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Hagege E, Pirtea P, Burette J, Canepa AS, Graesslin O, de Ziegler D. Patient experience of social and medical fertility preservation fully reimbursed in France. J Assist Reprod Genet 2024:10.1007/s10815-024-03222-6. [PMID: 39138766 DOI: 10.1007/s10815-024-03222-6] [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: 03/20/2024] [Accepted: 08/06/2024] [Indexed: 08/15/2024] Open
Abstract
PURPOSE The purpose of this study is to review patient experience with social fertility preservation (sFP), as compared to medical fertility preservation (mFP), in a context where sFP is fully reimbursed. METHODS We conducted a retrospective cohort study involving patients who underwent oocyte cryopreservation for mFP between 2017 and 2023 and sFP between 2022 and 2023 at a large ART single center. Additionally, we surveyed patients undergoing sFP and mFP, regarding their experiences, intentions, awareness, and financial consideration. RESULTS A total of 97 oocyte retrievals were performed for sFP in 75 women, and 155 were performed in mFP (127 women). Median ages were 36.4 years for sFP and 28.9 years for mFP. Median oocytes retrieved per session were 10 for sFP and 8 for mFP. Ninety-seven percent of of mFP participants were informed by healthcare professionals, while half of sFP participants learned through personal acquaintances. The primary motivation for sFP was a desire for pregnancy while being single. Most respondents in both groups knew that 15-20 oocytes are typically needed for a successful birth. None were aware of the "DuoStim" option, but interest was expressed by most women. Surprisingly, despite full reimbursement for sFP in France, 78% expressed willingness to pay if necessary. CONCLUSION Many women choose sFP due to concerns about declining fertility, often informed by non-medical sources. Free access to sFP can help mitigate the global decline in natality by allowing women to anticipate age-related fertility decline. This study should be considered by other countries as they may increasingly cover sFP costs in the future.
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Affiliation(s)
- Estelle Hagege
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France.
| | - Paul Pirtea
- Department of Obstetrics, Gynecology and Reproductive Medicine, Foch Hospital, Suresnes, France
| | - Julie Burette
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France
| | - Anne-Sophie Canepa
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France
| | - Olivier Graesslin
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France
| | - Dominique de Ziegler
- Department of Obstetrics, Gynecology and Reproductive Medicine, Foch Hospital, Suresnes, France
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Yao Y, Tang Y, Qin H, Meng R, Zhang C, Zhang Y, Yang Y, Qiao P, Liu J, Su J. Zinc supplementation promotes oocyte maturation and subsequent embryonic development in sheep. Theriogenology 2023; 206:161-169. [PMID: 37210940 DOI: 10.1016/j.theriogenology.2023.04.025] [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: 01/14/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/23/2023]
Abstract
Zinc plays a crucial role in the growth and reproductive functions of animals. Despite the positive effects of zinc that have been reported in oocytes of cows, pigs, yaks, and other animals, the influence of zinc on sheep is little known. To investigate the effect of zinc on the in vitro maturation of sheep oocytes and subsequent parthenogenesis-activated embryonic development, we added different concentrations of zinc sulfate to the in vitro maturation (IVM) culture medium. The IVM culture medium with zinc improved the maturation of sheep oocytes and the subsequent blastocyst rate after parthenogenesis activation. Notably, it also enhanced the level of glutathione and mitochondrial activity while reducing levels of reactive oxygen species. Thus, zinc addition to the IVM medium improved the quality of oocytes with a positive effect on the subsequent development of oocytes and embryos.
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Affiliation(s)
- Yupei Yao
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China
| | - Yujie Tang
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China
| | - Haoqiang Qin
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China
| | - Ru Meng
- Xining Animal Disease Prevention and Control Center, Xining, Qinghai Province, 810003, PR China
| | - Chengtu Zhang
- Xining Animal Disease Prevention and Control Center, Xining, Qinghai Province, 810003, PR China
| | - Yingbing Zhang
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China
| | - Ying Yang
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China
| | - Peipei Qiao
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China
| | - Jun Liu
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China.
| | - Jianmin Su
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shanxi Province, 712100, PR China.
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The live birth rate of vitrified oocyte accumulation for managing diminished ovarian reserve: a retrospective cohort study. J Ovarian Res 2023; 16:49. [PMID: 36869354 PMCID: PMC9983267 DOI: 10.1186/s13048-023-01128-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Vitrified M-II oocyte accumulation for later simultaneous insemination has been used for managing POR. Our study aimed to determine whether vitrified oocyte accumulation strategy improves live birth rate (LBR) for managing diminished ovarian reserve (DOR). METHODS A retrospective study included 440 women with DOR fulfilling Poseidon classification groups 3 and 4, defined as the presence of serum anti-Müllerian hormone (AMH) hormone level < 1.2 ng/ml or antral follicle count (AFC) < 5, from January 1, 2014, to December 31, 2019, in a single department. Patients underwent accumulation of vitrified oocytes (DOR-Accu) and embryo transfer (ET) or controlled ovarian stimulation (COS) using fresh oocytes (DOR-fresh) and ET. Primary outcomes were LBR per ET and cumulative LBR (CLBR) per intention to treat (ITT). Secondary outcomes were clinical pregnancy rate (CPR) and miscarriage rate (MR). RESULTS Two hundred eleven patients underwent simultaneous insemination of vitrified oocyte accumulation and ET in the DOR-Accu group (maternal age: 39.29 ± 4.23 y, AMH: 0.54 ± 0.35 ng/ml), and 229 patients underwent COS and ET in the DOR-fresh group (maternal age: 38.07 ± 3.77 y, AMH: 0.72 ± 0.32 ng/ml). CPR in the DOR-Accu group was similar in the DOR-fresh group (27.5% vs. 31.0%, p = 0.418). However, MR was statistically higher (41.4% vs. 14.1%, p = 0.001), while LBR per ET was statistically lower (15.2% vs. 26.2%, p < 0.001) in the DOR-Accu group. There is no difference in CLBR per ITT between groups (20.4% vs. 27.5%, p = 0.081). The secondary analysis categorized clinical outcomes into four groups regarding patients' age. CPR, LBR per ET, and CLBR did not improve in the DOR-Accu group. In the group of 31 patients, accumulated vitrified metaphase II (M-II) oocytes reached a total number of ≥ 15, and CPR improved among the DOR-Accu group (48.4% vs. 31.0%, p = 0.054); however, higher MR (40.0% vs. 14.1%, p = 0.03) resulted in similar LBR per ET (29.0% vs. 26.2%, p = 0.738). CONCLUSIONS Vitrified oocyte accumulation for managing DOR did not improve LBR. Higher MR resulted in lower LBR in the DOR-Accu group. Therefore, the vitrified oocyte accumulation strategy for managing DOR is not clinically practical. TRIAL REGISTRATION The study protocol was retrospectively registered and was approved by Institutional Review Board of Mackay Memorial Hospital (21MMHIS219e) on August 26, 2021.
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Ceschin II, Ceschin AP, Joya MS, Mitsugi TG, Nishikawa LK, Krepischi AC, Okamoto OK. Functional assessment of donated human embryos for the generation of pluripotent embryonic stem cell lines. Reprod Biomed Online 2023; 46:491-501. [PMID: 36737274 DOI: 10.1016/j.rbmo.2022.11.020] [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: 08/16/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/04/2022]
Abstract
RESEARCH QUESTION Can discarded embryos at blastocyst stage, donated to research because of genetic abnormalities and poor morphological quality, become a reliable source of human embryonic stem cell (HESC) lines? DESIGN This study was consecutively conducted with 23 discarded embryos that were donated to research between February 2020 and April 2021. All embryos, except one, were morphologically evaluated and underwent trophectoderm biopsy for preimplantation genetic testing using next-generation sequencing (NGS), and then vitrified. After warming, the embryos were placed in appropriate culture conditions for the generation of HESCs, which was functionally assessed with immunofluorescence and flow cytometry for pluripotency capacity and spontaneous in-vitro differentiation. Cytogenetic assessment of the HESC was conducted with multiplex ligation-dependent probe amplification, and micro array comparative genomic hybridization. RESULTS From the 23 embryos initially included, 17 survived warming, and 16 of them presented viability. Overall, the embryos presented poor morphological quality after warming. Only the previously untested embryo was capable of generating a new HESC line. Further characterization of this line revealed fully functional, euploid HESCs with preserved pluripotency, becoming a useful resource for research into human development and therapeutic investigation. CONCLUSIONS None of the donated blastocysts with poor morphological quality in association with genetic abnormalities detected by NGS had the capacity for further in-vitro expansion to originate pluripotent HESC lines. This finding seems to provide extra support to genetic counselling on the suitability of this type of embryo for clinical use.
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Affiliation(s)
- Ianaê I Ceschin
- Human Genome and Stem Cells Research Center, Biosciences Institute, University of São Paulo (IB-USP), Rua do Matão, Travessa 14, 321-05508-090, São Paulo, Brazil; Feliccità Instituto de Fertilidade, Rua Conselheiro Dantas, 1154-80220-191, Curitiba, Brazil.
| | - Alvaro P Ceschin
- Feliccità Instituto de Fertilidade, Rua Conselheiro Dantas, 1154-80220-191, Curitiba, Brazil
| | - Maria S Joya
- Human Genome and Stem Cells Research Center, Biosciences Institute, University of São Paulo (IB-USP), Rua do Matão, Travessa 14, 321-05508-090, São Paulo, Brazil
| | - Thiago G Mitsugi
- Human Genome and Stem Cells Research Center, Biosciences Institute, University of São Paulo (IB-USP), Rua do Matão, Travessa 14, 321-05508-090, São Paulo, Brazil
| | - Lucileine K Nishikawa
- Feliccità Instituto de Fertilidade, Rua Conselheiro Dantas, 1154-80220-191, Curitiba, Brazil
| | - Ana Cv Krepischi
- Human Genome and Stem Cells Research Center, Biosciences Institute, University of São Paulo (IB-USP), Rua do Matão, Travessa 14, 321-05508-090, São Paulo, Brazil
| | - Oswaldo K Okamoto
- Human Genome and Stem Cells Research Center, Biosciences Institute, University of São Paulo (IB-USP), Rua do Matão, Travessa 14, 321-05508-090, São Paulo, Brazil
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5
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Almodin CG. Concerns regarding the study "Comparing the effects of a commercial and a prototype vitrification medium on meiotic spindle morphology and survival rate of mouse oocytes". JBRA Assist Reprod 2022; 26:679. [PMID: 36350243 PMCID: PMC9635614 DOI: 10.5935/1518-0557.20220038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/15/2022] [Indexed: 01/05/2023] Open
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Bakkensen JB, Flannagan KSJ, Mumford SL, Hutchinson AP, Cheung EO, Moreno PI, Jordan N, Feinberg EC, Goldman KN. A SART data cost-effectiveness analysis of planned oocyte cryopreservation versus in vitro fertilization with preimplantation genetic testing for aneuploidy considering ideal family size. Fertil Steril 2022; 118:875-884. [PMID: 36175208 PMCID: PMC9613595 DOI: 10.1016/j.fertnstert.2022.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To determine the cost-effectiveness of planned oocyte cryopreservation (OC) as a strategy for delayed childbearing to achieve 1 or 2 live births (LB) compared with in vitro fertilization (IVF) and preimplantation genetic testing for aneuploidy (PGT-A) at advanced reproductive age. DESIGN Decision tree model with sensitivity analyses using data from the Society for Assisted Reproductive Technology Clinical Outcome Reporting System and other clinical sources. SETTING Not applicable. PATIENT(S) A data-driven simulated cohort of patients desiring delayed childbearing with an ideal family size of 1 or 2 LB. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Probability of achieving ≥1 or 2 LB, average and maximum cost per patient, cost per percentage point increase in chance of LB, and population-level cost/LB. RESULT(S) For those desiring 1 LB, planned OC at age 33 with warming at age 43 decreased the average total cost per patient from $62,308 to $30,333 and increased the likelihood of LB from 50% to 73% when compared with no OC with up to 3 cycles of IVF/PGT-A at age 43. For those desiring 2 LB, 2 cycles of OC at age 33 and warming at age 40 yielded the lowest cost per patient and highest likelihood of achieving 2 LB ($51,250 and 77%, respectively) when compared withpursuing only 1 cycle of OC ($75,373 and 61%, respectively), no OC and IVF/PGT-A with embryo banking ($79,728 and 48%, respectively), or no OC and IVF/PGT-A without embryo banking ($79,057 and 19%, respectively). Sensitivity analyses showed that OC remained cost-effective across a wide range of ages at cryopreservation. For 1 LB, OC achieved the highest likelihood of success when pursued before age 32 and remained more effective than IVF/PGT-A when pursued before age 39, and for 2 LB, 2 cycles of OC achieved the highest likelihood of success when pursued before age 31 and remained more effective than IVF/PGT-A when pursued before age 39. CONCLUSION(S) Among patients planning to postpone childbearing, OC is cost-effective and increases the odds of achieving 1 or 2 LB when compared with IVF/PGT-A at a more advanced reproductive age.
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Affiliation(s)
- Jennifer B Bakkensen
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Kerry S J Flannagan
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Kelly Government Solutions, Rockville, Maryland
| | - Sunni L Mumford
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Anne P Hutchinson
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Shady Grove Fertility, Rockville, MD
| | - Elaine O Cheung
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Patricia I Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Neil Jordan
- Department of Psychiatry and Behavioral Sciences, Mental Health Services & Policy Program, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Eve C Feinberg
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kara N Goldman
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Gursu T, Goksever Celik H, Eraslan A, Angun B, Ozaltin S, Yeh J, Bastu E. Comparison of pregnancy outcomes of 7515 same donor oocyte cycle fresh and cryopreserved-thawed oocytes in 609 donor oocyte recipient cycles: A single institution analysis. Eur J Obstet Gynecol Reprod Biol 2022; 277:110-115. [PMID: 36067608 DOI: 10.1016/j.ejogrb.2022.08.015] [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: 04/08/2022] [Revised: 07/07/2022] [Accepted: 08/21/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Oocyte donation (OD) cycles have been used extensively over the last decades due to high success regarding live birth rate (LBR). We evaluated the reproductive outcomes of fresh and vitrified sibling oocytes in terms of fertilization rates, blast ratio, clinical pregnancy rates, and LBR. MATERIALS AND METHODS This retrospective cohort study was conducted at a tertiary in vitro fertilization (IVF) center. A total of 7515 metaphase II (MII) donor oocytes from 304 donor cycles for 609 oocyte recipients undergoing embryo transfers with either fresh or cryopreserved-thawed donor oocytes. Donor cycles that provided both 12 fresh MII oocytes to be used for one recipient and at least 12 MII oocytes which were suitable for vitrification to be used for another recipient at another time were analyzed. Fertilization rates, blastocyst ratios, clinical pregnancy rates (CPR), LBR were evaluated as main outcome measures. RESULTS When the fresh and cryopreserved-thawed OD cycles were compared, there was no significant differences between two groups in terms of age of the recipient (41.9 ± 5.7 and 40.3 ± 6.8, p = NS), number of MII oocytes (12.1 ± 0.3 and 12.6 ± 0.8, p = NS), number of 2 pronuclear (PN) (9.1 ± 1.6 and 9.7 ± 2.0, p = NS), blastocyst ratio (58.9 ± 21.7 and 51.3 ± 21.2, p = NS) and number of transferred embryos (1.9 ± 0.3 and 1.9 ± 0.3, p = NS). There was no significant difference between fresh and cryopreserved-thawed sibling donor oocyte cycles in terms of CPR (66.8 % and 60.7 % respectively, p = NS) or LBR (59.5 % and 55.1 %, respectively; p = NS). Miscarriage and multiple gestation rates were similar between groups (p = NS). Log-binomial regression analysis revealed that the use of fresh sibling oocytes was not associated with CPR or LBR, when compared to cryopreserved-thawed oocytes. CONCLUSIONS There was no significant difference in terms of reproductive outcomes between sibling fresh OD and cryopreserved-thawed OD cycles.
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Affiliation(s)
- Turkan Gursu
- University of Health Sciences, Istanbul Zeynep Kamil Maternity and Children's Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Hale Goksever Celik
- Acibadem Fulya Hospital, Department of Obstetrics and Gynecology, IVF and Endometriosis Center, Istanbul, Turkey.
| | - Alper Eraslan
- Dunya IVF Center, Department of Reproductive Endocrinology and Infertility, Kyrenia, Cyprus
| | - Berk Angun
- Dunya IVF Center, Department of Reproductive Endocrinology and Infertility, Kyrenia, Cyprus.
| | - Selin Ozaltin
- Acibadem Fulya Hospital, Department of Obstetrics and Gynecology, IVF and Endometriosis Center, Istanbul, Turkey
| | - John Yeh
- University of Harvard Medical School, Department of Obstetrics and Gynecology, Boston, MA, USA
| | - Ercan Bastu
- Biruni University, Department of Obstetrics and Gynecology, Istanbul, Turkey; UMass Chan Medical School, Worcester, USA
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Viana IGR, Vireque AA, Navarro PA. Comparing the effects of a commercial and a prototype vitrification medium on meiotic spindle morphology and survival rate of mouse oocytes. JBRA Assist Reprod 2022; 26:500-507. [PMID: 35261222 PMCID: PMC9355432 DOI: 10.5935/1518-0557.20210117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 12/30/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To compare oocyte survival and meiotic spindle normality between vitrified-warmed oocytes in a mouse embryo assay using Tvitri-4 or Ingámed vitrification media. METHODS C57BL/6 female mice aged 8-12 weeks were submitted to superovulation with pregnant mare's serum gonadotropin and human chorionic gonadotropin (hCG) for obtaining of in vivo matured oocytes. The oocytes were randomly distributed into one of the following three groups: CTR - control (fresh oocytes); ING - oocytes vitrified-warmed in a standard commercial kit supplied by Ingámed, and T4 - oocytes vitrified-warmed in the novel prototype Tvitri-4 medium. After warming and recovery culture, oocytes were assessed with respect to survival rate (SR) and both meiotic spindle morphology and chromosome alignment of each oocyte fixed in the sagittal position after immunostaining and analysis by confocal microscopy. RESULTS A total of 354 mature oocytes were vitrified in ING (n=178) and T4 (n=176), out of which 299 (85%) survived after warming. Oocyte survival rates were not statistically different (p=0.08) between ING (145/178=81.5%) and T4 (154/176=87.5%). Regarding meiotic normality, there were no significant changes in the proportion of oocytes with normal meiotic spindle morphology and chromosome structure between ING (52,2%) and T4 (63.4%) after warming (RR: 0.95, 95% CI: 0.92-1.607). When the meiotic normality was assessed using the CTR group as a reference in the analysis of relative risk, no significant differences were observed between T4 (63.4%) and CTR (70.5%) (RR: 0.95, 95% CI: 0.72-1.12). On the other hand, the percentage of oocytes retaining normal meiotic spindle morphology and chromosome configuration in ING (52.2%) was lower than in the CTR group (RR: 0.95, 95% CI: 0.57-0.97). CONCLUSIONS The novel prototype Tvitri-4 medium was efficient in preserve survival rate and meiotic spindle normality of oocytes and, with further verification, may be able to replace commercially available media in future clinical applications.
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Affiliation(s)
- Iara Gonçalves Roberto Viana
- Division of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP, Brazil
- Clinic Semear Fertility, Ribeirao Preto, SP, Brazil
| | | | - Paula Andrea Navarro
- Division of Human Reproduction, Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP, Brazil
- National Institute of Hormones and Women’s Health CNPq, Brazil
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Nakano R, Radaelli MR, Fujihara LS, Yoshinaga F, Nakano E, Almodin CG. Efficacy of a modified transvaginal ultrasound-guided fresh embryo transfer procedure. JBRA Assist Reprod 2022; 26:78-83. [PMID: 34415124 PMCID: PMC8769173 DOI: 10.5935/1518-0557.20210048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/20/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To present a modified transvaginal ultrasound (TVUS) guided embryo transfer (ET) procedure and analyze its efficacy in comparison with conventional transabdominal ultrasound (TAUS) guided ET in an unselected population of Brazilian women. METHODS This retrospective observational case-control study involved 447 fresh ET cycles, 221 guided by TVUS (Group 1), conducted between June 2016 and February 2019, and 226 by TAUS (Group 2), conducted between July 2012 and December 2015. Pregnancy rate was the main endpoint. Groups were compared using the Z test at a level of significance of 95% (p≤0.05). RESULTS Patient age ranged from 21 and 48 years; mean age was 37.7 years in Group 1 and 38 years in Group 2. Overall, patients that underwent TVUS-guided fresh ET demonstrated significantly higher pregnancy rates than their counterparts that underwent TAUS-guided fresh ET (p=0.0107). TVUS-guided fresh ET also yielded significantly higher pregnancy rates in the subgroups of women aged 36-39 years (p=0.0037) and ≥ 40 years (p=0.0025). However, no significant pregnancy rate difference was observed in women aged ≤ 35 years (p=0.0905). CONCLUSIONS The results suggested that TVUS-guided fresh ET was at least as effective as TAUS-guided fresh ET in the studied sample. Pending further prospective studies to better ascertain the effect of TVUS-guided ET, the technique presented deserves consideration since it can offer better visualization, more comfort to patients, and requires only one operator, without negatively affecting pregnancy results.
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Affiliation(s)
- Raul Nakano
- Clínica de Reprodução Humana FERTICLIN, São Paulo, SP, Brazil
| | | | | | | | - Enzo Nakano
- Clínica de Reprodução Humana FERTICLIN, São Paulo, SP, Brazil
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Martello CL, Kulmann MIR, Donatti LM, Bos-Mikich A, Frantz N. Preimplantation genetic testing for aneuploidies does not increase success rates in fresh oocyte donation cycles: a paired cohort study. J Assist Reprod Genet 2021; 38:2909-2914. [PMID: 34611788 PMCID: PMC8609072 DOI: 10.1007/s10815-021-02339-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To determine whether in vitro fertilization cycles using fresh oocyte donations benefit from preimplantation genetic testing for aneuploidies. METHODS A paired cohort study compared 44 fresh oocyte donation cycles with or without preimplantation genetic testing for aneuploidy (PGT-A). The sibling oocyte study analyzed fertilized oocytes, blastocyst development, and euploidy rate. Only frozen embryo transfers were performed. Pregnancy, implantation, biochemical pregnancy, miscarriage, stillbirth, live birth, and twin pregnancy rates were analyzed between groups. RESULTS Fresh oocyte donation cycles between PGT-A and non-PGT-A groups were similar in all laboratory and clinical outcomes. A euploidy rate of 74.2% was observed in the PGT-A group. Although a slight trend was observed for implantation rate in the PGT-A group, it was not statistically significant. No difference was observed for live birth between groups. CONCLUSION PGT-A associated with fresh oocyte donation cycles does not improve clinical outcomes and can be seen as over-treatment for patients.
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Affiliation(s)
| | | | | | - Adriana Bos-Mikich
- Basic Health Sciences Institute, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Nilo Frantz
- Nilo Frantz Reproductive Medicine, Porto Alegre, RS, Brazil
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Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline. Fertil Steril 2021; 116:36-47. [PMID: 34148587 DOI: 10.1016/j.fertnstert.2021.02.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To provide evidence-based recommendations to practicing physicians and others regarding the efficacy of oocyte cryopreservation (OC) for donor oocyte in vitro fertilization and planned OC. METHODS The American Society for Reproductive Medicine conducted a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1986 to 2018. The American Society for Reproductive Medicine Practice Committee and a task force of experts used available evidence and through consensus developed evidence-based guideline recommendations. MAIN OUTCOME MEASURE(S) Outcomes of interest included live birth rate, clinical pregnancy rate, obstetrical and neonatal outcomes, and factors predicting reproductive outcomes. RESULT(S) The literature search identified 30 relevant studies to inform the evidence base for this guideline. RECOMMENDATION(S) Evidence-based recommendations were developed for predicting the likelihood of live births after planned OC, autologous OC in infertile women, and donor OC, as well as factors that may impact live birth rates. Recommendations were developed regarding neonatal outcomes after using fresh vs. cryopreserved oocytes in cases of autologous or donor oocytes. CONCLUSION(S) There is insufficient evidence to predict live birth rates after planned OC. On the basis of limited data, ongoing and live birth rates appear to be improved for women who undergo planned OC at a younger vs. older age. Although there are no significant differences in per transfer pregnancy rates with cryopreserved vs. fresh donor oocytes, there is insufficient evidence that the live birth rate is the same with vitrified vs. fresh donor oocytes. Neonatal outcomes appear similar with cryopreserved oocytes compared with fresh oocytes. Future studies that compare cumulative live birth rates are needed.
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Affiliation(s)
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- The American Society for Reproductive Medicine, Birmingham, Alabama
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Porcu E, Tranquillo ML, Notarangelo L, Ciotti PM, Calza N, Zuffa S, Mori L, Nardi E, Dirodi M, Cipriani L, Labriola FS, Damiano G. High-security closed devices are efficient and safe to protect human oocytes from potential risk of viral contamination during vitrification and storage especially in the COVID-19 pandemic. J Assist Reprod Genet 2021; 38:681-688. [PMID: 33432422 PMCID: PMC7799863 DOI: 10.1007/s10815-021-02062-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/02/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The main purpose and research question of the study are to compare the efficacy of high-security closed versus open devices for human oocytes' vitrification. METHODS A prospective randomized study was conducted. A total of 737 patients attending the Infertility and IVF Unit at S.Orsola University Hospital (Italy) between October 2015 and April 2020 were randomly assigned to two groups. A total of 368 patients were assigned to group 1 (High-Security Vitrification™ - HSV) and 369 to group 2 (Cryotop® open system). Oocyte survival, fertilization, cleavage, pregnancy, implantation, and miscarriage rate were compared between the two groups. RESULTS No statistically significant differences were observed on survival rate (70.3% vs. 73.3%), fertilization rate (70.8% vs. 74.9%), cleavage rate (90.6% vs. 90.3%), pregnancy/transfer ratio (32.0% vs. 31.8%), implantation rate (19.7% vs. 19.9%), nor miscarriage rates (22.1% vs. 21.5%) between the two groups. Women's mean age in group 1 (36.18 ± 3.92) and group 2 (35.88 ± 3.88) was not significantly different (P = .297). A total of 4029 oocytes were vitrified (1980 and 2049 in groups 1 and 2 respectively). A total of 2564 were warmed (1469 and 1095 in groups 1 and 2 respectively). A total of 1386 morphologically eligible oocytes were inseminated by intracytoplasmic sperm injection (792 and 594 respectively, P = .304). CONCLUSIONS The present study shows that the replacement of the open vitrification system by a closed one has no impact on in vitro and in vivo survival, development, pregnancy and implantation rate. Furthermore, to ensure safety, especially during the current COVID-19 pandemic, the use of the closed device eliminates the potential samples' contamination during vitrification and storage.
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Affiliation(s)
- Eleonora Porcu
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Maria Lucrezia Tranquillo
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Leonardo Notarangelo
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Patrizia Maria Ciotti
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
| | - Nilla Calza
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
| | - Silvia Zuffa
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
| | - Lisa Mori
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Elena Nardi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Maria Dirodi
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
| | - Linda Cipriani
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
| | - Francesca Sonia Labriola
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Damiano
- Infertility and IVF Unit, University of Bologna, Sant’Orsola University Hospital, Bologna, Italy
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Gürtin ZB, Tiemann E. The marketing of elective egg freezing: A content, cost and quality analysis of UK fertility clinic websites. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 12:56-68. [PMID: 33336090 PMCID: PMC7732876 DOI: 10.1016/j.rbms.2020.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/17/2020] [Accepted: 10/22/2020] [Indexed: 05/23/2023]
Abstract
To the authors' knowledge, this is the first UK-based study to analyse the marketing of elective egg freezing (EEF) by fertility clinics. Analyses were based on the websites of the top 15 UK clinics, which together provided 87.8% of all egg freezing cycles in the UK between 2008 and 2017 inclusive. The analyses included three phases: content analysis; systematic cost analysis and comparison; and quality analysis examining the information available on egg freezing and its adherence to the guidelines of the Human Fertilisation and Embryology Authority (HFEA). The results show that clinics frame EEF according to four main themes: as a new and exciting technology; as a solution to (a modern woman's) life circumstances; as a means to gain control, freedom and more reproductive options; and as a means to avoid the reproductive risks of ageing. This study also found that most clinics are not sufficiently clear and transparent about the 'true' cost of an EEF cycle, present an unbalanced view of EEF, and do not provide satisfactory data or information. Most importantly, none of the clinics adhere adequately to the HFEA guidelines regarding advertising and the provision of information. As the EEF market continues to grow, offered exclusively by private clinics, these findings require urgent attention. Clinics must improve the type and quality of EEF information on their websites such that potential patients can make informed choices, and this article provides 10 basic criteria which can be used as a checklist. It is suggested that the time may have come to grant greater economic regulatory powers to HFEA to avoid overcommercialization of the fertility industry.
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Affiliation(s)
- Zeynep B. Gürtin
- EGA Institute for Women’s Health, University College London, London, UK
| | - Emily Tiemann
- EGA Institute for Women’s Health, University College London, London, UK
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Colodetti L, Pinho de França P, Sampaio M, Geber S. Do different culture intervals (2 × 24 hours) after thaw of cleavage stage embryos affect pregnancy rates? A randomized controlled trial. Cryobiology 2020; 95:80-83. [PMID: 32533985 DOI: 10.1016/j.cryobiol.2020.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 11/18/2022]
Abstract
The aim of the study was to evaluate whether selecting embryos for transfer after prolonged culture after thaw (18-24 h) has better pregnancy rates than selecting embryos for transfer after short culture after thaw (2-5 h). We performed a double-blinded, randomized, controlled trial, evaluating 388 patients submitted to ART treatment who had embryos frozen on day-2 and subsequently transferred. All patients received the same endometrial priming with estradiol valerate followed by vaginal progesterone. Patients were randomized for Frozen embryo transfer 2-5 h after thaw (Group D2) or 18-24 h after thaw (Group D2/D3). The main Outcome Measure was ongoing pregnancy rate (OPR) at 20 weeks' gestation per embryo transfer. A total of 179 patients had embryos transferred 2-5 h after thaw and 209 patients had embryos transferred 18-24 h after thaw. The mean age in group D2 was 36 ± 4.4 and 36 ± 5.4 in group D2/D3. Ongoing pregnancy rate was 28% and 33.5% (p = 0.2) for groups D2 and D2/D3, respectively. These results suggest that increasing the culture time of embryos in one day to improve selection before transfer does not increase ongoing pregnancy rate. CLINICAL TRIAL REGISTRATION NUMBER: NCT03381001.
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Affiliation(s)
- Laudislena Colodetti
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Marcos Sampaio
- ORIGEN - Centre for Reproductive Medicine, Belo Horizonte, Brazil
| | - Selmo Geber
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; ORIGEN - Centre for Reproductive Medicine, Belo Horizonte, Brazil.
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Arnanz A, De Munck N, Bayram A, El-Damen A, Abdalla A, ElKhatib I, Melado L, Lawrenz B, Fatemi HM. Blastocyst mitochondrial DNA (mtDNA) is not affected by oocyte vitrification: a sibling oocyte study. J Assist Reprod Genet 2020; 37:1387-1397. [PMID: 32372301 PMCID: PMC7311594 DOI: 10.1007/s10815-020-01795-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/24/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To evaluate whether mtDNA content at the blastocyst stage differs between embryos derived from fresh or vitrified sibling oocytes. MATERIAL AND METHODS A retrospective analysis was performed between March 2017 and September 2018, including 504 blastocysts from 94 couples undergoing preimplantation genetic testing for aneuploidies (PGT-A), using fresh oocytes together with previously vitrified oocytes. Trophectoderm biopsies were performed and subjected to next generation sequencing. RESULTS On average, 1.8 ± 1.0 oocyte vitrification cycles were performed per patient. Between fresh and vitrified cycles, no difference was observed between the number of fertilized oocytes (5.3 ± 4.2 versus 5.5 ± 3.0). Blastulation rate on day 5 per fertilized oocyte was significantly higher in the fresh group (62% ± 29% versus 44% ± 31%; p < 0.001). For the 504 biopsied blastocysts, 294 fresh versus 210 vitrified, no significant differences were found in the euploid rate, 40.5% versus 38.6% (p = 0.667), and mtDNA content, 30.1 (± 10.6) versus 30.0 (± 12.5) (p = 0.871), respectively. Regardless of the origin of the oocytes, aneuploid blastocysts contained significantly higher mtDNA values compared with the euploid ones (31.4 versus 28.0; p = 0.001). Furthermore, top-quality blastocysts had a significantly lower mtDNA content compared with moderate and poor-quality blastocysts (p < 0.001) and blastocysts biopsied on day 5 showed significantly lower mtDNA content compared with day 6 or day 7 blastocysts (p < 0.001). However, when analyzing the blastocyst mtDNA content according to the ploidy state, no differences were found for blastocyst quality or day of biopsy between blastocysts originating from fresh or vitrified oocytes. CONCLUSION Oocyte vitrification does not affect the mtDNA content of trophectoderm biopsies.
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Affiliation(s)
- Ana Arnanz
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Neelke De Munck
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Aşina Bayram
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Ahmed El-Damen
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Andrea Abdalla
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Ibrahim ElKhatib
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Laura Melado
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Barbara Lawrenz
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
| | - Human M. Fatemi
- IVIRMA Middle East Fertility Clinic, Abu Dhabi, United Arab Emirates
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Almodin CG, Radaelli MR, Almodin PM, Mingetti-Câmara VC, Silva CGD. Vitrification technique for female germinative tissue cryopreservation and banking. JBRA Assist Reprod 2020; 24:128-134. [PMID: 31692315 PMCID: PMC7169907 DOI: 10.5935/1518-0557.20190069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective To report on a device designed for the vitrification of germinative tissue, and a systematic vitrification/warming protocol. Methods We obtained six fragments of cortical germinative tissue from a human ovary. We randomly chose two fragments and sent them to histological analysis. We vitrified four test samples and stored them for one week in liquid nitrogen (LN), and warmed one week later. We sent the vitrified/warmed fragments to the pathology laboratory, where they analyzed them morphologically under an optical microscope (10-40X). They analyzed the nuclear and cytoplasmic characteristics of the follicular cells, luteal layer, and stroma. The primordial and primary follicles in the fresh and vitrified/warmed fragments were counted and compared with the Mann-Whitney test (p<0.05). Results There were ovarian follicles in different phases of maturation in both fresh and vitrified/warmed fragments, with a predominance of healthy-looking primordial and primary follicles. In the test fragments, the fusocellular architecture supporting the stromal cells exhibited some foci of edema, and were associated with cells with hydropic degeneration, with cytoplasmic fragmentation and eosinophilia. However, there were no signs of tissue necrosis or autolysis. There was no statistically significant difference between the number of follicles found in the control and test tissue fragments (p>0.05). Conclusions There were no significant morphological changes between fresh and vitrified/warmed germinative tissue. The vitrification device and protocol tested were effective in the preservation of human follicles, and should be considered for the banking germinative tissue for the restoration of fertility of women who are submitted to life-saving sterilizing treatments.
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Affiliation(s)
| | - Moacir Rafael Radaelli
- Materbaby - Reprodução Humana e Genética. Maringá, Brazil.,Departamento de Urologia, Escola de Medicina, Faculdade Ingá, Maringá, Brazil
| | | | - Vânia Cibelle Mingetti-Câmara
- Materbaby - Reprodução Humana e Genética. Maringá, Brazil.,Departamento de Análise Farmacêutica, Universidade Estadual de Maringá - UEM, Maringá, Brazil
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Melado L, Arnanz A, Bayram A, Elkhatib I, De Munck N, Navarro AT, Coughlan C, Lawrenz B, Fatemi HM. Anti-Müllerian hormone is an independent marker for oocyte survival after vitrification. Reprod Biomed Online 2020; 41:119-127. [PMID: 32499103 DOI: 10.1016/j.rbmo.2020.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/26/2020] [Accepted: 03/23/2020] [Indexed: 01/04/2023]
Abstract
RESEARCH QUESTION This study explored the relationship between anti-Müllerian hormone (AMH) and oocyte survival after vitrification. The association between AMH and blastocyst formation after oocyte vitrification was also assessed. DESIGN A retrospective observational analysis was performed in a private IVF centre. A total of 4507 metaphase-II warmed oocytes were included from 450 couples, predominantly of Arab ethnicity. Between August 2015 and August 2018, couples underwent 484 intracytoplasmic sperm injection (ICSI) treatments using vitrified-warmed oocytes. RESULTS Patients' median age ± SD was 36.2 ± 6.1 years, AMH concentration 2.6 ± 3.4 ng/ml and body mass index (BMI) 26.5 ± 4.6 kg/m2. The oocyte survival rate after vitrification was 87.37 ± 20.42%. AMH concentration showed a significant correlation (Kendall's tau 0.087, P = 0.0079) with oocyte survival rate independent of oocyte yield. Correlation was significant (odds ratio 1.041, 95% confidence interval 1.007-1.077, P = 0.018) when a multivariant model was applied that included AMH, age and BMI. The receiver operating characteristic curve showed an AMH cut-off value of 1.09 ng/ml that could obtain at least a 70% survival rate, with an area under the curve of 0.669. Regarding embryo development in ICSI cycles including fresh and warmed oocytes for the same patient, blastocyst formation rate was higher in fresh compared with warmed oocytes (P < 0.001). In this subgroup no significant correlation was seen between fertilization or blastocyst rate and AMH concentration. CONCLUSIONS AMH concentration showed a significant correlation with oocyte survival. Blastocyst formation was significantly lower after oocyte vitrification, but no correlation was found with AMH. Clinicians should carefully evaluate oocyte vitrification for patients with AMH below 1.09 ng/ml and consider embryo accumulation for these patients in preference to oocyte accumulation.
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Affiliation(s)
- Laura Melado
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE; IVF Department, IVI Middle-East Fertility Clinic, Dubai, UAE.
| | - Ana Arnanz
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Asina Bayram
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Ibrahim Elkhatib
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Neelke De Munck
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | | | - Carol Coughlan
- IVF Department, IVI Middle-East Fertility Clinic, Dubai, UAE
| | - Barbara Lawrenz
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE; Women's University Hospital Tuebingen, Tuebingen, Germany
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Nigmetova K, Karibaeva S, Abshekenova A, Rybina A, Begimbaeva A, Dzhansugurova L, Lokshin V. COMPARATIVE ANALYSIS OF PROGRAMS WITH THE USE OF NATIVE AND CRYOPRESERVED OOCYTES IN IN -VIRTO FERTILIZATION PROCEDURES. REPRODUCTIVE MEDICINE 2020. [DOI: 10.37800/rm2020-1-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This article release data about comparative survival of oocytes after freezing, fertilization, blastocyst formation and clinical results of IVF/ICSI programs in International Clinical Centre of Reproductology Persona during period from 2016 to 2019.
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Comparison between in vitro embryo production using Y-sorted sperm and timed artificial insemination with non-sorted sperm to produce crossbred calves. Anim Reprod Sci 2019; 208:106101. [PMID: 31405466 DOI: 10.1016/j.anireprosci.2019.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/17/2019] [Accepted: 06/18/2019] [Indexed: 11/21/2022]
Abstract
Due to the increasing use of in vitro embryo production (IVEP) and the importance of crossbreeding for beef production, pregnancy rates of Nelore recipients were evaluated following Fixed Time Embryo Transfer with fresh or vitrified IVEP embryos produced with Y-sorted sperm of Angus bulls (B. taurus) or Fixed Time Artificial Insemination using non-sorted sperm. For IVEP in Experiment 1, oocytes were obtained using Ovum Pick Up (OPU) (n = 84 embryos) or from ovaries from a slaughterhouse (SLAUGHTER, n = 66 embryos). In Experiment 2, with oocytes obtained by OPU, IVEP embryos were fresh (FRESH, n = 271) or after vitrification/warming (VITRIFIED, n = 79) and PR was compared with FTAI (n = 239). In Experiment 1, cleavage rates were 63.8% and 39.1% for OPU and SLAUGHTER groups, respectively (P = 0.02), and blastocyst rates were 30.5% and 14.7%, respectively (P = 0.09). The PR was similar when considering the source of oocytes (OPU = 35.7%; SLAUGHTER = 25.8%; P = 0.17). In Experiment 2, there was no difference in PR for FRESH or VITRIFIED embryos (34.3% and 30.4%, respectively, P = 0.72), but lesser than FTAI (47.7, P = 0.002). It is concluded that the IVEP with Y-sorted sperm associated with vitrification or embryos produced with oocytes from different sources did not affect PR when there was transfer of crossbred embryos into recipients, and can optimize large-scale application of IVEP technology; however, FTAI pregnancy rates with non-sex sorted sperm were greater.
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Simopoulou M, Sfakianoudis K, Bakas P, Giannelou P, Papapetrou C, Kalampokas T, Rapani A, Chatzaki E, Lambropoulou M, Lourida C, Deligeoroglou E, Pantos K, Koutsilieris M. Postponing Pregnancy Through Oocyte Cryopreservation for Social Reasons: Considerations Regarding Clinical Practice and the Socio-Psychological and Bioethical Issues Involved. MEDICINA (KAUNAS, LITHUANIA) 2018; 54:E76. [PMID: 30366459 PMCID: PMC6262467 DOI: 10.3390/medicina54050076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/01/2018] [Accepted: 10/19/2018] [Indexed: 11/21/2022]
Abstract
Oocyte freezing for 'social reasons' refers to women of reproductive age who are aiming to prolong, protect and secure their fertility. The term emerged to describe application of the highly promising technique, namely vitrification on oocytes retrieved through controlled ovarian stimulation (COS) from women intending to preserve their fertility for social reasons. These women opt to cryopreserve their oocytes at a point in their life when they need to postpone childbearing on the grounds of so called 'social' reasons. These reasons may include a highly driven career, absence of an adequate partner, financial instability, or personal reasons that make them feel unprepared for motherhood. This is a sensitive and multifaceted issue that entails medical, bioethical and socio-psychological components. The latest trend and the apparent increase noted on oocyte freezing for 'social reasons' has prompted our team of fertility specialists, embryologists, obstetricians, gynecologists and psychologists to proceed with a thorough, critical and all-inclusive comprehensive analysis. The wide range of findings of this analysis involve concerns of embryology and epigenetics that shape decisions made in the IVF laboratory, issues regarding obstetric and perinatal concerns on the pregnancy concluding from these oocytes and the respective delivery management and neonatal data, to the social and bioethical impact of this trend's application. This literature review refers to matters rising from the moment the 'idea' of this option is 'birthed' in a woman's thoughts, to proceeding and executing it clinically, up until the point of the pediatric follow up of the children born. We aim to shed light to the controversial issue of oocyte freezing, while objectively exhibit all aspects regarding this complex matter, as well as to respectfully approach how could the prospect of our future expectations be shaped from the impact of its application.
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Affiliation(s)
- Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | | | - Panagiotis Bakas
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Polina Giannelou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
- Centre for Human Reproduction, Genesis Athens Clinic, 14⁻16, Papanikoli, 15232 Athens, Greece.
| | - Christina Papapetrou
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Theodoros Kalampokas
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
| | - Ekaterini Chatzaki
- Laboratory of Histology-Embryology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Maria Lambropoulou
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Chrysoula Lourida
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Efthymios Deligeoroglou
- Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, Greece.
| | - Konstantinos Pantos
- Centre for Human Reproduction, Genesis Athens Clinic, 14⁻16, Papanikoli, 15232 Athens, Greece.
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece.
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Leão BCS, Rocha-Frigoni NAS, Nogueira É, Cabral EC, Ferreira CR, Eberlin MN, Accorsi MF, Neves TV, Mingoti GZ. Membrane lipid profile of in vitro-produced embryos is affected by vitrification but not by long-term dietary supplementation of polyunsaturated fatty acids for oocyte donor beef heifers. Reprod Fertil Dev 2018; 29:1217-1230. [PMID: 27220988 DOI: 10.1071/rd15414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 03/24/2016] [Indexed: 11/23/2022] Open
Abstract
Dietary rumen-protected polyunsaturated fatty acids (PUFAs) rich in linoleic acid (LA) may affect embryo yield, and LA can modulate the molecular mechanisms of lipid uptake in bovine blastocysts produced in vitro. In embryos, membrane lipids, such as phosphatidylcholines (PCs) and sphingomyelins (SMs), affect cryopreservation success. The aim of the present study was to evaluate embryonic developmental rates after the IVF of oocytes retrieved from Nellore heifers fed for approximately 90 days with rumen-protected PUFAs rich in LA. In addition, we evaluated embryo cryotolerance and the membrane structure lipid composition using matrix-assisted laser desorption ionisation mass spectrometry of fresh and vitrified embryos. Embryo development to the blastocyst stage (mean 43.2%) and embryo survival after vitrification and warming (mean 79.3%) were unaffected by diet. The relative abundance of one lipid species (PC ether (PCe; 38:2, which means that this lipid has 38 carbon atoms and 2 double bonds in the fatty acyl residues) was increased after PUFAs supplementation. However, 10 ions were affected by cryopreservation; ions consistent with PC 32:0, PC 34:1, SM 24:1, PC 40:6 or PC 42:9, PC plasmalogen (PCp) 44:10 or PC 42:7, triacylglycerol (TAG) 54:9 and a not assigned ion (m/z 833.2) were lower in blastocysts that survived to the cryopreservation process compared with fresh blastocysts, whereas the abundance of the ions PC 36:3 or PC 34:0, PCe 38:2 or PC 36:6 and PC 36:5 or PCe 38:1 were increased after cryopreservation. Thus, the results demonstrate that the mass spectrometry profiles of PC, SM and TAG species differ significantly in bovine blastocysts upon cryopreservation. Because the lipid ion abundances of fresh and vitrified-warmed embryos were distinct, they can be used as potential markers of post-cryopreservation embryonic survival.
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Affiliation(s)
- Beatriz C S Leão
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, UNESP - Universidade Estadual Paulista, Rua Clóvis Pestana 793, 16050-680, Araçatuba, SP, Brazil
| | - Nathália A S Rocha-Frigoni
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, UNESP - Universidade Estadual Paulista, Rua Clóvis Pestana 793, 16050-680, Araçatuba, SP, Brazil
| | - Ériklis Nogueira
- Embrapa Pantanal, Rua 21 de Setembro 1880, 79320-900, Corumbá, MS, Brazil
| | - Elaine C Cabral
- ThoMSon Mass Spectrometry Laboratory, Institute of Chemistry, University of Campinas, Cidade Universitária Zeferino Vaz s/n, CP 6154, bloco A6, sala 111, 13083-970, Distrito de Barão Geraldo, Campinas, SP, Brazil
| | - Christina R Ferreira
- ThoMSon Mass Spectrometry Laboratory, Institute of Chemistry, University of Campinas, Cidade Universitária Zeferino Vaz s/n, CP 6154, bloco A6, sala 111, 13083-970, Distrito de Barão Geraldo, Campinas, SP, Brazil
| | - Marcos N Eberlin
- ThoMSon Mass Spectrometry Laboratory, Institute of Chemistry, University of Campinas, Cidade Universitária Zeferino Vaz s/n, CP 6154, bloco A6, sala 111, 13083-970, Distrito de Barão Geraldo, Campinas, SP, Brazil
| | - Mônica F Accorsi
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, UNESP - Universidade Estadual Paulista, Rua Clóvis Pestana 793, 16050-680, Araçatuba, SP, Brazil
| | - Thiago V Neves
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, UNESP - Universidade Estadual Paulista, Rua Clóvis Pestana 793, 16050-680, Araçatuba, SP, Brazil
| | - Gisele Z Mingoti
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, UNESP - Universidade Estadual Paulista, Rua Clóvis Pestana 793, 16050-680, Araçatuba, SP, Brazil
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22
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Oocyte vitrification for elective fertility preservation: the past, present, and future. Curr Opin Obstet Gynecol 2017; 29:59-63. [PMID: 27922944 DOI: 10.1097/gco.0000000000000339] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Oocyte cryopreservation is no longer experimental and one of its rapidly growing indications is elective fertility preservation. Currently there is no sufficient evidence to support its practice and therefore its place in IVF remains uncertain. RECENT FINDINGS Vitrification has superior post-thaw survival and fertilization outcomes compared with oocytes that were frozen with the slow-freeze technique. Oocyte vitrification produces similar IVF outcomes compared with fresh oocytes and is not associated with further obstetrical or perinatal morbidity. Undergoing elective oocyte cryopreservation between ages 35 and 37 will optimize live birth rates as well as cost effectiveness from mathematical models. SUMMARY In women who delay child bearing, elective oocyte cryopreservation in the mid 30s may be beneficial in terms of live birth rates and cost effectiveness. Prospective studies of women who have undergone oocyte cryopreservation and are now attempting conception are needed before official recommendations can be made regarding elective egg freezing.
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Paul AK, Liang Y, Srirattana K, Nagai T, Parnpai R. Vitrification of bovine matured oocytes and blastocysts in a paper container. Anim Sci J 2017; 89:307-315. [DOI: 10.1111/asj.12892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 07/10/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Ashit Kumar Paul
- Embryo Technology and Stem Cell Research Center; School of Biotechnology; Suranaree University of Technology; Nakhon Ratchasima Thailand
- Department of Medicine and Surgery; Faculty of Animal Science and Veterinary Medicine; Patuakhali Science and Technology University; Barisal Bangladesh
| | - Yuanyuan Liang
- Embryo Technology and Stem Cell Research Center; School of Biotechnology; Suranaree University of Technology; Nakhon Ratchasima Thailand
| | - Kanokwan Srirattana
- Embryo Technology and Stem Cell Research Center; School of Biotechnology; Suranaree University of Technology; Nakhon Ratchasima Thailand
| | - Takashi Nagai
- International Cooperation Section; National Agriculture and Food Research Organization (NARO); Tsukuba Japan
- Seoul National University 1 Gwanak-ro; Gwanak-gu Seoul Korea
| | - Rangsun Parnpai
- Embryo Technology and Stem Cell Research Center; School of Biotechnology; Suranaree University of Technology; Nakhon Ratchasima Thailand
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24
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Radaelli MRM, Almodin CG, Minguetti-Câmara VC, Cerialli PMA, Nassif AE, Gonçalves AJ. A comparison between a new vitrification protocol and the slow freezing method in the cryopreservation of prepubertal testicular tissue. JBRA Assist Reprod 2017; 21:188-195. [PMID: 28837026 DOI: 10.5935/1518-0557.20170037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study aimed to compare a new vitrification protocol with reduced cryoprotectant exposure to the slow freezing method in the cryopreservation of prepubertal rat testicular tissue. METHODS Five sexually immature male Wistar rats were submitted to bilateral orchiectomy. Tissue samples from each testicle were fragmented into small pieces and randomly assigned to three groups: Group A, fresh tissue (control); Group B, slow programmable freezing (SPF); and Group C (vitrification). Frozen/thawed, vitrified/warmed, and fresh testicular tissue were histologically compared. A pathologist blinded to the procedures assessed the morphology (cell differentiation, nuclei, and epithelium) of 10 seminiferous tubules from each testicle (100 tubules per Group). RESULTS Sertoli and spermatogonial stem cells were easily differentiated, and the nucleoli were easily viewed in the tubules assessed in all three groups. Small alterations in tissue architecture were observed in the control group as a result of tissue handling. Moderate alterations of the epithelium with the formation of small gaps and cell detachment from the basement membrane were observed in 28% of the frozen and 9% of the vitrified tubules. Condensed nuclei involving a small proportion of cells were observed in six and three tubules of the frozen and vitrified group, respectively. Despite the alterations, 97% of the frozen and 99% of the vitrified tubules were considered well preserved. CONCLUSIONS The findings indicate that the vitrification protocol tested in this study adequately preserved the morphological integrity of prepubertal testicular tissue in a rat model. Further studies are required to confirm testicular tissue function after grafting.
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Affiliation(s)
- Moacir R M Radaelli
- Urology Department, Medical School, Faculdade Ingá, Maringá, Brazil.,Surgery Department, Santa Casa de São Paulo Medical Sciences School, São Paulo, Brazil.,Materbaby - Human Reproduction and Genetics Clinic, Maringá - 87.013-230, Brazil
| | - Carlos G Almodin
- Materbaby - Human Reproduction and Genetics Clinic, Maringá - 87.013-230, Brazil
| | | | | | - Aissar E Nassif
- Urology Department, Medical School, Faculdade Ingá, Maringá, Brazil
| | - Antonio J Gonçalves
- Surgery Department, Santa Casa de São Paulo Medical Sciences School, São Paulo, Brazil
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25
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De Munck N, Vajta G. Safety and efficiency of oocyte vitrification. Cryobiology 2017; 78:119-127. [PMID: 28774548 DOI: 10.1016/j.cryobiol.2017.07.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 12/22/2022]
Abstract
As the oocyte is the starting point for a new life, artificial reproductive technology (ART) techniques should not affect the (ultra) structural and functional integrity, or the developmental competence. Oocyte vitrification -one of the most significant achievements in human ART during the past decade- should therefore be a safe and efficient technique. This review discusses the principles and developments of the existing and future techniques, applications possibilities and safety concerns. The broad range of vitrification media and devices that are currently available, show differences in their effects on the oocyte ultrastructure and preimplantation development. It is not yet fully decided whether this has an influence on the obstetric and neonatal outcome, since only limited information is available with different media and devices. For autologous oocytes, the obstetric and neonatal outcomes appear promising and comparable to pregnancies obtained with fresh oocytes. This however, is not the case for heterologous fresh or vitrified oocytes, where the immunological foreign foetus induces adverse obstetric and neonatal outcomes. Besides the oocyte vitrification process itself, the effect of multiple stimulations (for oocyte banking or for oocyte donors), seems to influence the possibility to develop gynaecological cancers further in life. Automated vitrification/warming should offer a consistent, cross-contamination free process that offers the highest safety level for the users. They should also produce more consistent results in survival, development and clinical pregnancies between different IVF clinics.
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Affiliation(s)
- Neelke De Munck
- Universitair Ziekenhuis Brussel (UZ Brussel), Centrum voor Reproductieve Geneeskunde, Laarbeeklaan 101, 1090 Brussels, Belgium.
| | - Gábor Vajta
- Central Queensland University, Bruce Highway, North Rockhampton QLD 4702, Australia
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26
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Rienzi L, Gracia C, Maggiulli R, LaBarbera AR, Kaser DJ, Ubaldi FM, Vanderpoel S, Racowsky C. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update 2017; 23:139-155. [PMID: 27827818 PMCID: PMC5850862 DOI: 10.1093/humupd/dmw038] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/15/2016] [Accepted: 10/14/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Successful cryopreservation of oocytes and embryos is essential not only to maximize the safety and efficacy of ovarian stimulation cycles in an IVF treatment, but also to enable fertility preservation. Two cryopreservation methods are routinely used: slow-freezing or vitrification. Slow-freezing allows for freezing to occur at a sufficiently slow rate to permit adequate cellular dehydration while minimizing intracellular ice formation. Vitrification allows the solidification of the cell(s) and of the extracellular milieu into a glass-like state without the formation of ice. OBJECTIVE AND RATIONALE The objective of our study was to provide a systematic review and meta-analysis of clinical outcomes following slow-freezing/thawing versus vitrification/warming of oocytes and embryos and to inform the development of World Health Organization guidance on the most effective cryopreservation method. SEARCH METHODS A Medline search was performed from 1966 to 1 August 2016 using the following search terms: (Oocyte(s) [tiab] OR (Pronuclear[tiab] OR Embryo[tiab] OR Blastocyst[tiab]) AND (vitrification[tiab] OR freezing[tiab] OR freeze[tiab]) AND (pregnancy[tiab] OR birth[tiab] OR clinical[tiab]). Queries were limited to those involving humans. RCTs and cohort studies that were published in full-length were considered eligible. Each reference was reviewed for relevance and only primary evidence and relevant articles from the bibliographies of included articles were considered. References were included if they reported cryosurvival rate, clinical pregnancy rate (CPR), live-birth rate (LBR) or delivery rate for slow-frozen or vitrified human oocytes or embryos. A meta-analysis was performed using a random effects model to calculate relative risk ratios (RR) and 95% CI. OUTCOMES One RCT study comparing slow-freezing versus vitrification of oocytes was included. Vitrification was associated with increased ongoing CPR per cycle (RR = 2.81, 95% CI: 1.05-7.51; P = 0.039; 48 and 30 cycles, respectively, per transfer (RR = 1.81, 95% CI 0.71-4.67; P = 0.214; 47 and 19 transfers) and per warmed/thawed oocyte (RR = 1.14, 95% CI: 1.02-1.28; P = 0.018; 260 and 238 oocytes). One RCT comparing vitrification versus fresh oocytes was analysed. In vitrification and fresh cycles, respectively, no evidence for a difference in ongoing CPR per randomized woman (RR = 1.03, 95% CI: 0.87-1.21; P = 0.744, 300 women in each group), per cycle (RR = 1.01, 95% CI: 0.86-1.18; P = 0.934; 267 versus 259 cycles) and per oocyte utilized (RR = 1.02, 95% CI: 0.82-1.26; P = 0.873; 3286 versus 3185 oocytes) was reported. Findings were consistent with relevant cohort studies. Of the seven RCTs on embryo cryopreservation identified, three met the inclusion criteria (638 warming/thawing cycles at cleavage and blastocyst stage), none of which involved pronuclear-stage embryos. A higher CPR per cycle was noted with embryo vitrification compared with slow-freezing, though this was of borderline statistical significance (RR = 1.89, 95% CI: 1.00-3.59; P = 0.051; three RCTs; I2 = 71.9%). LBR per cycle was reported by one RCT performed with cleavage-stage embryos and was higher for vitrification (RR = 2.28; 95% CI: 1.17-4.44; P = 0.016; 216 cycles; one RCT). A secondary analysis was performed focusing on embryo cryosurvival rate. Pooled data from seven RCTs (3615 embryos) revealed a significant improvement in embryo cryosurvival following vitrification as compared with slow-freezing (RR = 1.59, 95% CI: 1.30-1.93; P < 0.001; I2 = 93%). WIDER IMPLICATIONS Data from available RCTs suggest that vitrification/warming is superior to slow-freezing/thawing with regard to clinical outcomes (low quality of the evidence) and cryosurvival rates (moderate quality of the evidence) for oocytes, cleavage-stage embryos and blastocysts. The results were confirmed by cohort studies. The improvements obtained with the introduction of vitrification have several important clinical implications in ART. Based on this evidence, in particular regarding cryosurvival rates, laboratories that continue to use slow-freezing should consider transitioning to the use of vitrification for cryopreservation.
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Affiliation(s)
- Laura Rienzi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, via de Notaris 2b, Rome, Italy
| | - Clarisa Gracia
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Roberta Maggiulli
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, via de Notaris 2b, Rome, Italy
| | | | - Daniel J. Kaser
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Filippo M. Ubaldi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, via de Notaris 2b, Rome, Italy
| | - Sheryl Vanderpoel
- HRP (the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction), Geneva, Switzerland(at the time of the study)
- Population Council, Reproductive Health Programme, New York, USA
| | - Catherine Racowsky
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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27
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Goldman R, Racowsky C, Farland L, Munné S, Ribustello L, Fox J. Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients. Hum Reprod 2017; 32:853-859. [DOI: 10.1093/humrep/dex008] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/11/2017] [Indexed: 12/28/2022] Open
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Ambrogi M, Dall'Acqua PC, Rocha-Frigoni N, Leão B, Mingoti GZ. Transporting bovine oocytes in a medium supplemented with different macromolecules and antioxidants: Effects on nuclear and cytoplasmic maturation and embryonic development in vitro. Reprod Domest Anim 2017; 52:409-421. [PMID: 28120355 DOI: 10.1111/rda.12923] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 12/04/2016] [Indexed: 11/29/2022]
Abstract
We investigated whether supplementing the medium used to transport bovine oocytes with different macromolecules [foetal calf serum (FCS) or bovine serum albumin (BSA)] or a mixture of antioxidants (cysteine, cysteamine and catalase) affects their nuclear and cytoplasmic maturation and thereby affects their subsequent embryonic development and cryotolerance. Oocytes were transported for 6 hr in a portable incubator and then subjected to standard in vitro maturation (IVM) for 18 hr. The oocytes in the control groups were cultured (standard IVM) for 24 hr in medium containing 10% FCS (Control FCS) or 10% FCS and the antioxidant mixture (Control FCS+Antiox). The intracellular concentrations of reactive oxygen species (ROS) at the end of IVM period were lower in the oocytes subjected to simulated transport in the presence of a macromolecular supplement or the antioxidant mixture than that of the control group (FCS: 0.62 and BSA: 0.66 vs. Control FCS: 1.00, p < .05; and Transp: 0.58 and Transp Antiox: 0.70 vs. Control FCS: 1.00, p < .05). After IVM, the mitochondrial membrane potentials of the transported oocytes were lower than those of the non-transported oocytes (FCS: 0.41 and BSA: 0.57 vs. Control FCS: 1.00, p < .05; and Transp: 0.48 and Transp Antiox: 0.51 vs. Control FCS: 1.00 and Control Antiox: 0.84, p < .05). The blastocyst formation rates (36.9% average) and the re-expansion rates of vitrified-warmed blastocysts (53%, average) were unaffected (p > .05) by the treatments. In conclusion, supplementing the medium in which bovine oocytes are transported with antioxidants or different macromolecules did not affect their in vitro production of embryos or their cryotolerance.
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Affiliation(s)
- M Ambrogi
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba, SP, Brazil.,Post-Graduation Program in Veterinary Medicine, School of Agrarian and Veterinarian Sciences, Department of Animal Reproduction, Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
| | - P C Dall'Acqua
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba, SP, Brazil.,Post-Graduation Program in Veterinary Medicine, School of Agrarian and Veterinarian Sciences, Department of Animal Reproduction, Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
| | - Nas Rocha-Frigoni
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba, SP, Brazil.,Post-Graduation Program in Veterinary Medicine, School of Agrarian and Veterinarian Sciences, Department of Animal Reproduction, Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
| | - Bcs Leão
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba, SP, Brazil.,Post-Graduation Program in Veterinary Medicine, School of Agrarian and Veterinarian Sciences, Department of Animal Reproduction, Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
| | - G Z Mingoti
- Laboratory of Physiology of Reproduction, School of Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba, SP, Brazil.,Post-Graduation Program in Veterinary Medicine, School of Agrarian and Veterinarian Sciences, Department of Animal Reproduction, Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
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Crawford S, Boulet SL, Kawwass JF, Jamieson DJ, Kissin DM. Cryopreserved oocyte versus fresh oocyte assisted reproductive technology cycles, United States, 2013. Fertil Steril 2016; 107:110-118. [PMID: 27842997 DOI: 10.1016/j.fertnstert.2016.10.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/16/2016] [Accepted: 10/03/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare characteristics, explore predictors, and compare assisted reproductive technology (ART) cycle, transfer, and pregnancy outcomes of autologous and donor cryopreserved oocyte cycles with fresh oocyte cycles. DESIGN Retrospective cohort study from the National ART Surveillance System. SETTING Fertility treatment centers. PATIENT(S) Fresh embryo cycles initiated in 2013 utilizing embryos created with fresh and cryopreserved, autologous and donor oocytes. INTERVENTION(S) Cryopreservation of oocytes versus fresh. MAIN OUTCOMES MEASURE(S) Cancellation, implantation, pregnancy, miscarriage, and live birth rates per cycle, transfer, and/or pregnancy. RESULT(S) There was no evidence of differences in cancellation, implantation, pregnancy, miscarriage, or live birth rates between autologous fresh and cryopreserved oocyte cycles. Donor cryopreserved oocyte cycles had a decreased risk of cancellation before transfer (adjusted risk ratio [aRR] 0.74, 95% confidence interval [CI] 0.57-0.96) as well as decreased likelihood of pregnancy (aRR 0.88, 95% CI 0.81-0.95) and live birth (aRR 0.87, 95% CI 0.80-0.95); however, there was no evidence of differences in implantation, pregnancy, or live birth rates when cycles were restricted to those proceeding to transfer. Donor cryopreserved oocyte cycles proceeding to pregnancy had a decreased risk of miscarriage (aRR 0.75, 95% CI 0.58-0.97) and higher live birth rate (aRR 1.05, 95% CI 1.01-1.09) with the transfer of one embryo, but higher miscarriage rate (aRR 1.28, 95% CI 1.07-1.54) and lower live birth rate (aRR 0.95, 95% CI 0.92-0.99) with the transfer of two or more. CONCLUSION(S) There was no evidence of differences in ART outcomes between autologous fresh and cryopreserved oocyte cycles. There was evidence of differences in per-cycle and per-pregnancy outcomes between donor cryopreserved and fresh oocyte cycles, but not in per-transfer outcomes.
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Affiliation(s)
- Sara Crawford
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Sheree L Boulet
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer F Kawwass
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia
| | - Denise J Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dmitry M Kissin
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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30
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Roque M, Valle M, Guimarães F, Sampaio M, Geber S. Freeze-all cycle for all normal responders? J Assist Reprod Genet 2016; 34:179-185. [PMID: 27817036 DOI: 10.1007/s10815-016-0834-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/23/2016] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate the freeze-all strategy in subgroups of normal responders, to assess whether this strategy is beneficial regardless of ovarian response, and to evaluate the possibility of implementing an individualized embryo transfer (iET) based on ovarian response. METHODS This was an observational, cohort study performed in a private IVF center. A total of 938 IVF cycles were included in this study. The patients were submitted to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone (GnRH) antagonist protocol and a cleavage-stage day 3 embryo transfer. We performed a comparison of outcomes between the fresh embryo transfer (n = 523) and the freeze-all cycles (n = 415). The analysis was performed in two subgroups of patients based on the number of retrieved oocytes: Group 1 (4-9 oocytes) and Group 2 (10-15 oocytes). RESULT(S) In Group 1 (4-9 retrieved oocytes), the implantation rates (IR) were 17.9 and 20.5% (P = 0.259) in the fresh and freeze-all group, respectively; the ongoing pregnancy rates (OPR) were 31 and 33% (P = 0.577) in the fresh and freeze-all group, respectively. In Group 2 (10-15 oocytes), the IR were 22.1 and 30.1% (P = 0.028) and the OPR were 34 and 47% (P = 0.021) in the fresh and freeze-all groups, respectively. CONCLUSION(S) Although the freeze-all policy may be related to better in vitro fertilization (IVF) outcomes in normal responders, these potential advantages decrease with worsening ovarian response. Patients with poorer ovarian response do not benefit from the freeze-all strategy.
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Affiliation(s)
- Matheus Roque
- ORIGEN-Center for Reproductive Medicine, Avenida Rodolfo de Amoedo, 140-Barra da Tijuca, Rio de Janeiro, Brazil. .,Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, Brazil.
| | - Marcello Valle
- ORIGEN-Center for Reproductive Medicine, Avenida Rodolfo de Amoedo, 140-Barra da Tijuca, Rio de Janeiro, Brazil
| | - Fernando Guimarães
- ORIGEN-Center for Reproductive Medicine, Avenida Rodolfo de Amoedo, 140-Barra da Tijuca, Rio de Janeiro, Brazil
| | - Marcos Sampaio
- ORIGEN-Center for Reproductive Medicine, Av do Contorno, 7747-Lourdes, Belo Horizonte, Brazil
| | - Selmo Geber
- Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, Brazil.,ORIGEN-Center for Reproductive Medicine, Av do Contorno, 7747-Lourdes, Belo Horizonte, Brazil
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31
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Mandawala A, Harvey S, Roy T, Fowler K. Cryopreservation of animal oocytes and embryos: Current progress and future prospects. Theriogenology 2016; 86:1637-44. [DOI: 10.1016/j.theriogenology.2016.07.018] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 10/21/2022]
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Devi L, Goel S. Fertility preservation through gonadal cryopreservation. Reprod Med Biol 2016; 15:235-251. [PMID: 29259441 PMCID: PMC5715865 DOI: 10.1007/s12522-016-0240-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/01/2016] [Indexed: 12/20/2022] Open
Abstract
Fertility preservation is an area of immense interest in today's society. The most effective and established means of fertility preservation is cryopreservation of gametes (sperm and oocytes) and embryos. Gonadal cryopreservation is yet another means for fertility preservation, especially if the gonadal function is threatened by premature menopause, gonadotoxic cancer treatment, surgical castration, or diseases. It can also aid in the preservation of germplasm of animals that die before attaining sexual maturity. This is especially of significance for valuable, rare, and endangered animals whose population is affected by high neonatal/juvenile mortality because of diseases, poor management practices, or inbreeding depression. Establishing genome resource banks to conserve the genetic status of wild animals will provide a critical interface between ex-situ and in-situ conservation strategies. Cryopreservation of gonads effectively lengthens the genetic lifespan of individuals in a breeding program even after their death and contributes towards germplasm conservation of prized animals. Although the studies on domestic animals are quite promising, there are limitations for developing cryopreservation strategies in wild animals. In this review, we discuss different options for gonadal tissue cryopreservation with respect to humans and to laboratory, domestic, and wild animals. This review also covers recent developments in gonadal tissue cryopreservation and transplantation, providing a systematic view and the advances in the field with the possibility for its application in fertility preservation and for the conservation of germplasm in domestic and wild species.
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Affiliation(s)
- Lalitha Devi
- Laboratory for the Conservation of Endangered Species, Centre for Cellular and Molecular BiologyCouncil for Scientific and Industrial ResearchUppal Road500 007HyderabadIndia
| | - Sandeep Goel
- Laboratory for the Conservation of Endangered Species, Centre for Cellular and Molecular BiologyCouncil for Scientific and Industrial ResearchUppal Road500 007HyderabadIndia
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Argyle CE, Harper JC, Davies MC. Oocyte cryopreservation: where are we now? Hum Reprod Update 2016; 22:440-9. [DOI: 10.1093/humupd/dmw007] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/15/2016] [Indexed: 11/15/2022] Open
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De Munck N, Belva F, Van de Velde H, Verheyen G, Stoop D. Closed oocyte vitrification and storage in an oocyte donation programme: obstetric and neonatal outcome. Hum Reprod 2016; 31:1024-33. [DOI: 10.1093/humrep/dew029] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/02/2016] [Indexed: 01/04/2023] Open
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Tsafrir A, Haimov-Kochman R, Margalioth EJ, Eldar-Geva T, Gal M, Bdolah Y, Imbar T, Hurwitz A, Ben-Chetrit A, Goldberg D. Ovarian stimulation for oocyte cryopreservation for prevention of age-related fertility loss: one in five is a low responder. Gynecol Endocrinol 2015; 31:779-82. [PMID: 26291805 DOI: 10.3109/09513590.2015.1062859] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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
Oocyte cryopreservation for age-related fertility loss is gaining interest considering the tendency to postpone motherhood in many societies. Little is currently known about the actual efficiency of this approach. We aimed to explore ovarian response of presumably fertile women undergoing in vitro fertilization for this indication. A total of 105 women underwent 151 stimulation cycles at mean age 37.7 ± 2.4. None had known infertility. Mean daily starting FSH dose was 371 ± 110 (225-600). Mean number of mature oocytes cryopreserved at the first completed cycle was 9.7 ± 7.5 (0-43). However, 21% of started cycles were either cancelled before egg retrieval or resulted in 0-3 mature oocytes retrieved. Therefore, women considering oocyte cryopreservation for prevention of age-related fertility decline should be encouraged to perform this procedure at younger age than, preferably before 35.
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Affiliation(s)
- Avi Tsafrir
- a Shaare-Zedek, IVF Unit, Department of Obstetrics and Gynecology , Affiliated with the Hebrew University School of Medicine , Jerusalem , Israel and
| | - Ronit Haimov-Kochman
- b IVF Unit, Department of Obstetrics and Gynecology , Hadassah Hebrew University Medical Center , Mt Scopus , Jerusalem , Israel
| | - Ehud J Margalioth
- a Shaare-Zedek, IVF Unit, Department of Obstetrics and Gynecology , Affiliated with the Hebrew University School of Medicine , Jerusalem , Israel and
| | - Talia Eldar-Geva
- a Shaare-Zedek, IVF Unit, Department of Obstetrics and Gynecology , Affiliated with the Hebrew University School of Medicine , Jerusalem , Israel and
| | - Michael Gal
- a Shaare-Zedek, IVF Unit, Department of Obstetrics and Gynecology , Affiliated with the Hebrew University School of Medicine , Jerusalem , Israel and
| | - Yuval Bdolah
- b IVF Unit, Department of Obstetrics and Gynecology , Hadassah Hebrew University Medical Center , Mt Scopus , Jerusalem , Israel
| | - Tal Imbar
- b IVF Unit, Department of Obstetrics and Gynecology , Hadassah Hebrew University Medical Center , Mt Scopus , Jerusalem , Israel
| | - Arye Hurwitz
- b IVF Unit, Department of Obstetrics and Gynecology , Hadassah Hebrew University Medical Center , Mt Scopus , Jerusalem , Israel
| | - Avraham Ben-Chetrit
- a Shaare-Zedek, IVF Unit, Department of Obstetrics and Gynecology , Affiliated with the Hebrew University School of Medicine , Jerusalem , Israel and
| | - Doron Goldberg
- a Shaare-Zedek, IVF Unit, Department of Obstetrics and Gynecology , Affiliated with the Hebrew University School of Medicine , Jerusalem , Israel and
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Rocha-Frigoni NAS, Leão BCS, Nogueira É, Accorsi MF, Mingoti GZ. Reduced levels of intracellular reactive oxygen species and apoptotic status are not correlated with increases in cryotolerance of bovine embryos produced in vitro in the presence of antioxidants. Reprod Fertil Dev 2015; 26:797-805. [PMID: 25319378 DOI: 10.1071/rd12354] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 05/14/2013] [Indexed: 11/23/2022] Open
Abstract
The effects of intracellular (cysteine and β-mercaptoethanol) and extracellular (catalase) antioxidant supplementation at different times during in vitro production (IVM and/or in vitro culture (IVC)) on bovine embryo development, intracellular reactive oxygen species (ROS) levels, apoptosis and re-expansion rates after a vitrification-thawing process were examined. Blastocyst frequencies were not affected by either antioxidant supplementation (40.5%-56.4%) or the timing of supplementation (41.7%-55.4%) compared with control (48.7%; P>0.05). Similarly, antioxidants and the moment of supplementation did not affect (P>0.05) the total number of blastomeres (86.2-90.5 and 84.4-90.5, respectively) compared with control (85.7). However, the percentage of apoptotic cells was reduced (P<0.05) in groups supplemented during IVM (1.7%), IVC (2.0%) or both (1.8%) compared with control (4.3%). Intracellular ROS levels measured in Day 7 blastocysts were reduced (P<0.05) in all groups (0.60-0.78), with the exception of the group supplemented with β-mercaptoethanol during IVC (0.88), which did not differ (P>0.05) from that in the control group (1.00). Re-expansion rates were not affected (P>0.05) by the treatments (50.0%-93.0%). In conclusion, antioxidant supplementation during IVM and/or IVC reduces intracellular ROS and the rate of apoptosis; however, supplementation does not increase embryonic development and survival after vitrification.
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Affiliation(s)
- Nathália A S Rocha-Frigoni
- Department of Animal Health School of Veterinary Medicine, UNESP-Universidade Estadual Paulista, Araçatuba, SP 16050-680, Brazil
| | - Beatriz C S Leão
- Department of Animal Health School of Veterinary Medicine, UNESP-Universidade Estadual Paulista, Araçatuba, SP 16050-680, Brazil
| | - Ériklis Nogueira
- Brazilian Agricultural Research Corporation, EMBRAPA Pantanal, Corumbá, MS 79320-900, Brazil
| | - Mônica F Accorsi
- Department of Animal Health School of Veterinary Medicine, UNESP-Universidade Estadual Paulista, Araçatuba, SP 16050-680, Brazil
| | - Gisele Z Mingoti
- Department of Animal Health School of Veterinary Medicine, UNESP-Universidade Estadual Paulista, Araçatuba, SP 16050-680, Brazil
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Leão B, Rocha-Frigoni N, Cabral E, Coelho M, Ferreira C, Eberlin M, Accorsi M, Nogueira É, Mingoti G. Improved embryonic cryosurvival observed after in vitro supplementation with conjugated linoleic acid is related to changes in the membrane lipid profile. Theriogenology 2015; 84:127-36. [DOI: 10.1016/j.theriogenology.2015.02.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 02/27/2015] [Accepted: 02/28/2015] [Indexed: 11/27/2022]
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Open versus closed systems for vitrification of human oocytes and embryos. Reprod Biomed Online 2015; 30:325-33. [DOI: 10.1016/j.rbmo.2014.12.012] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 12/09/2014] [Accepted: 12/10/2014] [Indexed: 11/22/2022]
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De Munck N, Petrussa L, Verheyen G, Staessen C, Vandeskelde Y, Sterckx J, Bocken G, Jacobs K, Stoop D, De Rycke M, Van de Velde H. Chromosomal meiotic segregation, embryonic developmental kinetics and DNA (hydroxy)methylation analysis consolidate the safety of human oocyte vitrification. ACTA ACUST UNITED AC 2015; 21:535-44. [DOI: 10.1093/molehr/gav013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/26/2015] [Indexed: 01/11/2023]
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Kovacs P. Fertility preservation in reproductive age women with cancer. J Obstet Gynaecol India 2014; 64:381-7. [PMID: 25489139 DOI: 10.1007/s13224-014-0626-0] [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] [Received: 08/27/2014] [Accepted: 09/22/2014] [Indexed: 11/28/2022] Open
Abstract
Cancer may be detected at any age and could affect children, and reproductive age women as well. In recent years, cancer treatment has become less destructive and more specific. As a result, survival rates and quality of life following successful treatment have continuously improved. Cancer treatment typically involves surgery, chemo- or radiation therapy, or the combinations of these. These interventions often adversely affect the function of the reproductive organs. Chemo- and radiation therapy are known to be gonadotoxic. Survivors of oncologic therapy are typically rendered infertile primarily due to the loss of ovarian function. There are, however, several medical, surgical, and assisted reproductive technology options that could be and should be offered to those diagnosed with cancer and wish to maintain their fertility. Embryo cryopreservation has been available for decades and has been successfully applied for fertility preservation in women diagnosed with cancer. Recent advances in cryobiology have increased the efficacy of not just embryo but even oocyte and ovarian tissue freezing-thawing. Oocyte vitrification just like embryo cryopreservation requires the use of stimulation but does not require the patient to be in a stable relationship or accept the use of donor sperm. Ovarian tissue cryopreservation does not require stimulation and, following successful transplantation, provides the patient with the most eggs but is currently still considered experimental. This paper summarizes the various fertility-sparing medical, surgical and assisted reproductive technology options. It reviews the current status of embryo, oocyte, and ovarian tissue cryopreservation and discusses their risks and benefits.
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Affiliation(s)
- Peter Kovacs
- Kaali Institute, IVF Center, Istenhegyi ut 54/a, Budapest, 1125 Hungary
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Membrane lipid profile monitored by mass spectrometry detected differences between fresh and vitrified in vitro-produced bovine embryos. ZYGOTE 2014; 23:732-41. [DOI: 10.1017/s0967199414000380] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
SummaryThis study aimed to evaluate the impact of vitrification on membrane lipid profile obtained by mass spectrometry (MS) of in vitro-produced bovine embryos. Matrix-assisted laser desorption ionization–mass spectrometry (MALDI–MS) has been used to obtain individual embryo membrane lipid profiles. Due to conditions of analysis, mainly membrane lipids, most favorably phosphatidylcholines (PCs) and sphingomyelins (SMs) have been detected. The following ions described by their mass-to-charge ratio (m/z) and respective attribution presented increased relative abundance (1.2–20×) in the vitrified group: 703.5 [SM (16:0) + H]+; 722.5 [PC (40:3) + Na]+; 758.5 [PC (34:2) + H]+; 762.5 [PC (34:0) + H]+; 790.5 [PC (36:0) + H]+ and 810.5 [PC (38:4) + H]+ and/or [PC (36:1) + Na]+. The ion with a m/z 744.5 [PCp (34:1) and/or PCe (34:2)] was 3.4-fold more abundant in the fresh group. Interestingly, ions with m/z 722.5 or 744.5 indicate the presence of lipid species, which are more resistant to enzymatic degradation as they contain fatty acyl residues linked through ether type bonds (alkyl ether or plasmalogens, indicated by the lowercase ‘e’ and ‘p‘, respectively) to the glycerol structure. The results indicate that cryopreservation impacts the membrane lipid profile, and that these alterations can be properly monitored by MALDI-MS. Membrane lipids can therefore be evaluated by MALDI-MS to monitor the effect of cryopreservation on membrane lipids, and to investigate changes in lipid profile that may reflect the metabolic response to the cryopreservation stress or changes in the environmental conditions.
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Arav A. Cryopreservation of oocytes and embryos. Theriogenology 2014; 81:96-102. [PMID: 24274414 DOI: 10.1016/j.theriogenology.2013.09.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/11/2013] [Accepted: 09/11/2013] [Indexed: 10/26/2022]
Abstract
Two hundred years have passed since the first description of supercooled water by Gey-Lussac to the recently high survival rates of embryo and oocytes after vitrification. This review discusses important milestones that have made vitrification the method of choice for oocytes and embryos cryopreservation. We will go through the first cells ever to survive low temperature exposure in the beginning of the last century, the finding of glycerol in the late 1940s and the first mouse and bovine embryos freezing in the 1970s. During the 1980s, embryo vitrification began and the time since is a tribute to the development of oocytes vitrification. Standardization and an automatic vitrification procedure are currently under development. The next evolutionary step in oocyte and embryo cryopreservation will be preserving them in the dry state at room temperature, allowing home storage for future use a reality.
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Affiliation(s)
- A Arav
- FertileSafe, Shlomzion Hamalca, Tel Aviv, Israel 62266.
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Oocyte vitrification in the 21st century and post-warming fertility outcomes: a systematic review and meta-analysis. Reprod Biomed Online 2014; 29:159-76. [DOI: 10.1016/j.rbmo.2014.03.024] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 03/20/2014] [Accepted: 03/25/2014] [Indexed: 11/20/2022]
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Konc J, Kanyó K, Kriston R, Somoskői B, Cseh S. Cryopreservation of embryos and oocytes in human assisted reproduction. BIOMED RESEARCH INTERNATIONAL 2014; 2014:307268. [PMID: 24779007 PMCID: PMC3980916 DOI: 10.1155/2014/307268] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 02/13/2014] [Indexed: 11/17/2022]
Abstract
Both sperm and embryo cryopreservation have become routine procedures in human assisted reproduction and oocyte cryopreservation is being introduced into clinical practice and is getting more and more widely used. Embryo cryopreservation has decreased the number of fresh embryo transfers and maximized the effectiveness of the IVF cycle. The data shows that women who had transfers of fresh and frozen embryos obtained 8% additional births by using their cryopreserved embryos. Oocyte cryopreservation offers more advantages compared to embryo freezing, such as fertility preservation in women at risk of losing fertility due to oncological treatment or chronic disease, egg donation, and postponing childbirth, and eliminates religious and/or other ethical, legal, and moral concerns of embryo freezing. In this review, the basic principles, methodology, and practical experiences as well as safety and other aspects concerning slow cooling and ultrarapid cooling (vitrification) of human embryos and oocytes are summarized.
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Affiliation(s)
- János Konc
- Infertility and IVF Center of Buda, Szent János Hospital, Budapest 1125, Hungary
| | - Katalin Kanyó
- Infertility and IVF Center of Buda, Szent János Hospital, Budapest 1125, Hungary
| | - Rita Kriston
- Infertility and IVF Center of Buda, Szent János Hospital, Budapest 1125, Hungary
| | - Bence Somoskői
- Faculty of Veterinary Science, Szent István University, Budapest 1078, Hungary
| | - Sándor Cseh
- Faculty of Veterinary Science, Szent István University, Budapest 1078, Hungary
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Ronn R, Holzer HEG. Oncofertility in Canada: cryopreservation and alternative options for future parenthood. CURRENT ONCOLOGY (TORONTO, ONT.) 2014; 21:e137-46. [PMID: 24523611 DOI: 10.3747/co.20.1360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cancer can be a devastating diagnosis. In particular, malignancy and its indicated treatments have profoundly negative effects on the fertility of young cancer patients. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer therapies and to facilitate fertility preservation. In Canada, these fertility issues are often inadequately addressed despite the availability of resources. The goal of this four-part series is to facilitate systemic improvements in fertility preservation for adolescent and young adult Canadians with a new diagnosis of cancer. METHODS This article reviews fertility preservation options that use cryopreservation techniques. It also outlines some of the alternative options for future parenthood. RESULTS Cryopreservation of a woman's gametes and gonadal tissue may involve embryo, oocyte, and ovarian tissue cryopreservation with or without ovarian stimulation. Similarly, male gametes and gonadal tissue may be cryopreserved. Techniques and success rates continue to improve. Third-party assistance through gamete donation, gestational carriers, and adoption are also alternative options for parenthood. CONCLUSIONS Cryopreservation techniques are especially feasible options for fertility preservation in the newly diagnosed cancer patient.
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Affiliation(s)
- R Ronn
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
| | - H E G Holzer
- McGill University Health Centre, Reproductive Centre, and Department of Obstetrics and Gynecology, McGill University, Montreal, QC
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Vajta G. Vitrification in human and domestic animal embryology: work in progress. Reprod Fertil Dev 2014; 25:719-27. [PMID: 22951206 DOI: 10.1071/rd12118] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 06/16/2012] [Indexed: 11/23/2022] Open
Abstract
According to the analysis of papers published in major international journals, rapidly increasing application of vitrification is one of the greatest achievements in domestic animal and especially human embryology during the first decade of our century. This review highlights factors supporting or hampering this progress, summarises results achieved with vitrification and outlines future tasks to fully exploit the benefits of this amazing approach that has changed or will change many aspects of laboratory (and also clinical) embryology. Supporting factors include the simplicity, cost efficiency and convincing success of vitrification compared with other approaches in all species and developmental stages in mammalian embryology, while causes that slow down the progress are mostly of human origin: inadequate tools and solutions, superficial teaching, improper application and unjustified concerns resulting in legal restrictions. Elimination of these hindrances seems to be a slower process and more demanding task than meeting the biological challenge. A key element of future progress will be to pass the pioneer age, establish a consensus regarding biosafety requirements, outline the indispensable features of a standard approach and design fully-automated vitrification machines executing all phases of the procedure, including equilibration, cooling, warming and dilution steps.
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Affiliation(s)
- Gábor Vajta
- Institute for Resource Industries and Sustainability, Central Queensland University, Rockhampton, Qld 4702, Australia.
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Sole M, Santalo J, Boada M, Clua E, Rodriguez I, Martinez F, Coroleu B, Barri PN, Veiga A. How does vitrification affect oocyte viability in oocyte donation cycles? A prospective study to compare outcomes achieved with fresh versus vitrified sibling oocytes. Hum Reprod 2013; 28:2087-92. [DOI: 10.1093/humrep/det242] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cil AP, Bang H, Oktay K. Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis. Fertil Steril 2013; 100:492-9.e3. [PMID: 23706339 DOI: 10.1016/j.fertnstert.2013.04.023] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 04/08/2013] [Accepted: 04/09/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To estimate age-specific probabilities of live birth with oocyte cryopreservation in nondonor (ND) egg cycles. DESIGN Individual patient data meta-analysis. SETTING Assisted reproduction centers. PATIENT(S) Infertile patients undergoing ND mature oocyte cryopreservation. INTERVENTION(S) PubMed was searched for clinical studies on oocyte cryopreservation from January 1996 through July 2011. Randomized and nonrandomized studies that used ND frozen-thawed mature oocytes with pregnancy outcomes were included. Authors of eligible studies were contacted to obtain individual patient data. MAIN OUTCOME MEASURE(S) Live birth probabilities based on age, cryopreservation method, and the number of oocytes thawed, injected, or embryos transferred. RESULT(S) Original data from 10 studies including 2,265 cycles from 1,805 patients were obtained. Live birth success rates declined with age regardless of the freezing technique. Despite this age-induced compromise, live births continued to occur as late as ages 42 and 44 years with slowly frozen and vitrified oocytes, respectively. Estimated probabilities of live birth for vitrified oocytes were higher than those for slowly frozen. CONCLUSION(S) The live birth probabilities we calculated would enable more accurate counseling and informed decisions for infertile women considering oocyte cryopreservation. Given the success probabilities, we suggest that policy makers should consider oocyte freezing as an integral part of prevention and treatment of infertility.
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Affiliation(s)
- Aylin Pelin Cil
- Innovation Institute for Fertility Preservation and IVF, New York, NY 10028, USA
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De Munck N, Verheyen G, Van Landuyt L, Stoop D, Van de Velde H. Survival and post-warming in vitro competence of human oocytes after high security closed system vitrification. J Assist Reprod Genet 2013; 30:361-9. [PMID: 23354587 DOI: 10.1007/s10815-013-9930-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 01/06/2013] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To compare two vitrification methods and two warming methods for human oocyte vitrification using a high security closed device in terms of survival, fertilization and embryo development. METHODS For vitrification, oocytes were (1) immediately placed in equilibration solution or (2) they were gradually exposed to the cryoprotectants. For warming, oocytes were placed (1) in a 25 μl preheated (37 °C) thawing solution droplet that was put at room temperature for 1 min once the oocytes were inside or (2) in a 150 μl droplet for 1 minute at 37 °C. RESULTS Survival and preimplantation development were significantly lower when warming was performed in a small preheated droplet. There was no significant difference in survival and embryo development between the gradual or direct exposure to cryoprotectants. CONCLUSIONS Using this high security closed vitrification device a 90 % survival rate can be achieved when the oocytes are immediately warmed in a large volume at 37 °C.
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Affiliation(s)
- N De Munck
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels, Belgium.
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50
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Arav A, Natan Y. Vitrification of Oocytes: From Basic Science to Clinical Application. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 761:69-83. [DOI: 10.1007/978-1-4614-8214-7_6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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