastocysts from 138 patients. Morphokinetic features of preimplantation development were detected in a timelapse incubator. Blastocysts were subjected to trophectodermal biopsy and comprehensive chromosomal screening. Analyses were conducted by means of logistic mixed-effects models, with a subject-specific intercept. No statistical correlation between 16 commonly detected morphokinetic characteristics of in-vitro embryo development and aneuploidy was found. Results suggest that morphokinetic characteristics cannot be used to select euploid blastocysts in poor-prognosis patients regarded as candidates for pre-implantation genetic screening.
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Zhang K, Huang K, Luo Y, Li S. Identification and functional analysis of long non-coding RNAs in mouse cleavage stage embryonic development based on single cell transcriptome data. BMC Genomics 2014; 15:845. [PMID: 25277336 PMCID: PMC4200203 DOI: 10.1186/1471-2164-15-845] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 09/24/2014] [Indexed: 01/10/2023] Open
Abstract
Background Long non-coding RNAs (lncRNAs) regulate embryonic development and cell fate decision in various ways, such as modulation of chromatin modification and post-transcription regulation of gene expression. However, the profiles and roles of lncRNAs in early mammalian development have not yet been demonstrated. Here, we reported a comprehensive analysis of mouse cleavage stage embryonic lncRNA profiles based on public single-cell RNA-seq data. Results We reconstructed 50,006 high-confidence transcripts in 22,827 loci, and identified 5563 novel lncRNAs from 3492 loci expressed in mouse cleavage stage embryos. These lncRNAs share similar characteristics with previously reported vertebrate lncRNAs, such as relatively short length, low exon number, low expression level and low sequence conservation. Expression profile analysis revealed that the profiles of lncRNA vary considerably at different stages of cleavage stage embryos, suggesting that many lncRNAs in cleavage stage embryos are stage-specifically expressed. Co-expression network analysis suggested many lncRNAs in cleavage stage embryos are associated with cell cycle regulation, transcription, translation and oxidative phosphorylation to regulate the process of cleavage stage embryonic development. Conclusions This study provides the first catalog of lncRNAs expressed in mouse cleavage stage embryos and gives a revealing insight into the molecular mechanism responsible for early embryonic development. Electronic supplementary material The online version of this article (doi:10.1186/1471-2164-15-845) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Yuping Luo
- Stem Cell Translational Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200092, China.
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Molina I, Martínez JV, Pertusa JF, Balasch S, Iniesta I, Pellicer A. Assessment of the implantation of day-2 human embryos by morphometric nonsubjective parameters. Fertil Steril 2014; 102:1022-8. [DOI: 10.1016/j.fertnstert.2014.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 06/17/2014] [Accepted: 06/17/2014] [Indexed: 11/16/2022]
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Liu Y, Chapple V, Roberts P, Matson P. Prevalence, consequence, and significance of reverse cleavage by human embryos viewed with the use of the Embryoscope time-lapse video system. Fertil Steril 2014; 102:1295-1300.e2. [PMID: 25225070 DOI: 10.1016/j.fertnstert.2014.07.1235] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/09/2014] [Accepted: 07/14/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the prevalence and potential causes of reverse cleavage (RC) by human early-cleavage embryos and its associations with embryonic development and implantation after transfer. DESIGN Clinical retrospective cohort study. SETTING Private fertility treatment center. PATIENT(S) A total of 126 consecutive in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment cycles, with 353 IVF and 436 ICSI embryos cultured in the Embryoscope until day 3. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Embryo assessment on day 3, incidence of abnormal division, embryo morphokinetic parameters, and fetal heart beat. RESULT(S) RC, referring to either blastomere fusion or failed cytokinesis, occurred up to three times per individual embryo in 27.4% of embryos during the first three cleavage cycles. A higher incidence was associated with GnRH antagonist cycles compared with agonist cycles (odds ratio [OR] 1.683), or with ICSI compared with IVF (OR 1.600). After ICSI, sperm progressive motility was associated with RC (area under the receiver operating characteristic curve: 0.573). Compared with RC-negative embryos, a lower proportion of RC-positive embryos reached 6-cell stage or beyond by day 3 (47.7% vs. 71.7%), and were more likely to have multinucleation at the 4-cell stage (10.1% vs. 5.0%). Embryos showing RC had significantly poorer performance in both conventional grading and morphokinetic parameters, and they implanted less (0/22 vs. 29/131) than those not showing RC. CONCLUSION(S) RC significantly compromised embryo development, culminating in poor implantation potential. For each embryo, it can occur on more than one occasion at any stage during the first 3 days of culture. It is associated with factors affecting both oocyte and sperm.
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Affiliation(s)
- Yanhe Liu
- Fertility North, Joondalup Health Campus, Joondalup, Western Australia, Australia; School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
| | - Vincent Chapple
- Fertility North, Joondalup Health Campus, Joondalup, Western Australia, Australia
| | - Peter Roberts
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Phillip Matson
- Fertility North, Joondalup Health Campus, Joondalup, Western Australia, Australia; School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Ziebe S. Morphometric analysis of human embryos to predict developmental competence. Reprod Fertil Dev 2014; 26:55-64. [PMID: 24305177 DOI: 10.1071/rd13296] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Morphometric and morphokinetic approaches toward embryo quality assessment have for many years been difficult due to technical limitations. Today, with improvements in laboratory techniques and subsequent quality, we have a better understanding of the morphometric and kinetics of embryo development. Fertility clinics are moving from "sensing" embryo quality to measuring embryo quality--and this is happening every day in fertility clinics all over the world. However, we cannot select for something that is not there. In daily clinical life it is almost never a question of selecting the optimal embryo, but rather choosing and prioritising between the available embryos. Data suggest that only approximately 5% of aspirated human oocytes have the competence to implant and develop into a child and that, in most treatment cycles, there is no oocyte capable of implanting. The most likely outcome is a negative pregnancy test, no matter what we choose in the laboratory. Still, both with the increasing complexity of infertile patients treated today and the important focus on reducing multiple pregnancies, it becomes increasingly important to improve our ability to predict the developmental competence of each embryo. This involves an improved understanding of the basic biology controlling early embryonic development and, over the years, many groups have tried to identify parameters reflecting embryonic competence.
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Affiliation(s)
- Søren Ziebe
- The Fertility Clinic, Rigshospitalet, Section 4071, University Hospital of Copenhagen, Blegdamsvej 9, Dk-2100 Denmark.
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Molina I, Lázaro-Ibáñez E, Pertusa J, Debón A, Martínez-Sanchís JV, Pellicer A. A minimally invasive methodology based on morphometric parameters for day 2 embryo quality assessment. Reprod Biomed Online 2014; 29:470-80. [PMID: 25154014 DOI: 10.1016/j.rbmo.2014.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 05/23/2014] [Accepted: 06/11/2014] [Indexed: 11/24/2022]
Abstract
The risk of multiple pregnancy to maternal-fetal health can be minimized by reducing the number of embryos transferred. New tools for selecting embryos with the highest implantation potential should be developed. The aim of this study was to evaluate the ability of morphological and morphometric variables to predict implantation by analysing images of embryos. This was a retrospective study of 135 embryo photographs from 112 IVF-ICSI cycles carried out between January and March 2011. The embryos were photographed immediately before transfer using Cronus 3 software. Their images were analysed using the public program ImageJ. Significant effects (P < 0.05), and higher discriminant power to predict implantation were observed for the morphometric embryo variables compared with morphological ones. The features for successfully implanted embryos were as follows: four cells on day 2 of development; all blastomeres with circular shape (roundness factor greater than 0.9), an average zona pellucida thickness of 13 µm and an average of 17695.1 µm² for the embryo area. Embryo size, which is described by its area and the average roundness factor for each cell, provides two objective variables to consider when predicting implantation. This approach should be further investigated for its potential ability to improve embryo scoring.
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Affiliation(s)
- Inmaculada Molina
- Unidad de Reproducción Humana, Hospital Universitari i Politècnic La Fe de Valencia, Avenida Campanar 21, 46009 Valencia, Spain;; Departamento de Ciencia Animal, Universitat Politécnica de València, 46022 Valencia, Spain
| | - Elisa Lázaro-Ibáñez
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland
| | - Jose Pertusa
- Dpto. Biología Funcional y Antropología Física, Facultad C. Biológicas, Universitat de València, 46100 Burjasot (Valencia), Spain
| | - Ana Debón
- Centro de Gestión de la Calidad y del Cambio, Universitat Politécnica de València, 46022 Valencia, Spain;.
| | - Juan Vicente Martínez-Sanchís
- Unidad de Reproducción Humana, Hospital Universitari i Politècnic La Fe de Valencia, Avenida Campanar 21, 46009 Valencia, Spain
| | - Antonio Pellicer
- Unidad de Reproducción Humana, Hospital Universitari i Politècnic La Fe de Valencia, Avenida Campanar 21, 46009 Valencia, Spain;; Dpto de Obstetricia y Ginecología, Facultad de Medicina y Odontología, Universitat de València, 46010 Valencia, Spain
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50
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First polar body morphology affects potential development of porcine parthenogenetic embryo in vitro. ZYGOTE 2014; 23:615-21. [PMID: 24990597 DOI: 10.1017/s0967199414000252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous studies have reported that the first polar body (PB1) morphology reflects embryo development competence, but the effects of PB1 on porcine embryo development remain unknown. This study aims to determine whether the ability of porcine embryo development is related to oocytes' PB1 in vitro. The distribution of type II cortical granules (CGs) of porcine matured oocytes in grade B PB1 is significantly greater compared with those in grades A and C PB1 (71.43% versus 52.46% and 50%; P 0.05). The acetylation level of porcine embryos in the group with grade B PB1 is significantly greater compared with those in the other groups (P < 0.05), and is almost 2.5 times higher than that in grade A. Therefore, porcine oocytes with PB1 in grade B are more competitive in cytoplasmic maturation and further embryo development in vitro.
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