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Li D, Zhao YJ, Wang Q, Chu MW, Xie JK, Zhang CL. Fertility preservation in hematological cancer patients. Clin Transl Oncol 2024; 26:1836-1843. [PMID: 38575837 DOI: 10.1007/s12094-024-03419-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/23/2024] [Indexed: 04/06/2024]
Abstract
Among adolescents and young adults, hematological malignancies are the most common malignancies. Although the survival rate of hematological malignancies in young patients has been dramatically improved, due to the continuous improvement and development of tumor diagnosis and treatment options, cytotoxic therapies can significantly reduce a patient's reproductive capacity and cause irreversible infertility. The most two established solutions are embryo cryopreservation and oocyte cryopreservation which can be considered in single female. Sperm or testicular tissue cryopreservation in adult male are feasible approaches that must be considered before gonadotoxic therapy. A comprehensive consultation with reproductive specialists when once diagnosed is a significantly issue which would help those survivors who want to have children. In this article, we review germ cell toxicity, which happens during the treatment of hematological malignancies, and aims to propose safety, efficacy fertility preservation methods in younger patients with hematological malignancies.
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Affiliation(s)
- Dan Li
- Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Yi-Jun Zhao
- Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qian Wang
- Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Man-Wei Chu
- Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Juan-Ke Xie
- Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Cui-Lian Zhang
- Reproductive Medicine Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
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Zhu L, Sun L, Liu W, Han W, Huang G, Li J. Long-term storage does not affect the DNA methylation profiles of vitrified-warmed human embryos. Mol Reprod Dev 2024; 91:e23713. [PMID: 37882215 DOI: 10.1002/mrd.23713] [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: 05/29/2023] [Revised: 08/31/2023] [Accepted: 09/24/2023] [Indexed: 10/27/2023]
Abstract
With the widespread application of embryo cryopreservation in assisted reproductive techniques, it is necessary to assess the safety of long-term cryopreservation of human embryos and it is unclear whether storage time has an impact on the DNA methylation profiles of human embryos. Nine women who received IVF treatment were recruited for this study. The retrieved eight-cell human embryos were classified into three groups including fresh embryos, cryopreserved embryos stored for 3 years, and cryopreserved embryos stored for 8 years. Single-cell whole-genome bisulfite sequencing (scWGBS) was conducted. The genome-wide methylation pattern of the fresh and two cryopreserved groups were similar. In addition, the methylation level in different genomic regions showed comparable patterns and no significant differences were observed in the methylation level of imprinted genes among the three groups. A total of 587 differentially methylated regions (DMRs) in the 3-year group and 540 DMRs in the 8-year group were identified comparing to fresh group. However, they were not enriched in promoters and had a similar genome-wide distributions, suggesting that these DMRs may not contribute to the changes in corresponding gene expressions. Our study illustrated that long-term cryopreservation will not affect the DNA methylation profiles of human eight-cell embryos at single-cell level.
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Affiliation(s)
- Ling Zhu
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Liwei Sun
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Weiwei Liu
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Wei Han
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Guoning Huang
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jingyu Li
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
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Mahmoudinia M, Sovizi B, Ebadi SMR, Zakerinasab F, Sadeghi T, Mahmoudinia M. Live Birth after Cleavage-Stage versus Blastocyst-Stage Embryo Transfer in Assisted Reproductive Technology: A Randomised Controlled Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2024; 18:10-16. [PMID: 39033365 PMCID: PMC11263845 DOI: 10.22074/ijfs.2023.2000574.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/20/2023] [Accepted: 11/16/2023] [Indexed: 07/23/2024]
Abstract
BACKGROUND Blastocyst stage transfer appears to improve pregnancy outcomes. The aim of this study is to evaluate the pregnancy results between fresh cycle blastocyst stage embryo transfer and cleavage stage embryo transfer in patients who undergo intracytoplasmic sperm injection (ICSI). MATERIALS AND METHODS This randomised clinical trial study was conducted at the Infertility Research Centre of Milad Hospital in Mashhad, Iran from 2018 to 2020 on 240 infertile women who presented for their first ICSI procedure. These patients were assigned to receive either cleavage embryo transfer (n=112) or blastocyst stage transfer (n=107). Pregnancy outcomes were measured in both groups. RESULTS There were no differences regarding age, body mass index (BMI), serum follicle-stimulating hormone (FSH), duration of infertility, and aetiology of infertility between the groups (P>0.05). There were more follicles, total oocytes, and metaphase II (M2) oocytes in the blastocyst stage group. Considerably more cleavage stage embryos were transferred compared to the number of transferred blastocysts (P=0.001). The blastocyst group had more vitrified embryos than the cleavage group (P=0.000). The rates of implantation (P=0.332), chemical pregnancy (P=0.165), clinical pregnancy (P=0.694), and live births (P=0.727) were higher in the blastocyst group, but they were not significantly different. The rate of abortion was also not significantly higher in the blastocyst group (P=0.296). CONCLUSION Blastocysts transferred in the fresh cycle of an ICSI procedure may be more advantageous compared to cleavage stage embryo transfer (registration number: IRCT20181030041503N1).
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Affiliation(s)
- Malihe Mahmoudinia
- Supporting The Family and The Youth of Population Research Core, Department of Obstetrics and Gynaecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Behnaze Sovizi
- Department of Obstetrics and Gynaecology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Faezeh Zakerinasab
- Department of Obstetrics and Gynaecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tahereh Sadeghi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Akbar Hospital, Mashhad University of Medical Sciences, Iran
| | - Mahbbobeh Mahmoudinia
- Department of Obstetrics and Gynaecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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胡 沛, 潘 洁, 刘 欣, 黄 荷. [Reproductive Health-Oriented Development in Assisted Reproductive Technologies]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:501-506. [PMID: 38948299 PMCID: PMC11211779 DOI: 10.12182/20240560401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Indexed: 07/02/2024]
Abstract
Assisted reproductive technologies (ARTs) are core components of the field of reproductive medicine, encompassing multiple pivotal stages of early development from gamete maturation and fertilization to embryo development. Against the backdrop of a deteriorating trend of global decline in fertility rates, patients with infertility problems increasingly turn to ARTs to realize their dreams of parenthood. However, concomitant with this trend is a growing apprehension regarding the potential adverse effects of ARTs. Herein, we endeavor to discuss several common ARTs procedures utilized in clinical settings and the relevant cutting-edge advancements. The ARTs discussed in the article include in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), biphasic in vitro maturation (biphasic IVM), frozen embryo transfer (FET), preimplantation genetic testing (PGT), non-invasive PGT (niPGT), etc. In addition, we reevaluated their roles within the broader context of assisted reproduction aimed at promoting reproductive health. Additionally, we will delve into the impact of ARTs on the reproductive health of the offspring. By prioritizing the reproductive well-being of both patients and their offspring, the ongoing development and improvement of ARTs to enhance their efficacy and safety will contribute significantly to the advancement of human reproductive health.
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Affiliation(s)
- 沛然 胡
- 复旦大学附属妇产科医院 生殖与发育研究院 (上海 200030)Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200030, China
| | - 洁雪 潘
- 复旦大学附属妇产科医院 生殖与发育研究院 (上海 200030)Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200030, China
| | - 欣梅 刘
- 复旦大学附属妇产科医院 生殖与发育研究院 (上海 200030)Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200030, China
| | - 荷凤 黄
- 复旦大学附属妇产科医院 生殖与发育研究院 (上海 200030)Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200030, China
- 上海市生殖与发育重点实验室 (上海 200030)Shanghai Key Laboratory of Reproduction and Development, Shanghai 200030, China
- 中国医学科学院 胚胎源性疾病研究创新单元2019RU056 (上海 200030)Research Units of Diseases of Embryonic Origin (No. 2019RU056), Chinese Academy of Medical Sciences, Shanghai 200030, China
- 浙江大学医学院附属妇产科医院 生殖遗传教育部重点实验室 (杭州 310030)Key Laboratory of Reproductive Genetics of the Ministry of Education, Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310030, China
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Sciorio R, Tramontano L, Campos G, Greco PF, Mondrone G, Surbone A, Greco E, Talevi R, Pluchino N, Fleming S. Vitrification of human blastocysts for couples undergoing assisted reproduction: an updated review. Front Cell Dev Biol 2024; 12:1398049. [PMID: 38827525 PMCID: PMC11140474 DOI: 10.3389/fcell.2024.1398049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/25/2024] [Indexed: 06/04/2024] Open
Abstract
Over the past 40 years there has been a worldwide critical change in the field of assisted reproduction technology (ART), leading to the increased application of single blastocyst transfer, which is extremely important to avoid the risks of multiple pregnancy and associated complications for both mother and babies. Indeed, advancements in ART over the last few decades have been obtained thanks to several improvements, including ovarian stimulation, embryo culture conditions and, of course, progress in cryopreservation methods, especially with the application of vitrification. The ability to cryopreserve human embryos has improved significantly with vitrification compared to the initially adopted slow-freezing procedures. Since the introduction of vitrification, it has become the gold standard method to effectively cryopreserve human blastocysts. However, some new protocols are now being explored, such as the short warming procedure and even shorter exposure to the equilibration solution before vitrification, which seem to provide optimal results. Therefore, the main aim of the current narrative review, will be to illustrate the benefit of vitrification as an effective method to cryopreserve the human blastocyst and to illustrate new protocols and variations which in future may increase the performance of vitrification protocols.
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Affiliation(s)
- Romualdo Sciorio
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman Mother Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Luca Tramontano
- Département de Gynécologie-Obstétrique, Réseau Hospitalier Neuchâtelois, Neuchâtel, Switzerland
| | - Gerard Campos
- Fertility Geisinger Medical Center, Women’s Health Fertility Clinic, Danville, PA, United States
- GIREXX Fertility Clinics, Girona-Barcelona, Spain
| | | | | | - Anna Surbone
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman Mother Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Ermanno Greco
- Villa Mafalda, Centre for Reproductive Medicine, Rome, Italy
- Department of Obstetrics and Gynecology, UniCamillus, International Medical University, Rome, Italy
| | - Riccardo Talevi
- Dipartimento di Biologia Strutturale e Funzionale, Universita’ di Napoli ‘Federico II’, Complesso Universitario di Monte S, Napoli, Italy
| | - Nicola Pluchino
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman Mother Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Steven Fleming
- Discipline of Anatomy and Histology, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
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Nicholson TM, Tokihiro JC, Tu WC, Khor JW, Lee UN, Berthier E, Amory JK, Walsh TJ, Muller CH, Theberge AB. Open-Channel Droplet Microfluidic Platform for Passive Generation of Human Sperm Microdroplets. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.09.593416. [PMID: 38798664 PMCID: PMC11118337 DOI: 10.1101/2024.05.09.593416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Sperm cryopreservation is important for individuals undergoing infertility treatment, and for those who wish to preserve fertility potential, prior to treatments like chemotherapy, radiation therapy, gender-affirming medical interventions, elective fertility delay, or individuals in high-risk professions such as the military. Current methods for sperm cryopreservation result in approximately 30-50% decrease in sperm motility. However, recent studies have shown that ultra-rapid freezing (vitrification) is a valuable approach for maintaining sperm quality after freeze-thawing processes in the clinical laboratory setting and requires submicroliter to microliter volumes. A major challenge for the adoption of vitrification in fertility laboratories is the ability to pipette small volumes of sample. Here, we present a method that leverages open-channel droplet microfluidics to autonomously generate sub-microliter to microliter volumes of purified human sperm samples. Using a novel, open-channel droplet generator, we found no change in sperm movement and kinematic data after exposure to device and reagents in our platform. We conclude that our platform is compatible with human sperm, an important foundation for future implementation of vitrification in fertility laboratories.
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Hernandez-Nieto C, Siddiqui S, Mejia-Fernandez L, Alkon-Meadows T, Lee J, Slifkin R, Mukherjee T, Copperman AB. Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation. Reprod Biomed Online 2024; 49:104105. [PMID: 38986195 DOI: 10.1016/j.rbmo.2024.104105] [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: 02/08/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 07/12/2024]
Abstract
RESEARCH QUESTION Do the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)? DESIGN This retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus-oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts. RESULTS A total of 4059 oocyte freezing cycles were included in the analysis. Eight types of contraceptive method were recognized in patients undergoing ovarian stimulation: intrauterine device (IUD), copper (n = 84); IUD, levonorgestrel low dose (<52 mg) (n = 37); IUD, levonorgestrel (n = 192); subdermal etonogestrel implant (n = 14); injectable medroxyprogesterone acetate (n = 11); etonogestrel vaginal ring (n = 142); combined oral contraceptive pills (n = 2349); and norelgestromin transdermal patch (n = 10). The control group included patients not using contraceptives or using barrier or calendar methods (n = 1220). Among all the cohorts the median number of cumulus-oocyte complexes retrieved during oocyte retrieval was comparable (P = 0.054), and a significant difference in oocyte maturity rate with median number of vitrified oocytes was found (P = 0.03, P < 0.001, respectively). After adjusting for confounders a multivariate analysis found no association between the type of contraceptive and proportion of metaphase II oocytes available for cryopreservation. CONCLUSIONS Among the various forms of contraception, none was shown to have an adverse association with oocyte yield or maturation rate in patients undergoing POC.
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Affiliation(s)
| | - Saher Siddiqui
- Reproductive Medicine Associates of New York, New York, NY, USA
| | | | | | - Joseph Lee
- Reproductive Medicine Associates of New York, New York, NY, USA
| | - Richard Slifkin
- Reproductive Medicine Associates of New York, New York, NY, USA
| | - Tanmoy Mukherjee
- Reproductive Medicine Associates of New York, New York, NY, USA; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan B Copperman
- Reproductive Medicine Associates of New York, New York, NY, USA; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Fu L, Ma J, Chen L, Guo Y, Li W, Zhang X, Lu W, Wang S, Liu Y. Enhancement of Frozen-Thawed Human Sperm Quality with Zinc as a Cryoprotective Additive. Med Sci Monit 2024; 30:e942946. [PMID: 38698627 PMCID: PMC11075574 DOI: 10.12659/msm.942946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Cryopreservation preserves male fertility, crucial in oncology, advanced age, and infertility. However, it damages sperm motility, membrane, and DNA. Zinc (Zn), an antioxidant, shows promise in improving sperm quality after thawing, highlighting its potential as a cryoprotectant in reproductive medicine. MATERIAL AND METHODS Gradient concentration of ZnSO₄ (0, 12.5, 25, 50, and 100 µM) was added in the Glycerol-egg yolk-citrate (GEYC) cryopreservative medium as an extender. Alterations in sperm viability and motility parameters after cryopreservation were detected in each group. Sperm plasma membrane integrity (PMI), acrosome integrity (ACR), DNA fragment index (DFI), and changes in sperm mitochondrial function were examined, including: mitochondrial potential (MMP), sperm reactive oxygen species (ROS), and sperm ATP. RESULTS We found that 50 µM ZnSO₄ was the most effective for the curvilinear velocity (VCL) and the average path velocity (VAP) of sperm after cryo-resuscitation. Compared to the Zn-free group, sperm plasma membrane integrity (PMI) was increased, DNA fragmentation index (DFI) was decreased, reactive oxygen species (ROS) was reduced, and mitochondrial membrane potential (MMP) was increased after cryorevival in the presence of 50 µM ZnSO₄. CONCLUSIONS Zn ion is one of the antioxidants in the cell. The results of our current clinical study are sufficient to demonstrate that Zn can improve preserves sperm quality during cryopreservation when added to GEYC. The addition of 50 µM ZnSO₄ increased curve velocity, mean path velocity, sperm survival (or plasma membrane integrity), and mitochondrial membrane potential while reducing ROS production and DNA breaks compared to GEYC thawed without ZnSO₄.
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Affiliation(s)
- Longlong Fu
- Reproductive Health Research Centre, National Research Institute for Family Planning, Beijing, China (mainland)
| | - Jing Ma
- Hebei Key Laboratory of Reproductive Medicine, Hebei Reproductive Health Hospital, Shijiazhuang, Hebei, China (mainland)
| | - Lixia Chen
- Department of Family Planning, Maternal and Child Health Care Hospital of Zhangjiakou, Zhangjiakou, Hebei, China (mainland)
| | - Ying Guo
- National Health Commission Key Laboratory of Male Reproductive Health, National Research Institute for Family Planning, Beijing, China (mainland)
| | - Wenjie Li
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Xingguo Zhang
- Department of Family Planning, Maternal and Child Health Care Hospital of Zhangjiakou, Zhangjiakou, Hebei, China (mainland)
| | - Wenhong Lu
- Reproductive Health Research Centre, National Research Institute for Family Planning, Beijing, China (mainland)
| | - Shusong Wang
- Hebei Key Laboratory of Reproductive Medicine, Hebei Reproductive Health Hospital, Shijiazhuang, Hebei, China (mainland)
| | - Ying Liu
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
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Khajedehi N, Fathi R, Akbarinejad V, Gourabi H. Oocyte Vitrification Reduces its Capability to Repair Sperm DNA Fragmentation and Impairs Embryonic Development. Reprod Sci 2024; 31:1256-1267. [PMID: 38151654 DOI: 10.1007/s43032-023-01419-1] [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: 08/28/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
Oocytes play a crucial role in repairing sperm DNA damage, which can affect the next generation; however, certain factors can impair this ability. This study examined whether oocyte vitrification, a widely used method for fertility preservation, negatively affects repair ability. Male DBA/2 mice (n = 28) were injected with 101.60 µmol/100 g body weight of tert-Butyl hydroperoxide (tBHP) for 14 days to induce sperm DNA damage. Histological changes, sperm functions, and DNA fragmentation were assessed using the TUNEL assay. Cumulus-oocyte-complexes (COCs) of superovulated female DBA/2 mice (n = 28) were vitrified using the Cryotop method. Fresh and vitrified oocytes were then fertilized by tBHP-treated and untreated sperms, and subsequent embryonic development was monitored. Additionally, the expression of Mre11a, Rad51, Brca1, and Xrcc4 was assessed in resulting zygotes and blastocysts using real-time PCR. The sperm tBHP treatment reduced differentiated spermatogenic cells in the testicular tissue, sperm concentration, and motility, while increasing DNA fragmentation (P < 0.05). The fertilization rate was decreased in the tBHP-treated sperm-vitrified oocyte group (P < 0.05), and the two-cell rate diminished in tBHP-treated sperm-fresh and vitrified oocyte groups (P < 0.05). The four-cell to blastocyst rate decreased in the untreated sperm-vitrified oocyte and the tBHP-treated sperm-fresh and vitrified oocyte groups (P < 0.05), and the tBHP-treated sperm-vitrified oocyte groups had the lowest blastocyst rate. In zygotes, Brca1 was upregulated in the tBHP-treated sperm-vitrified oocyte group (P < 0.05). Also, in blastocysts, Rad51, Brca1, and Xrcc4 were significantly upregulated in the untreated sperm-vitrified oocytes group (P < 0.05). Damages to the oocyte due to vitrification can disrupt the repair of sperm DNA fragmentation and consequently impair the embryo development.
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Affiliation(s)
- Niloofar Khajedehi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Rouhollah Fathi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Vahid Akbarinejad
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Hamid Gourabi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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Jiang VS, Cherouveim P, Naert MN, Dimitriadis I, Souter I, Bormann CL. Live birth outcomes following single-step blastocyst warming technique - optimizing efficiency without impacting live birth rates. J Assist Reprod Genet 2024; 41:1193-1202. [PMID: 38472563 PMCID: PMC11143112 DOI: 10.1007/s10815-024-03069-x] [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: 11/13/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
PURPOSE To evaluate the impact of a single-step (SS) warming versus standard warming (SW) protocol on the survival/expansion of vitrified blastocysts and their clinical outcomes post-frozen embryo transfer (FET). METHODS Retrospective analysis was performed on 200 vitrified/warmed research blastocysts equally divided amongst two thawing protocols utilizing the Fujifilm Warming NX kits (Fujifilm, CA). SW utilized the standard 14-minute manufacturer's guidelines. SS protocol required only a one-minute immersion in thaw solution (TS) before the embryos were transferred to culture media. A time-interrupted study was performed evaluating 752 FETs (SW: 376 FETs, SS 376 FETs) between April 2021-December 2022 at a single academic fertility clinic in Boston, Massachusetts. Embryologic, clinical pregnancy, and live birth outcomes were assessed using generalized estimated equation (GEE) models, which accounted for potential confounders. RESULTS There was 100% survival for all blastocysts (n = 952 embryos) with no differences in blastocyst re-expansion regardless of PGT status. Adjusted analysis showed no differences in implantation, clinical pregnancy, spontaneous abortion, or biochemical pregnancy rate. A higher odds of multiple gestation [AdjOR(95%CI) 1.06 (1.01, 1.11), p = 0.019] were noted, even when adjusting for number of embryos transferred [AdjOR(95%CI) 1.05 (1.01, 1.10)]. Live birth outcomes showed no differences in live birth rates or birthweight at delivery. CONCLUSIONS The study found equivalent outcomes for SS and SW in all parameters except for a slight rise in the rate of multiple gestations. The results suggest that SS warming is an efficient, viable alternative to SW, reducing thaw times without adverse effects on live birth rates or neonatal birth weights.
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Affiliation(s)
- Victoria S Jiang
- Division of Reproductive Endocrinology and Infertility, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Suite 10A, Boston, MA, 02114, USA
| | - Panagiotis Cherouveim
- Division of Reproductive Endocrinology and Infertility, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Suite 10A, Boston, MA, 02114, USA
| | - Mackenzie N Naert
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 32 Fruit Street, Suite 4F, Boston, MA, 02114, USA
| | - Irene Dimitriadis
- Division of Reproductive Endocrinology and Infertility, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Suite 10A, Boston, MA, 02114, USA
| | - Irene Souter
- Division of Reproductive Endocrinology and Infertility, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Suite 10A, Boston, MA, 02114, USA
| | - Charles L Bormann
- Division of Reproductive Endocrinology and Infertility, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Suite 10A, Boston, MA, 02114, USA.
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11
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Snow KS, Raburn DJ, Price TM. Differential Gene Regulation of the Human Blastocyst Trophectoderm and Inner Cell Mass by Progesterone. Reprod Sci 2024; 31:1363-1372. [PMID: 38151652 DOI: 10.1007/s43032-023-01429-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
Knowledge of action of progesterone (P4) on the human preimplantation embryo is lacking. The objective of this study was to determine expression of a mitochondrial P4 receptor (PR-M) in the trophectoderm (TE) and the inner cell mass (ICM) of the human blastocyst and to determine P4-induced gene expression during growth from the cleavage to the blastocyst stage. Previously cryopreserved cleavage stage embryos were treated with P4 (10-6 M) or vehicle until blastocyst development. Cells from the TE and the ICM of dissected euploid embryos underwent RNA-seq analysis, while other embryos were used for analysis of nuclear PR (nPR) and PR-M expression.PR-M expression was confirmed in the TE, the ICM, and a human embryonic stem cell line (HESC). Conversely, nPR expression was absent in the TE and the ICM with low expression in the HESC line. RNA-seq analysis revealed P4 effects greater in the TE with 183 significant pathway changes compared to 27 in the ICM. The TE response included significant upregulation of genes associated with DNA replication, cell cycle phase transition and others, exemplified by a 7.6-fold increase in the cell proliferation gene, F-Box Associated Domain Containing. The majority of ICM pathways were downregulated including chromosome separation, centromere complex assembly and chromatin remodeling at centromere. This study confirms that human blastocysts express PR-M in both the TE and the ICM, but lack expression of nPR. P4-induced gene regulation differs greatly in the two cell fractions with the predominant effect of cell proliferation in the TE and not the ICM.
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Affiliation(s)
- Kathryn Shaia Snow
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Duke University, 5601 Arringdon Park Dr Suite 210, Morrisville, NC, 27560, USA
| | - Douglas J Raburn
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Duke University, 5601 Arringdon Park Dr Suite 210, Morrisville, NC, 27560, USA
| | - Thomas M Price
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Duke University, 5601 Arringdon Park Dr Suite 210, Morrisville, NC, 27560, USA.
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12
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Wang X, Xiao Y, Sun Z, Xiong W. Effect of post-vitrification cryopreservation duration on singleton birth-weight in frozen-thawed blastocysts transfer cycles. Front Endocrinol (Lausanne) 2024; 15:1366360. [PMID: 38745950 PMCID: PMC11091412 DOI: 10.3389/fendo.2024.1366360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction This study aimed to explore the effect of cryopreservation duration after blastocyst vitrification on the singleton birth-weight of newborns to assess the safety of long-term preservation of frozen-thawed blastocyst transfer (FBT) cycles. Methods This was a retrospective observational study conducted at the Gynecological Endocrinology and Assisted Reproduction Center of the Peking Union Medical College Hospital. Patients who gave birth to singletons between January 2006 and December 2021 after undergoing FBT cycles were included. Five groups were formed according to the duration of cryopreservation of embryos at FBT: Group I included 274 patients with a storage time < 3 months. Group II included 607 patients with a storage time of 3-6 months. Group III included 322 patients with a storage time of 6-12 months. Group IV included 190 patients with a storage time of 12-24 months. Group V included 118 patients with a storage time of > 24 months. Neonatal outcomes were compared among the groups. Multivariate linear regression analysis was performed to evaluate birth-weights and other birth-related outcomes. Results A total of 1,511 patients were included in the analysis. The longest cryopreservation period was 12 years. The birth-weights of neonates in the five groups were 3344.1 ± 529.3, 3326.1 ± 565.7, 3260.3 ± 584.1, 3349.9 ± 582.7, and 3296.7 ± 491.9 g, respectively (P > 0.05). The incidences of preterm birth, very preterm birth, low birth-weight, and very low birth-weight were similar in all groups (P > 0.05). The large-for-gestational-age and small-for-gestational-age rates did not differ significantly among the groups (P > 0.05). After adjusting for confounding factors that may affect neonatal outcomes, a trend for an increased risk of low birth-weight with prolonged cryopreservation was observed. However, cryopreservation duration and neonatal birth-weight were not significantly correlated (P > 0.05). Conclusion The duration of cryopreservation after blastocyst vitrification with an open device for more than 2 years had no significant effect on the birth-weight of FBT singletons; however, attention should be paid to a possible increase in the risk of low birth-weight.
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Affiliation(s)
| | | | - Zhengyi Sun
- Department of Gynecology Endocrine and Reproductive Center, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Vallée A, Saridogan E, Petraglia F, Keckstein J, Polyzos N, Wyns C, Gianaroli L, Tarlatzis B, Ayoubi JM, Feki A. Horizons in Endometriosis: Proceedings of the Montreux Reproductive Summit, 14-15 July 2023. Facts Views Vis Obgyn 2024; 16:1-32. [PMID: 38603778 PMCID: PMC11317919 DOI: 10.52054/fvvo.16.s1.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Endometriosis is a complex and chronic gynaecological disorder that affects millions of women worldwide, leading to significant morbidity and impacting reproductive health. This condition affects up to 10% of women of reproductive age and is characterised by the presence of endometrial-like tissue outside the uterus, potentially leading to symptoms such as chronic pelvic pain, dysmenorrhoea, dyspareunia, and infertility. The Montreux summit brought a number of experts in this field together to provide a platform for discussion and exchange of ideas. These proceedings summarise the six main topics that were discussed at this summit to shed light on future directions of endometriosis classification, diagnosis, and therapeutical management. The first question addressed the possibility of preventing endometriosis in the future by identifying risk factors, genetic predispositions, and further understanding of the pathophysiology of the condition to develop targeted interventions. The clinical presentation of endometriosis is varied, and the correlation between symptoms severity and disease extent is unclear. While there is currently no universally accepted optimal classification system for endometriosis, several attempts striving towards its optimisation - each with its own advantages and limitations - were discussed. The ideal classification should be able to reconcile disease status based on the various diagnostic tools, and prognosis to guide proper patient tailored management. Regarding diagnosis, we focused on future tools and critically discussed emerging approaches aimed at reducing diagnostic delay. Preserving fertility in endometriosis patients was another debatable aspect of management that was reviewed. Moreover, besides current treatment modalities, potential novel medical therapies that can target underlying mechanisms, provide effective symptom relief, and minimise side effects in endometriotic patients were considered, including hormonal therapies, immunomodulation, and regenerative medicine. Finally, the question of hormonal substitution therapy after radical treatment for endometriosis was debated, weighing the benefits of hormone replacement.
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14
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Sadeghi MR. Abandoned Cryopreserved Embryos: The Unresolved Challenge. J Reprod Infertil 2024; 25:77-78. [PMID: 39157799 PMCID: PMC11327423 DOI: 10.18502/jri.v25i2.16003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024] Open
Abstract
The Article Abstract is not available.
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15
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Zacà C, Coticchio G, Calesini C, Vigiliano V, Tarozzi N, Lagalla C, Borini A. Towards a more sustainable balance between optimal live birth rate and supernumerary embryos in ART treatments. J Assist Reprod Genet 2024; 41:939-946. [PMID: 38321266 PMCID: PMC11052976 DOI: 10.1007/s10815-024-03043-7] [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: 08/07/2023] [Accepted: 01/21/2024] [Indexed: 02/08/2024] Open
Abstract
PURPOSE To assess the relation between number of inseminated oocytes and cumulative live birth rate (CLBR) in order to provide guidance for limiting the number of surplus blastocysts. METHODS The study was a retrospective, single-center cohort analysis of 1223 ART complete cycles. Cycles were stratified according to female age (≤ 34, 35-38, and 39-42 years) and number of inseminated oocytes (1-5, 6-10, and > 10). Inclusion criteria were indication for IVF/ICSI with own spermatozoa and blastocyst culture up to day 6 of all embryos. RESULTS In patients younger than 35 years, insemination of more than ten oocytes produced an increase in overall blastocyst number, CLBR (40.3%, 54.3%, and 75.8%, respectively, for each oocyte group) and surplus embryo rate (12.9%, 27.8%, and 49.7% of cases for each group). Instead, in the middle age group, the use of more than ten oocytes was solely associated with an increase in the rate of surplus embryos (1.25%, 21.33%, and 28.68% of cases after stratification for oocyte number). In older patients, neither CLBR (9.1%, 23.9%, and 24.7%, respectively) nor rate of surplus embryos (2.0%, 7.1%, and 13.4% of cases for each group) were higher in cycles with more than ten inseminated oocytes. CONCLUSION In women up to 38 years, sustainable CLBR are achieved while limiting the number of inseminated oocytes and the resulting blastocysts remaining unused. Based on this notion, novel treatment strategies could pursue high outcome rates, while alleviating the problems derived from surplus stored embryos.
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Affiliation(s)
- Carlotta Zacà
- IVIRMA Global Research Alliance, 9.Baby, Bologna, Italy
| | - Giovanni Coticchio
- IVIRMA Global Research Alliance, 9.Baby, Bologna, Italy.
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy.
| | | | - Vincenzo Vigiliano
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | | | | | - Andrea Borini
- IVIRMA Global Research Alliance, 9.Baby, Bologna, Italy
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Ji J, Ling X, Zhou Q, Zhou L, Ji H, Wu X, Zhang J, Cao S. Prioritized single vitrified blastocyst to be warmed between grades 3 or 4 blastocyst on day 5 transfer cycles. Arch Gynecol Obstet 2024; 309:1629-1641. [PMID: 38315199 DOI: 10.1007/s00404-023-07336-7] [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: 08/24/2023] [Accepted: 12/05/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE Selecting the optimal blastocyst to implant during cryopreservation and warming is critial for in vitro fertilization success. Therefore, the aim of this study was to explore which blastocyst should be prioritized to be thawed when facing a single vitrified blastocyst on day 5 transfer. METHODS A retrospective study including 1,976 single vitrified-warmed blastocyst transfer cycles was conducted from January 2016 to December 2020. RESULTS We found that grade 4 vitrified blastocyst had a higher clinical pregnancy (60.64% vs. 49.48%, P < 0.001) and live birth rates (50.12% vs 39.59%, P < 0.001) than the grade 3 vitrified blastocyst. However, no statistical difference was found between groups in miscarriage rate, birth weight, or gestational age. Besides, the grade 4 vitrified-thawed blastocyst had significant potential to develop into grade 6 blastocyst after further culturing for 16 h (73.68% vs. 48.60%, P < 0.001). The grade 6 transferred blastocyst was markedly higher in both clinical pregnancy rate (61.88% vs. 51.53%, P < 0.001) and live birth rate (50.91% vs. 40.46%, P < 0.001) compared to grade 5 transferred blastocyst. CONCLUSIONS Grade 4 vitrified blastocyst is recommended when facing single vitrified blastocyst on day 5 transfer. More importantly, the "embryonic escape hypothesis" was firstly proposed to reveal the findings.
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Affiliation(s)
- Juan Ji
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China
| | - Xiufeng Ling
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China
| | - Qiao Zhou
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China
| | - Lin Zhou
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China
| | - Hui Ji
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China
| | - Xun Wu
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China
| | - Juanqiang Zhang
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China
| | - Shanren Cao
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, 123 Tianfeixiang, Mochou Road, Nanjing, 210004, Jiangsu, China.
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17
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Du S, Shen C, Zhang J. A comparative analysis of the clinical pregnancy and perinatal outcomes between oocyte vitrification and embryo vitrification based on the propensity score matching method. J Assist Reprod Genet 2024; 41:875-883. [PMID: 38366240 PMCID: PMC11052731 DOI: 10.1007/s10815-024-03055-3] [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: 08/21/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
PURPOSE This study investigated the safety and effectiveness of oocyte vitrification by comparing the clinical pregnancy and perinatal outcomes between transfer cycles of vitrified oocytes and those of vitrified embryos. METHODS A retrospective cohort study was conducted to analyze the clinical data of patients who underwent cleavage-stage embryo transfer at the Department of Reproductive Medicine between January 2011 and June 2021. Seventy-seven transfer cycles of fresh cleavage-stage embryos developed from vitrified-thawed oocytes (oocyte vitrification group) and 2170 transfer cycles of vitrified-thawed cleavage-stage embryos developed from fresh oocytes (embryo vitrification group) were included. Further, 293 cases were selected from the embryo vitrification group after applying propensity score matching at 1:4. The primary outcomes were miscarriage rate, live birth rate, and neonatal birth weight. RESULTS No statistically significant differences were observed in the baseline data, pregnancy, perinatal outcomes, or neonatal outcomes for either singleton or twin births between the two groups after matching. Backwards stepwise regression was used to analyze the length of gestation. The age of female participants (β = - 0.410, 95% CI = - 1.339 ~ - 0.620, P < 0.001) had a statistically significant effect. CONCLUSION Oocyte vitrification results in similar clinical pregnancy and perinatal outcomes as does embryo vitrification; hence, it is a relatively safe assisted reproductive technique.
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Affiliation(s)
- Shanshan Du
- The Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Chunyan Shen
- The Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianrui Zhang
- The Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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18
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Zhang S, Luo Q, Meng R, Yan J, Wu Y, Huang H. Long-term health risk of offspring born from assisted reproductive technologies. J Assist Reprod Genet 2024; 41:527-550. [PMID: 38146031 PMCID: PMC10957847 DOI: 10.1007/s10815-023-02988-5] [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: 06/29/2023] [Accepted: 11/02/2023] [Indexed: 12/27/2023] Open
Abstract
Since the world's first in vitro fertilization baby was born in 1978, there have been more than 8 million children conceived through assisted reproductive technologies (ART) worldwide, and a significant proportion of them have reached puberty or young adulthood. Many studies have found that ART increases the risk of adverse perinatal outcomes, including preterm birth, low birth weight, small size for gestational age, perinatal mortality, and congenital anomalies. However, data regarding the long-term outcomes of ART offspring are limited. According to the developmental origins of health and disease theory, adverse environments during early life stages may induce adaptive changes and subsequently result in an increased risk of diseases in later life. Increasing evidence also suggests that ART offspring are predisposed to an increased risk of non-communicable diseases, such as malignancies, asthma, obesity, metabolic syndrome, diabetes, cardiovascular diseases, and neurodevelopmental and psychiatric disorders. In this review, we summarize the risks for long-term health in ART offspring, discuss the underlying mechanisms, including underlying parental infertility, epigenetic alterations, non-physiological hormone levels, and placental dysfunction, and propose potential strategies to optimize the management of ART and health care of parents and children to eliminate the associated risks. Further ongoing follow-up and research are warranted to determine the effects of ART on the long-term health of ART offspring in later life.
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Affiliation(s)
- Siwei Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China
| | - Qinyu Luo
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University School of Medicine, Hangzhou, China
| | - Renyu Meng
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China
| | - Jing Yan
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China
| | - Yanting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China.
- Research Unit of Embryo Original Diseases (No. 2019RU056), Chinese Academy of Medical Sciences, Shanghai, China.
| | - Hefeng Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, No. 419, Fangxie Rd, Shanghai, 200011, China.
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University School of Medicine, Hangzhou, China.
- Research Unit of Embryo Original Diseases (No. 2019RU056), Chinese Academy of Medical Sciences, Shanghai, China.
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19
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Zhu Y, Liu H, Zheng L, Luo Y, Zhou G, Li J, Hou Y, Fu X. Vitrification of Mammalian Oocytes: Recent Studies on Mitochondrial Dysfunction. Biopreserv Biobank 2024. [PMID: 38227396 DOI: 10.1089/bio.2023.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
Vitrification of reproductive cells is definitely essential and integral in animal breeding, as well as in assisted reproduction. However, issues accompanied with this technology such as decreased oocyte competency and relatively low embryo survival rates appear to be a tough conundrum that has long perplexed us. As significant organelles in cell metabolism, mitochondria play pivotal roles in numerous pathways. Nonetheless, extensive evidence has demonstrated that vitrification can seriously impair mitochondrial function in mammalian oocytes. Thus, in this article, we summarize the current progress in oocyte vitrification and particularly outline the common mitochondrial abnormalities alongside subsequent injury cascades seen in mammalian oocytes following vitrification. Based on existing literature, we tentatively come up with the potential mechanisms related to mitochondrial dysfunction and generalize efficacious ways which have been recommended to restore mitochondrial function.
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Affiliation(s)
- Yixiao Zhu
- Key Laboratory of Animal Genetics, Breeding and Reproduction of the MARA, National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, State Key Laboratory of Animal Biotech Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, P. R. China
| | - Hongyu Liu
- Key Laboratory of Animal Genetics, Breeding and Reproduction of the MARA, National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, State Key Laboratory of Animal Biotech Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, P. R. China
| | - Lv Zheng
- Key Laboratory of Animal Genetics, Breeding and Reproduction of the MARA, National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, State Key Laboratory of Animal Biotech Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, P. R. China
| | - Yuwen Luo
- State Key Laboratory of Agrobiotechnology, College of Biological Sciences, China Agricultural University, Beijing, China
| | - Guizhen Zhou
- Key Laboratory of Animal Genetics, Breeding and Reproduction of the MARA, National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, State Key Laboratory of Animal Biotech Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, P. R. China
| | - Jun Li
- Department of Reproductive Medicine, Reproductive Medical Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yunpeng Hou
- State Key Laboratory of Agrobiotechnology, College of Biological Sciences, China Agricultural University, Beijing, China
| | - Xiangwei Fu
- Key Laboratory of Animal Genetics, Breeding and Reproduction of the MARA, National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, State Key Laboratory of Animal Biotech Breeding, College of Animal Science and Technology, China Agricultural University, Beijing, P. R. China
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20
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Somfai T. Vitrification of immature oocytes in pigs. Anim Sci J 2024; 95:e13943. [PMID: 38578008 DOI: 10.1111/asj.13943] [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: 12/27/2023] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 04/06/2024]
Abstract
Cryopreservation of oocytes is an important technology for the in vitro gene banking of female germplasm. Although slow freezing is not feasible, porcine oocytes survive vitrification at high rates. Cryopreservation at the germinal vesicle stage appears to be more advantageous than that at the metaphase-II stage. Several factors are considered to affect the success of vitrification and subsequent utilization of immature porcine oocytes such as the device, the protocols for cryoprotectant application, warming, and the post-warming culture. Although live piglets could be obtained from vitrified immature oocytes, their competence to develop to the blastocyst stage is still reduced compared to their non-vitrified counterparts, indicating that there is room for further improvement. Vitrified oocytes suffer various types of damage and alteration which may reduce their developmental ability. Some of these can recover to some extent during subsequent culture, such as the damage of the cytoskeleton and mitochondria. Others such as premature nuclear progression, DNA damage and epigenetic alterations will require further research to be clarified and addressed. To date, the practical application of oocyte vitrification in pigs has been confined to the gene banking of a few native breeds.
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Affiliation(s)
- Tamás Somfai
- Animal Model Development Group, Division of Biomaterial Sciences, Institute of Agrobiological Sciences, National Agriculture and Food Research Organization, Tsukuba, Japan
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21
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Zander-Fox DL, Pacella-Ince L, Morgan DK, Green MP. Mammalian embryo culture media: now and into the future. Reprod Fertil Dev 2023; 36:66-80. [PMID: 38064187 DOI: 10.1071/rd23168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
For over 70years, since the culture of the first mammalian embryo in vitro , scientists have undertaken studies to devise and optimise media to support the manipulation and culture of gametes and embryos. This area of research became especially active in the late 1970s onwards following the successful birth of the first human in vitro fertilised embryo. This review summarises some of the key advances in mammalian embryo culture media over time based on a greater understanding of the biochemical milieu of the reproductive tract. It highlights how learnings from studies in mice and agricultural species have informed human culture media compositions, in particular the inclusion of albumin, growth factors, cytokines, and antioxidants into contemporary culture media formulations, and how these advances may then in turn help to inform and guide development of in vitro culture systems used in other arenas, in particular agriculture. Additionally, it will highlight how the introduction of new technologies, such as timelapse, can influence current trends in media composition and usage that may see a return to a single step medium.
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Affiliation(s)
- Deirdre L Zander-Fox
- Monash IVF Group, Melbourne, Vic., Australia; and Biomedicine Discovery Institute, Monash University, Melbourne, Vic., Australia; and School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
| | - Leanne Pacella-Ince
- School of Biomedicine, University of Adelaide, Adelaide, SA, Australia; and Repromed, Adelaide, SA, Australia
| | | | - Mark P Green
- Monash IVF Group, Melbourne, Vic., Australia; and School of BioSciences, University of Melbourne, Melbourne, Vic., Australia
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22
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Wang J, Ma L, Mei J, Li L, Xu W, Jiang W, Wei Y, Xu Y, Sun S, Ma Y, Li Q. Impacts of different culture times on pregnancy outcomes after thawing of cleavage stage embryos. BMC Pregnancy Childbirth 2023; 23:824. [PMID: 38031033 PMCID: PMC10685551 DOI: 10.1186/s12884-023-06139-7] [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: 03/14/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE This study assessed the impacts of in vitro culture times of cleavage embryos on clinical pregnancy outcomes. METHODS This retrospective cohort study was performed at the Reproductive Medicine Department of Hainan Modern Women and Children's Hospital in China between January 2018 and December 2022. Patients who first underwent frozen embryo transfer with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles on day 3 were included. According to the time of embryo culture after thawing, the embryos were divided into long-term culture group(18-20 h) and short-term culture group (2-4 h). The clinical pregnancy rate was regarded as he primary outcome. To minimize confounding factors and reduce selection bias, the propensity score matching was used to balance the effects of known confounding factors and to reduce selection bias. Stratified analyses and multiple logistic regression analyses were used to evaluate the risk factors affecting the clinical pregnancy outcomes after matching. RESULTS General characteristics between two groups were comparable after matching. In the long-term culture group, 266/381 (69.81%) embryos had more than 10 blastomeres, and 75/381 (19.68%) reached the morula stage. After overnight culture, the implantation rate (27.97% vs. 14.28%, P = 0.018) and clinical pregnancy rate (38.46% vs. 22.5%, P = 0.05) were increased in the group with proliferating blastomeres. The long-term culture group trended to have a higher clinical pregnancy rate compared with the short-term culture group (35.74% vs. 29.79%). No statistical differences in clinical pregnancy outcomes between the two groups were observed after matching, including the rates of implantation (25.46% vs23.98%), miscarriages (25% vs. 22.85%), ongoing pregnancy rate (76.2% vs. 77.15%) and live birth rate (26.8% vs. 22.98%). Stratified analyses were performed according to the age of the patients. After matching, there were no significant differences in the clinical pregnancy, implantation and miscarriage rates between the two groups for patients > 35 or ≤ 35 years of age. Subgroup analyses were performed according to the quality of the transferred embryos. There were no significant differences in the clinical outcomes, between two groups after embryos transferred with the same quality. Multivariate Logistic regression analysis was used to evaluate the influencing factors of clinical pregnancy outcomes after matching. Culture time was not found to be an independent predictor for clinical pregnancy [OR 0.742, 95%CI 0.487 ~ 1.13; P = 0.165]. The age of oocyte retrieval [OR 0.906, 95%CI 0.865 ~ 0.949; P <0.001] and the number of high-quality embryos transferred [OR 1.787, 95%CI 1.256 ~ 2.543; P = 0.001] were independent factors affecting clinical pregnancy outcomes. CONCLUSIONS In vitro 18-20 h culture of embryos with either good-or non-good-quality will not adversely affect the clinical pregnancy.
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Affiliation(s)
- Jieyou Wang
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China
| | - Linna Ma
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Clinical Research Center for Thalassemia, Haikou Key Laboratory for Preservation of Human Genetic Resource, Reproductive Medical Center, National Center for International Research "China-Myanmar Joint Research Center for Prevention and Treatment of Regional Major Disease", The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, 570102, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, 3 Xueyuan Road, Haikou, 571199, China
| | - Jiaoqi Mei
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Clinical Research Center for Thalassemia, Haikou Key Laboratory for Preservation of Human Genetic Resource, Reproductive Medical Center, National Center for International Research "China-Myanmar Joint Research Center for Prevention and Treatment of Regional Major Disease", The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, 570102, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, 3 Xueyuan Road, Haikou, 571199, China
| | - Linjiang Li
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China
| | - Wen Xu
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China
| | - Weimin Jiang
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China
| | - Yueyan Wei
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China
| | - Yu Xu
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China
| | - Shaoqing Sun
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China
| | - Yanlin Ma
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Clinical Research Center for Thalassemia, Haikou Key Laboratory for Preservation of Human Genetic Resource, Reproductive Medical Center, National Center for International Research "China-Myanmar Joint Research Center for Prevention and Treatment of Regional Major Disease", The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, 570102, China.
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, 3 Xueyuan Road, Haikou, 571199, China.
| | - Qi Li
- Hainan Modern Women and Children's Hospital, 18 Qiongzhou Road, Haikou, 570100, China.
- Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research, Hainan Clinical Research Center for Thalassemia, Haikou Key Laboratory for Preservation of Human Genetic Resource, Reproductive Medical Center, National Center for International Research "China-Myanmar Joint Research Center for Prevention and Treatment of Regional Major Disease", The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, 570102, China.
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, 3 Xueyuan Road, Haikou, 571199, China.
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Park JK, Park JE, Bang S, Jeon HJ, Kim JW, Lee WS. Development and validation of a nomogram for predicting ongoing pregnancy in single vitrified-warmed blastocyst embryo transfer cycles. Front Endocrinol (Lausanne) 2023; 14:1257764. [PMID: 38075065 PMCID: PMC10702135 DOI: 10.3389/fendo.2023.1257764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/10/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction The global adoption of the "freeze-all strategy" has led to a continuous increase in utilization of single vitrified-warmed blastocyst embryo transfer (SVBT) owing to its clinical effectiveness. Accurate prediction of clinical pregnancy is crucial from a patient-centered perspective. However, this remains challenging, with inherent limitations due to the absence of precise and user-friendly prediction tools. Thus, this study primarily aimed to develop and assess a nomogram based on quantitative clinical data to optimize the efficacy of personalized prognosis assessment. Materials and methods We conducted a retrospective cohort analysis of ongoing pregnancy data from 658 patients with infertility who underwent SVBT at our center between October 17, 2017, and December 18, 2021. Patients were randomly assigned to the training (n=461) or validation (n=197) cohort for nomogram development and testing, respectively. A nomogram was constructed using the results of the multivariable logistic regression (MLR), which included clinical covariates that were assessed for their association with ongoing pregnancy. Results The MLR identified eight significant variables that independently predicted ongoing pregnancy outcomes in the study population. These predictors encompassed maternal physiology, including maternal age at oocyte retrieval and serum anti-Müllerian hormone levels; uterine factors, such as adenomyosis; and various embryo assessment parameters, including the number of fertilized embryos, blastocyst morphology, blastulation day, blastocyst re-expansion speed, and presence of embryo string. The area under the receiver operating characteristic curve in our prediction model was 0.675 (95% confidence interval [CI], 0.622-0.729) and 0.656 (95% CI, 0.573-0.739) in the training and validation cohorts, respectively, indicating good discrimination performance in both cohorts. Conclusions Our individualized nomogram is a practical and user-friendly tool that can provide accurate and useful SVBT information for patients and clinicians. By offering this model to patients, clinical stakeholders can alleviate uncertainty and confusion about fertility treatment options and enhance patients' confidence in making informed decisions.
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Affiliation(s)
| | | | | | | | - Ji Won Kim
- *Correspondence: Ji Won Kim, ; Woo Sik Lee,
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Gunst J, Vynck M, Hostens K, Standaert V, Roggeman S, van de Vijver A. Comparative Assessment of Survival and Clinical Outcome Between Two Commercial Vitrification Kits with Different Warming Protocols After Blastocyst Culture: Potential Perspectives Toward Simplified Warming Procedures. Reprod Sci 2023; 30:3212-3221. [PMID: 37311945 PMCID: PMC10643310 DOI: 10.1007/s43032-023-01281-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023]
Abstract
This study investigates whether there is an effect on laboratory results and clinical outcome using commercial kits with similar vitrification but different warming procedures for blastocysts vitrified on day 5 or day 6. A single-center retrospective cohort study was performed between 2011 and 2020. A change from a stage-specific kit (Kit 1) to a universal kit (Kit 2) was undertaken in 2017. A total of 1845 untested blastocysts were warmed for single vitrified-warmed blastocyst transfers (SVBT). Eight hundred and twenty-five blastocysts were vitrified with Kit 1 and 1020 with Kit 2. Blastocyst survival was not different (96.1% versus 97.3%). Seven hundred seventy-seven SVBT were performed from Kit 1 and 981 from Kit 2. Overall clinical pregnancy and live birth rates were not different (35.4% versus 34.1% and 30.9% versus 30.5% for Kit 1 and 2, respectively). Subgroup analysis for live birth rates in relation to the day of blastocyst vitrification showed no differences (36.1% and 36.1% for day 5 and 25.4% and 23.5% for day 6 blastocysts, respectively). For both kits, the mean gestational age was not different (38.8 ± 2.5 weeks versus 38.8 ± 2.0 weeks) with a singleton birth weight of 3413 ± 571 g and 3410 ± 528 g for Kit 1 and Kit 2, respectively. Differences in warming procedures do not affect laboratory performance or clinical outcome after blastocyst vitrification. The plasticity of a human blastocyst may allow for further investigation on simplification of blastocyst warming procedures.
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Affiliation(s)
- Jan Gunst
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge-Oostende, Ruddershove 10, 8000, Bruges, BE, Belgium.
| | - Matthijs Vynck
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge-Oostende, Ruddershove 10, 8000, Bruges, BE, Belgium
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Ghent, BE, Belgium
| | - Katleen Hostens
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge-Oostende, Ruddershove 10, 8000, Bruges, BE, Belgium
| | - Valerie Standaert
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge-Oostende, Ruddershove 10, 8000, Bruges, BE, Belgium
| | - Sylvie Roggeman
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge-Oostende, Ruddershove 10, 8000, Bruges, BE, Belgium
| | - Arne van de Vijver
- Department of Obstetrics and Gynecology - Center for Reproductive Medicine, General Hospital Sint-Jan Brugge-Oostende, Bruges, BE, Belgium
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25
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Maclellan LJ, Albertini DF, Stokes JE, Carnevale EM. Use of confocal microscopy and intracytoplasmic sperm injection (ICSI) to assess viability of equine oocytes from young and old mares after vitrification. J Assist Reprod Genet 2023; 40:2565-2576. [PMID: 37725179 PMCID: PMC10643763 DOI: 10.1007/s10815-023-02935-4] [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: 05/24/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The impact of vitrification on oocyte developmental competence as a function of donor age remains an important issue in assisted reproductive technologies (ARTs). METHODS Equine germinal vesicle (GV) or metaphase II (M(II) oocytes were vitrified using the Cryotop® method. Spindle organization and chromosome alignment were evaluated from confocal imaging data sets of in vivo (IVO) or in vitro (IVM) matured oocytes subjected to vitrification or not. Intracytoplasmic sperm injection (ICSI) from the same groups was used to assess developmental potential. RESULTS An increase in chromosome misalignment was observed in spindles from older mares when compared to those of younger mares (P < 0.05). When MII oocytes subjected to vitrification were examined following warming, there was no difference in the percentage of oocytes displaying chromosome misalignment. Next, GV oocytes, collected from the ovaries of younger and older mares, were compared between fresh IVM and IVM following vitrification and warming. For nonvitrified samples, an age difference was again noted for spindle organization and chromosome alignment, with a higher (P < 0.05) percentage of normal bipolar meiotic spindles with aligned chromosomes observed in nonvitrified oocytes from young versus older mares. Vitrification led to a reduction of spindle length (P < 0.05) for oocytes from old mares, whether vitrified at GV or MII stages, whereas this effect was not observed in oocytes from young mares except those vitrified at GV and subjected to IVM. Oocyte developmental potential after vitrification was evaluated after ICSI of vitrified and warmed MII or GV oocytes from young mares. From 25 MII oocytes, 18 oocytes were injected with sperm, and six blastocysts were produced, which, upon transfer to mares' uteri, resulted in four pregnancies. Immature (GV) oocytes collected from live mares were also vitrified, warmed, and matured in vitro before ICSI. In this group, nonvitrified, control, and vitrified oocytes did not differ (P > 0.05) with respect to the incidence of maturation to MII, cleavage after ICSI, or blastocyst development. CONCLUSION These findings demonstrate an effect of maternal age in an equine model at the level of meiotic spindle integrity and chromosome positioning that is influenced by both the meiotic stage at which oocytes are vitrified and whether meiotic maturation occurred in vivo or in vitro.
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Affiliation(s)
- Lisa J Maclellan
- Department of Biomedical Sciences, Colorado State University, 1601 Campus Delivery, Fort Collins, Colorado, 80523, USA
- Seven Creeks Equine Reproduction, Euroa, 3666, Australia
| | | | - Joanne E Stokes
- Department of Biomedical Sciences, Colorado State University, 1601 Campus Delivery, Fort Collins, Colorado, 80523, USA
| | - Elaine M Carnevale
- Department of Biomedical Sciences, Colorado State University, 1601 Campus Delivery, Fort Collins, Colorado, 80523, USA.
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26
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Nanassy L, Schoepper B, Schultze-Mosgau A, Depenbusch M, Eggersmann TK, Hiller RAF, Griesinger G. Evaluation of live birth rates and perinatal outcomes following two sequential vitrification/warming events at the zygote and blastocyst stages. J Assist Reprod Genet 2023; 40:2357-2365. [PMID: 37582908 PMCID: PMC10504135 DOI: 10.1007/s10815-023-02909-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023] Open
Abstract
PURPOSE To study the outcome of sequential cryopreservation-thawing of zygotes followed by the cryopreservation-thawing of blastocysts in the course of an IVF treatment on live birth rate and neonatal parameters. METHODS Single center, retrospective chart review for the time period of 2015-2020. Clinical and perinatal outcomes were compared between frozen embryo transfer cycles utilizing twice-cryopreserved (n = 182) vs. once-cryopreserved (n = 282) embryos. Univariate and multivariable analyses were used to adjust for relevant confounders. RESULTS After adjustment for maternal age, gravidity, parity, body mass index (BMI), paternal age, fertilization method used, the number of oocytes retrieved in the fresh cycle, fertilization rate, and transfer medium, the transfer of twice-cryopreserved embryos resulted in a reduced probability of live birth (OR, 0.52; 95% CI 0.27-0.97; p=0.041) compared to once-cryopreserved embryos. No differences in the sex ratio, the mean gestational age, the mean length at birth, or the mean birth weight were found between the two groups. CONCLUSION The circumstantial use of sequential double vitrification-warming in course of treatment is associated with a reduced (but still reasonable) live birth rate compared to once-cryopreserved embryos. As the neonatal outcomes of twice-cryopreserved embryos are similar to once-cryopreserved embryos, this treatment option appears still valid as a rescue scenario in selected cases.
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Affiliation(s)
- Laszlo Nanassy
- Universitäres Kinderwunschzentrum, Lübeck und Manhagen, Ratzeburger Allee 111-125, 23562, Lübeck, Germany.
| | - Beate Schoepper
- Universitäres Kinderwunschzentrum, Lübeck und Manhagen, Ratzeburger Allee 111-125, 23562, Lübeck, Germany
- Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Askan Schultze-Mosgau
- Universitäres Kinderwunschzentrum, Lübeck und Manhagen, Ratzeburger Allee 111-125, 23562, Lübeck, Germany
- Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Marion Depenbusch
- Universitäres Kinderwunschzentrum, Lübeck und Manhagen, Ratzeburger Allee 111-125, 23562, Lübeck, Germany
- Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Tanja K Eggersmann
- Universitäres Kinderwunschzentrum, Lübeck und Manhagen, Ratzeburger Allee 111-125, 23562, Lübeck, Germany
- Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Roman A F Hiller
- Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Georg Griesinger
- Universitäres Kinderwunschzentrum, Lübeck und Manhagen, Ratzeburger Allee 111-125, 23562, Lübeck, Germany
- Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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Zeng Z, Li J, Wang X, Yi S, Bi Y, Mo D, Liu B, Fu X, Yang Y, Ma W. Influence of maternal obesity on embryonic vitrification injury and subsequent pregnancy outcomes: A retrospective cohort study. Heliyon 2023; 9:e20095. [PMID: 37809804 PMCID: PMC10559855 DOI: 10.1016/j.heliyon.2023.e20095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
Background We previously reported that obese mice had significantly high lipid content in embryos, and excessive lipids are detrimental to embryonic development. However, whether maternal obesity has an effect on embryonic vitrification injury and subsequent pregnancy outcomes is still controversial. This study was conducted to clarify the influence of maternal obesity on embryonic vitrification injury and subsequent pregnancy outcomes by in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods We retrospectively collected medical record of IVF/ICSI patients from reproductive medicine centers in two tertiary hospitals. The patients were classified into a low-weight group (<18.5 kg/m2), normal-weight group (18.5-23.9 kg/m2), overweight group (24.0-27.9 kg/m2) and obese group (≥28.0 kg/m2) according to their body mass index (BMI). Multivariable logistic regression analysis was performed to compare pregnancy outcomes in fresh and frozen embryo transfer among different BMI groups to define the correlation between BMI and embryonic vitrification injury. Results A total of 44 773 women among 20-40 years old were recruited in this study, of which 27 797 underwent their first fresh embryo transfer and 16 976 underwent their first frozen embryo transfer. For fresh embryo transfer, there was no significant difference in the clinical pregnancy rate, live birth rate, and miscarriage rate of 4 BMI groups. For frozen-thawed embryo transfer, there was a significant increase in the clinical pregnancy rate of the overweight group (AOR = 1.14, 95% CI: 1.05-1.25) and the obese group (AOR = 1.24, 95% CI: 1.03-1.50), while the miscarriage rate (AOR = 1.42, 95% CI: 1.05-1.92) also showed a significant increase in the obese group compared to the normal-weight group. Conclusion This study provided a new understanding of the effect of maternal obesity on embryonic vitrification injury. Maternal obesity does not worsen the outcome of IVF/ICSI, particularly in the frozen-thawed group.
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Affiliation(s)
- Zhonghong Zeng
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Jingjing Li
- Reproductive Medicine Center, Liuzhou Municipal Maternity and Child Health Care Hospital, Liuzhou, 545001 China
| | - Xi Wang
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Shanjia Yi
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Yin Bi
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Dan Mo
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Bo Liu
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Xiaoqian Fu
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
| | - Yihua Yang
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, China
| | - Wenhong Ma
- Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China
- Reproductive Medicine Center, Nanning Women and Children's Hospital, Nanning, 530011 China
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Tan J, Li J, Zhou X. Generation of cell-laden GelMA microspheres using microfluidic chip and its cryopreservation method. Biomed Mater 2023; 18:055023. [PMID: 37582391 DOI: 10.1088/1748-605x/acf0ac] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/15/2023] [Indexed: 08/17/2023]
Abstract
Gelatin methacrylate (GelMA) hydrogels have been widely used in tissue engineering because of their excellent biological and physical properties. Here, we used a microfluidic flow-focusing chip based on polymethyl methacrylate to fabricate cell-laden GelMA hydrogel microspheres. Structures of the throat region and photo crosslinking region on the chip, flow rate ratio of GelMA and oil phase, and GelMA concentration were optimized to obtain the stable and suitable size of microspheres. Cell-laden GelMA microspheres can be cryopreserved by slow freezing and rapid freezing. The survival rate of encapsulated cells after rapid freezing was significantly higher than that of unencapsulated cells. There was no significant difference between the results of the rapid freezing of encapsulated cells with 5% DMSO and the traditional slow freezing of suspended cells with 10% DMSO. It demonstrates the possibility that GelMA hydrogel itself can replace some of the cryoprotective agents and has some protective effect on cells. Our study provides new ideas to optimize GelMA hydrogels for cell cryopreservation, facilitating the off-the-shelf availability of tissue-engineered constructs.
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Affiliation(s)
- Jia Tan
- Institute of Biothermal Science & Technology, University of Shanghai for Science and Technology, Shanghai 200093, People's Republic of China
- Shanghai Co-innovation Center for Energy Therapy of Tumors, Shanghai 200093, People's Republic of China
- Shanghai Technical Service Platform for Cryopreservation of Biological Resources, Shanghai 200093, People's Republic of China
| | - Jiahui Li
- Institute of Biothermal Science & Technology, University of Shanghai for Science and Technology, Shanghai 200093, People's Republic of China
- Shanghai Co-innovation Center for Energy Therapy of Tumors, Shanghai 200093, People's Republic of China
- Shanghai Technical Service Platform for Cryopreservation of Biological Resources, Shanghai 200093, People's Republic of China
| | - Xinli Zhou
- Institute of Biothermal Science & Technology, University of Shanghai for Science and Technology, Shanghai 200093, People's Republic of China
- Shanghai Co-innovation Center for Energy Therapy of Tumors, Shanghai 200093, People's Republic of China
- Shanghai Technical Service Platform for Cryopreservation of Biological Resources, Shanghai 200093, People's Republic of China
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Tsafrir A, BenHaroush A, Hyman J, Karavani G, Imbar T. What are the most common controversial clinical issues in fertility preservation? A content analysis of a collaborative professional online consultation group. Reprod Biol Endocrinol 2023; 21:77. [PMID: 37620900 PMCID: PMC10463612 DOI: 10.1186/s12958-023-01122-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
RESEARCH QUESTION Clinicians involved in fertility preservation (FP) are often required to make prompt and consequential decisions despite the absence of evidence-based data. We established a collaborative professional online consultation group for fertility preservation issues. We sought to determine the main controversial clinical issues in FP as raised by participants of this group. DESIGN Content analysis of a dedicated community of practice interacting via a messaging application (WhatsApp) and a survey of group participants. RESULTS Between January 2019 and July 2022, group members posed 39 clinical questions which were discussed and debated by the group. Common themes included management of oncofertility cases (33%), potential gonadotoxicity of various therapies (23%), fertility preservation in women and girls with premature ovarian insufficiency (POI) (18%), and technical aspects of ovarian tissue cryopreservation (10%). All but one query received prompt response (mean time for first response for 95% of queries 7.1 ± 9.0 min) from a mean of 5.4 ± 3.2 members. An anonymous online survey of group members was conducted during August 2022 (n = 31, response rate 94%). The majority of respondents stated they gained knowledge and assistance in clinical decision making from participation in the discussion group (90% and 58% of respondents, respectively). CONCLUSIONS Management of clinical oncofertility cases, potential gonadotoxic effect of therapeutics and fertility preservation in women and girls with POI were the most common controversial issues in our fertility preservation community of practice. Intra-professional collaborative communication via a messaging application can aid in clinical management of fertility preservation and augment clinician's knowledge.
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Affiliation(s)
- Avi Tsafrir
- IVF unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Avi BenHaroush
- IVF unit, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jordana Hyman
- IVF unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gilad Karavani
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Fertility preservation unit, Department of Obstetrics and Gynecology Hadassah Medical Center, Jerusalem, Israel
| | - Tal Imbar
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Fertility preservation unit, Department of Obstetrics and Gynecology Hadassah Medical Center, Jerusalem, Israel
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Chen CH, Lee CI, Huang CC, Chen HH, Chang CY, Cheng EH, Lin PY, Chen CI, Lee TH, Lee MS. Increased incidence of live births in implanted day 5 versus day 6 blastocysts following single embryo transfers with PGT-A. Sci Rep 2023; 13:12725. [PMID: 37543691 PMCID: PMC10404267 DOI: 10.1038/s41598-023-40052-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
Elective single-embryo transfers of euploid or low-level mosaic blastocysts were analyzed in this retrospective study to determine the correlations of live birth (LB) probability with embryonic developmental features of implanted day 5 (D5, n = 245) or day 6 (D6, n = 73) blastocysts using time-lapse (TL) monitoring. According to the logistic regression analyses (adjusted odds ratio [OR] = 0.341, 95% confidence interval [CI] = 0.169-0.685, P < 0.05), the LB probability was negatively associated with the D6 group. The LB rate of the D5 group was higher than the D6 group (88.2% vs. 75.3%; P < 0.05). Compared with the D5 blastocysts, the D6 blastocysts exhibited comparable dysmorphisms except for the multinucleation at the 4-cell stage (10.9% vs. 2.9%, P < 0.05). Moreover, D6 blastocysts had considerably slower developmental kinetics and poorer blastocyst morphologies. Further analysis confirmed that the LB rate was not associated with developmental kinetics or dysmorphisms but rather with blastocyst morphology (inner cell mass [ICM] grade ≤ C vs. ICM grade A, adjusted OR = 0.155, 95% CI = 0.04-0.596, P < 0.05; trophectoderm [TE] grade ≤ C vs. TE grade A, adjusted OR = 0.157, 95% CI = 0.032-0.760, P < 0.05). In conclusion, D6 implanted blastocysts have a considerably lower LB rate than D5 implanted blastocysts. As determined by TL monitoring, the diminished blastocyst morphology can be one of the primary reasons underlying the decreased likelihood of LB.
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Affiliation(s)
- Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chih-Ying Chang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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Oliveira CS, Camargo LSA, da Silva MVGB, Saraiva NZ, Quintão CC, Machado MA. Embryo biopsies for genomic selection in tropical dairy cattle. Anim Reprod 2023; 20:e20230064. [PMID: 37547565 PMCID: PMC10399131 DOI: 10.1590/1984-3143-ar2023-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/21/2023] [Indexed: 08/08/2023] Open
Abstract
Genomic selection has transformed the livestock industry, enabling early-life selection of animals. Biopsy sampling of pre-implantation embryos has been described since 1968. However, it was only after 2010, with the advancement of molecular biology techniques such as whole genomic amplification and SNP Chips, that next-generation sequencing became commercially available for bovine embryos. It is now possible to make decisions about which embryos to transfer not only based on recipients' availability or embryo morphology but also on genomic estimates. This technology can be implemented for a wide spectrum of applications in livestock. In this review, we discuss the use of embryo biopsy for genomic selection and share our experience with Gir and Girolando Brazilian breeding programs, as well as future goals for implementing it in Brazilian bovine in vitro embryo production practices.
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Aygün EG, Özbaşlı E, Köse MF. The Effect of Different Luteal Phase Support Applications on Clinical Pregnancy Outcomes in Frozen-Thawed Embryo Transfer. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8157210. [PMID: 37529251 PMCID: PMC10390266 DOI: 10.1155/2023/8157210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 08/03/2023]
Abstract
Purpose During the frozen-thawed embryo transfer (FET) method, controlled ovarian hyperstimulation is used. At the same time, progesterone support is given for luteal phase support. In this study, we investigated the effects of various luteal phase support agents administered orally, intramuscularly (IM), and vaginally during FET on pregnancy rates. Methods The files of 166 patients between the ages of 21 and 44 in the Assisted Reproductive Techniques Center of Acıbadem Mehmet Ali Aydınlar University Atakent Hospital were analyzed retrospectively between 2016 and 2022. The patients' FSH, LH, E2, P4, AMH, and TSH levels were measured. The GnRH antagonist protocol was initiated on the 2nd or 3rd day of menstruation. Three types of progesterone agents were used in females with PCOS. Three different methods were applied: 50 mg/ml of IM progesterone daily, 90 mg of progesterone gel 2∗1 vaginally, and dydrogesterone acetate tb. orally 3∗1. FET was performed on women who received 21 days of treatment by thawing 5th-day embryos. B-hCG was performed on the 12th day after the transfer, and evaluations were made. The study results were evaluated as follows: for the whole study group, for those <30 years of age, for those 30-35 years of age, and for those >35 years of age. Results A total of 164 patients, 57 females using vaginal progesterone gel, 30 females using oral progesterone tablet, and 77 females using IM progesterone, who met the inclusion criteria, were included in the study. The pregnancy outcomes of IM progesterone application were statistically significantly higher in the entire study group and the >35 age group when compared to the vaginal progesterone gel application. It was found that the pregnancy outcomes of IM progesterone application increased statistically significantly in the <30 age group when compared to outcomes in the other groups, using vaginal progesterone gel and oral progesterone tb. Conclusions We found that IM progesterone application was more effective than vaginal progesterone gel application for luteal phase support. Many randomized controlled, especially live birth rate studies, are required before results can more closely approximate those for the general population.
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Affiliation(s)
- Elif Ganime Aygün
- Atakent Hospital, Department of Gynecology and Obstetrics, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Esra Özbaşlı
- School of Medicine, Department of Gynecology and Obstetrics, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Mehmet Faruk Köse
- School of Medicine, Department of Gynecology and Obstetrics, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
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Zhang J, Du M, Wang Z, Wu S, Guan Y, Sun L. The duration of estrogen treatment before progesterone application does not affect neonatal and perinatal outcomes in frozen embryo transfer cycles. Front Endocrinol (Lausanne) 2023; 14:988398. [PMID: 37547302 PMCID: PMC10401476 DOI: 10.3389/fendo.2023.988398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To explore whether the duration of estrogen treatment before progesterone application affects neonatal and perinatal outcomes in artificial frozen embryo transfer (FET) cycles. Methods This was a retrospective cohort study. Patients who underwent FET via artificial cycles and delivered a singleton live birth between January 2015 and August 2019 were included in the analysis. According to the duration of estrogen treatment before progesterone application, we divided the cycles into four groups: ①≤12 days, ②13-15 days, ③16-19 days, and ④≥20 days. The '≤12 days group' was considered the reference group. The main outcome measures were preterm birth (PTB), small-for-gestational age (SGA), low birth weight (LBW), macrosomia, large-for-gestational age (LGA), gestational diabetes mellitus (GDM), gestational hypertension, premature rupture and placenta previa. Results Overall, 2010 FET cycles with singleton live births were included for analysis. Cycles were allocated to four groups according to the duration of estrogen treatment before progesterone application: ①≤12 days (n=372), ②13-15 days (n=745), ③16-19 days (n=654), ④≥20 days (n=239). The neonatal outcomes, including PTB, SGA, LBW, macrosomia and LGA, were comparable among the groups (P=0.328, P=0.390, P=0.551, P=0.565, P=0.358). The rates of gestational hypertension, premature rupture and placenta previa (P=0.676, P=0.662, P=0.211) were similar among the groups. The rates of GDM among the four groups were 4.0% (15/372), 6.7% (50/745), 6.4% (42/654), and 11.3% (27/239), with statistical significance (P=0.006). After multiple logistic regression analysis, the duration of estrogen treatment did not affect the rate of GDM or other outcomes. Conclusion The estrogen treatment duration before progesterone application does not affect neonatal and perinatal outcomes in single frozen blastocyst transfer cycles.
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Affiliation(s)
- Junwei Zhang
- The Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mingze Du
- The Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhongkai Wang
- Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Sheling Wu
- The Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yichun Guan
- The Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lijun Sun
- The Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Epelboin S, Labrosse J, De Mouzon J, Devaux A, Gervoise-Boyer MJ, Hesters L, Jonveaux P, Levy R, Sermondade N, Fauque P, Pessione F. Higher risk of pre-eclampsia and other vascular disorders with artificial cycle for frozen-thawed embryo transfer compared to ovulatory cycle or to fresh embryo transfer following in vitro fertilization. Front Endocrinol (Lausanne) 2023; 14:1182148. [PMID: 37284215 PMCID: PMC10240394 DOI: 10.3389/fendo.2023.1182148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/04/2023] [Indexed: 06/08/2023] Open
Abstract
Background Risks of maternal morbidity are known to be reduced in pregnancies resulting from frozen embryo transfer (FET) compared to fresh-embryo transfer (fresh-ET), except for the risk of pre-eclampsia, reported to be higher in FET pregnancies compared to fresh-ET or natural conception. Few studies have compared the risk of maternal vascular morbidities according to endometrial preparation for FET, either with ovulatory cycle (OC-FET) or artificial cycle (AC-FET). Furthermore, maternal pre-eclampsia could be associated with subsequent vascular disorders in the offspring. Methods A 2013-2018 French nationwide cohort study comparing maternal vascular morbidities in 3 groups of single pregnancies was conducted: FET with either OC or AC preparation, and fresh-ET. Data were extracted from the French National Health System database. Results were adjusted for maternal characteristics and infertility (age, parity, smoking, obesity, history of diabetes or hypertension, endometriosis, polycystic ovary syndrome and premature ovarian insufficiency). Results A total of 68025 single deliveries were included: fresh-ET (n=48152), OC-FET (n=9500), AC-FET (n=10373). The risk of pre-eclampsia was higher in AC-FET compared to OC-FET and fresh-ET groups in univariate analysis (5.3% vs. 2.3% and 2.4%, respectively, P<0.0001). In multivariate analysis the risk was significantly higher in AC-FET compared to fresh-ET: aOR=2.43 [2.18-2.70], P<0.0001). Similar results were observed for the risk of other vascular disorders in univariate analysis (4.7% vs. 3.4% and 3.3%, respectively, P=0.0002) and in multivariate analysis (AC-FET compared to fresh-ET: aOR=1.50 [1.36-1.67], P<0.0001). In multivariate analysis, the risk of pre-eclampsia and other vascular disorders were comparable in OC-FET and fresh-ET: aOR=1.01 [0.87-1.17, P= 0.91 and aOR=1.00 [0.89-1.13], P=0.97, respectively).Within the group of FET, the risks of pre-eclampsia and other vascular disorders in multivariate analysis were higher in AC-FET compared to OC-FET (aOR=2.43 [2.18-2.70], P<0.0001 and aOR=1.5 [1.36-1.67], P<0.0001, respectively). Conclusion This nationwide register-based cohort study highlights the possibly deleterious role of prolonged doses of exogenous estrogen-progesterone supplementation on gestational vascular pathologies and the protective role of the corpus luteum present in OC-FET for their prevention. Since OC-FET has been demonstrated not to strain the chances of pregnancy, OC preparation should be advocated as first-line preparation in FET as often as possible in ovulatory women.
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Affiliation(s)
- Sylvie Epelboin
- Department of Reproductive Medicine, Gynecology and Obstetrics, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris Nord, Université de Paris, Paris, France
| | - Julie Labrosse
- Department of Reproductive Medicine, Gynecology and Obstetrics, American Hospital of Paris, Neuilly-sur-Seine, France
| | - Jacques De Mouzon
- Department of Reproductive Biology, Unilabs, Direction médicale, Clichy La Garenne, France
| | - Aviva Devaux
- Department of Reproductive Biology, Centre Hospitalier Universitaire, Amiens, France
| | | | - Laetitia Hesters
- Department of Reproductive Biology, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France
| | - Philippe Jonveaux
- Department of Procreation, Agence de la biomédecine, La Plaine Saint Denis, France
| | - Rachel Levy
- Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Nathalie Sermondade
- Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Patricia Fauque
- Department of Reproductive Biology, Université Bourgogne Franche-Comté - INSERM UMR1231, Dijon, France
| | - Fabienne Pessione
- Department of Procreation, Agence de la biomédecine, La Plaine Saint Denis, France
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Chen L, Dong Z, Chen X. Fertility preservation in pediatric healthcare: a review. Front Endocrinol (Lausanne) 2023; 14:1147898. [PMID: 37206440 PMCID: PMC10189781 DOI: 10.3389/fendo.2023.1147898] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Survival rates for children and adolescents diagnosed with malignancy have been steadily increasing due to advances in oncology treatments. These treatments can have a toxic effect on the gonads. Currently, oocyte and sperm cryopreservation are recognized as well-established and successful strategies for fertility preservation for pubertal patients, while the use of gonadotropin-releasing hormone agonists for ovarian protection is controversial. For prepubertal girls, ovarian tissue cryopreservation is the sole option. However, the endocrinological and reproductive outcomes after ovarian tissue transplantation are highly heterogeneous. On the other hand, immature testicular tissue cryopreservation remains the only alternative for prepubertal boys, yet it is still experimental. Although there are several published guidelines for navigating fertility preservation for pediatric and adolescent patients as well as transgender populations, it is still restricted in clinical practice. This review aims to discuss the indications and clinical outcomes of fertility preservation. We also discuss the probably effective and efficient workflow to facilitate fertility preservation.
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Affiliation(s)
- Lin Chen
- Reproductive Medical Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zirui Dong
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Xiaoyan Chen
- Maternal-Fetal Medicine Institute, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen University, Shenzhen, China
- The Fertility Preservation Research Center, Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Vaiarelli A, Zacà C, Spadoni V, Cimadomo D, Conforti A, Alviggi C, Palermo R, Bulletti C, De Santis L, Pisaturo V, Vigiliano V, Scaravelli G, Ubaldi FM, Borini A. Clinical and laboratory key performance indicators in IVF: A consensus between the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR) and the Italian Society of Embryology, Reproduction and Research (SIERR). J Assist Reprod Genet 2023:10.1007/s10815-023-02792-1. [PMID: 37093443 DOI: 10.1007/s10815-023-02792-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
PURPOSE Infertility is increasing worldwide, and many couples seek IVF. Clinical management and laboratory work are fundamental in the IVF journey. Therefore, the definition of reliable key performance indicators (KPIs) based on clinical and laboratory parameters, is essential for internal quality control (IQC). Laboratory performance indicators have been identified and a first attempt to also determine clinical ones has been recently published. However, more detailed indicators are required. METHODS An Italian group of experts in Reproductive Medicine from both public and private clinics on behalf of SIFES-MR and SIERR was established to define IVF indicators to monitor clinical performance. RESULTS The working group built a consensus on a list of KPIs, performance indicators (PIs) and recommendation indicators (RIs). When deemed necessary, the reference population was stratified by woman age, response to ovarian stimulation and adoption of preimplantation genetic testing for aneuploidies (PGT-A). Each indicator was scored with a value from 1 to 5 and a weighted average formula - considering all the suggested parameters-was defined. This formula generates a center performance score, indicating low, average, good, or excellent performance. CONCLUSION This study is intended to provide KPIs, PIs and RIs that encompass several essential aspects of a modern IVF clinic, including quality control and constant monitoring of clinical and embryological features. These indicators could be used to assess the quality of each center with the aim of improving efficacy and efficiency in IVF.
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Affiliation(s)
- Alberto Vaiarelli
- GeneraLife IVF, Clinica Valle Giulia, Via G. De Notaris, 2B, Rome, Italy.
| | | | | | - Danilo Cimadomo
- GeneraLife IVF, Clinica Valle Giulia, Via G. De Notaris, 2B, Rome, Italy
| | - Alessandro Conforti
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Carlo Alviggi
- Department of Public Health, Federico II University, Naples, Italy
| | - Roberto Palermo
- Unità Di Procreazione Medicalmente Assistita, Centro A.M.B.R.A., Palermo, Italy
| | - Carlo Bulletti
- Department of Obstetrics, Gynecology and Reproductive Science, Yale University, New Haven, CT, USA
- Scientific Partner of Incintas Therapeutics, New Haven, CT, USA
| | - Lucia De Santis
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Valerio Pisaturo
- Fondazione IRCCS, Ca' Granda, Ospedale Maggiore, Policlinico Di Milano, Milan, Italy
| | - Vincenzo Vigiliano
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Giulia Scaravelli
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
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Antonouli S, Di Nisio V, Messini C, Daponte A, Rajender S, Anifandis G. A comprehensive review and update on human fertility cryopreservation methods and tools. Front Vet Sci 2023; 10:1151254. [PMID: 37143497 PMCID: PMC10151698 DOI: 10.3389/fvets.2023.1151254] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/29/2023] [Indexed: 05/06/2023] Open
Abstract
The broad conceptualization of fertility preservation and restoration has become already a major concern in the modern western world since a large number of individuals often face it in the everyday life. Driven by different health conditions and/or social reasons, a variety of patients currently rely on routinely and non-routinely applied assisted reproductive technologies, and mostly on the possibility to cryopreserve gametes and/or gonadal tissues for expanding their reproductive lifespan. This review embraces the data present in human-focused literature regarding the up-to-date methodologies and tools contemporarily applied in IVF laboratories' clinical setting of the oocyte, sperm, and embryo cryopreservation and explores the latest news and issues related to the optimization of methods used in ovarian and testicular tissue cryopreservation.
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Affiliation(s)
- Sevastiani Antonouli
- Department of Clinical Chemistry, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Valentina Di Nisio
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Christina Messini
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
| | - Alexandros Daponte
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
| | - Singh Rajender
- Division of Endocrinology, Central Drug Research Institute, Lucknow, India
| | - George Anifandis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
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Yan G, Yao Y, Yang W, Lu L, Wang L, Zhao D, Zhao S. An all-37 °C thawing method improves the clinical outcomes of vitrified frozen-thawed embryo transfer: a retrospective study using a case-control matching analysis. Arch Gynecol Obstet 2023; 307:1991-1999. [PMID: 37041370 DOI: 10.1007/s00404-023-07029-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/27/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE The purpose of this study is to assess the impact of different temperatures and incubation times on the clinical outcomes of FET cycles during the thawing procedure and to select a better thawing method to improve clinical outcomes. METHODS This retrospective study included 1734 FET cycles from January 1, 2020, to January 30, 2022. Embryos vitrified using a KITAZATO Vitrification Kit were thawed at 37 °C in all steps (the case group, denoted the "all-37 °C" group) or at 37 °C and then at room temperature (RT; the control group, denoted the "37 °C-RT" group), according to the kit instructions. The groups were matched 1:1 to avoid confounding. RESULTS After case-control matching, 366 all-37 °C cycles and 366 37 °C-RT cycles were included. The baseline characteristics were similar (all P > 0.05) between the two groups after matching. FET of the all-37 °C group yielded a higher clinical pregnancy rate (CPR; P = 0.009) and implantation rate (IR; P = 0.019) than FET of the 37 °C-RT group. For blastocyst transfers, the CPR (P = 0.019) and IR (P = 0.025) were significantly higher in the all-37 °C group than in the 37 °C-RT group. For D3-embryo transfers, the CPR and IR were non-significantly higher in the all-37 °C group than in the 37 °C-RT group (P > 0.05). CONCLUSIONS Thawing vitrified embryos at 37 °C in all steps with shortening wash time can enhance CPR and IR in FET cycles. Well-designed prospective studies are warranted to further evaluate the efficacy and safety of the all-37 °C thawing method.
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Affiliation(s)
- Gaofeng Yan
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Youlin Yao
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Wenjuan Yang
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Ling Lu
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Longda Wang
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Di Zhao
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Shuhua Zhao
- Department of Reproduction and Genetics, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China.
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Önalan G, Tunç M, Tohma A, Günakan E, Eryılmaz T, Zeyneloğlu HB. Extending the culture of cleavage-stage embryos to the blastocyst stage after warming increases the chance of live birth: does it have a regenerative effect? Arch Gynecol Obstet 2023; 307:1969-1974. [PMID: 37022346 DOI: 10.1007/s00404-023-07031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE We aimed to evaluate the effect of extending the culture of cleavage-stage embryos to the blastocyst stage in vitrified-warmed cycles on pregnancy outcomes. METHODS This is a retrospectively designed pilot study of a single center. All patients who applied for freeze-all cycle procedures during in vitro fertilization treatment were included in the study. Patients were classified into three subgroups. The embryos obtained were frozen at the cleavage or blastocyst stage. After a warming process, the cleavage-stage embryos were divided into two subgroups: the first group of embryos was transferred (vitrification day 3-embryo transfer (ET) day 3 (D3T3)) on the warming day; for the second group, the embryo culture was extended to the blastocyst stage (vitrification day 3-ET day 5 (after the extension of the embryo culture to the blastocyst stage), (D3T5)). Frozen blastocyst-stage embryos were transferred after warming (vitrification day 5-ET day 5 (D5T5)). Hormone replacement treatment was the only endometrial preparation regimen given during the embryo transfer cycle. The main outcome of the study was live birth rates. The clinical pregnancy rate and positive pregnancy test rate were determined as the secondary outcomes of the study. RESULTS The study included a total of 194 patients. The positive pregnancy test rates (PPR) and clinical pregnancy rates (CPR) of the D3T3, D3T5, and D5T5 groups were 14.0% and 59.2%; 43.8% and 9.3%; and 56.3% and 39.6%, respectively (p < 0.001 and p < 0.001). The live birth rates (LBR) of patients in the D3T3, D3T5, and D5T5 groups were 7.0%, 44.7%, and 27.1%, respectively (p < 0.001). In subgroup analysis of patients with a poor number of 2PN embryos (defined as having < = 4 2PN embryos), the D3T5 group had significantly higher PPR (10.7%, 60.6%, 42.4%; p < 0.001), CPR (7.1%, 57.6%, 39.4%; p < 0.001), and LBR (3.6%, 39.4%, 21.2%; p: 0.001). CONCLUSION Extending the culture after warming to the blastocyst stage may be a better alternative than a cleavage-stage embryo transfer.
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Affiliation(s)
- Göğşen Önalan
- Department of Obstetrics and Gynecology, Başkent University School of Medicine, Şehit Temel Kuğuoğlu Cd. No: 34 Bahçelievler, Ankara, Turkey
| | - Mehmet Tunç
- Department of Obstetrics and Gynecology, Başkent University School of Medicine, Şehit Temel Kuğuoğlu Cd. No: 34 Bahçelievler, Ankara, Turkey.
| | - Aytaç Tohma
- Department of Obstetrics and Gynecology, Başkent University School of Medicine, Şehit Temel Kuğuoğlu Cd. No: 34 Bahçelievler, Ankara, Turkey
| | - Emre Günakan
- Department of Obstetrics and Gynecology, Başkent University School of Medicine, Şehit Temel Kuğuoğlu Cd. No: 34 Bahçelievler, Ankara, Turkey
| | - Tahir Eryılmaz
- Department of Obstetrics and Gynecology, Başkent University School of Medicine, Şehit Temel Kuğuoğlu Cd. No: 34 Bahçelievler, Ankara, Turkey
| | - Hulusi B Zeyneloğlu
- Department of Obstetrics and Gynecology, Başkent University School of Medicine, Şehit Temel Kuğuoğlu Cd. No: 34 Bahçelievler, Ankara, Turkey
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Sciorio R, Aiello R, Janssens R. Considerations on staffing levels for a modern assisted reproductive laboratory. JBRA Assist Reprod 2023; 27:120-130. [PMID: 36515254 PMCID: PMC10065777 DOI: 10.5935/1518-0557.20220048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 08/23/2022] [Indexed: 12/12/2022] Open
Abstract
The duties recently performed in the embryology laboratory have deeply increased compared to those realized a couple of decades ago. Currently, procedures include conventional in vitro fertilization (IVF) and ICSI techniques, or processing of surgically retrieved sperm, embryo culture and time-lapse monitoring, blastocyst culture, as well as trophectoderm biopsy for preimplantation genetic testing and cryopreservation. These techniques require not only time, but also high knowledge level and acutely concentration by the embryologist team. The existing data indicate that an IVF laboratory need to have adequate staffing levels to perform the required daily duties, and to work in optimal conditions that are critical to assure a high quality service, as well as avoiding incidents and to provide the best outcomes. As a result, IVF clinics have invested in human resources, but there is still a large discrepancy between IVF centres on the number of embryologists employed. Currently there is no golden standard on the human resource requirements for assisted reproductive technology procedures; therefore, in this review paper we aim to provide arguments to take into account to determine the embryology staffing requirements in an embryology laboratory to assure optimal safety and efficiency of operations.
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Affiliation(s)
- Romualdo Sciorio
- Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of
Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, Scotland, EH16
4SA, UK
| | - Raffaele Aiello
- OMNIA Lab S.C.a.R.L, Via Cesare Rosaroll 24, 80139 Naples, Italy
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Angel-Velez D, De Coster T, Azari-Dolatabad N, Fernández-Montoro A, Benedetti C, Pavani K, Van Soom A, Bogado Pascottini O, Smits K. Embryo morphokinetics derived from fresh and vitrified bovine oocytes predict blastocyst development and nuclear abnormalities. Sci Rep 2023; 13:4765. [PMID: 36959320 PMCID: PMC10036495 DOI: 10.1038/s41598-023-31268-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
Embryo development is a dynamic process and critical stages may go unnoticed with the use of traditional morphologic assessments, especially the timing of embryonic divisions and aberrant zygotic cleavage patterns. Bovine embryo development is impaired after oocyte vitrification, but little is known about the underlying morphokinetic behavior. Here, bovine zygotes from fresh (n = 708) and vitrified oocytes (n = 182) were monitored by time-lapse imaging and the timing and nature of early blastomere divisions were modeled to find associations with blastocyst development at day 8. The predictive potential of morphokinetic parameters was analyzed by logistic regression and receiver operating characteristic curve analysis to determine optimal cut-off values. Lag-phase was highly correlated with embryo development. Remarkably, 100% of zygotes that reached the blastocyst stage showed a lag-phase. Fast first cleavage increased the chance of blastocyst development to 30% with a cut-off of 32 h and 22 min. Aberrant zygotic cleavage events, including multipolar division, unequal blastomere sizes, and membrane ruffling resulted in decreased blastocyst development. Multipolar division leads to uneven blastomeres, which was associated with anuclear and multinuclear blastomeres, indicating genome segregation errors. Moreover, we described for the first time morphokinetics of embryos derived from vitrified bovine oocytes. Vitrification severely affected blastocyst development, although lower cryoprotectant concentration in equilibration solutions seems to be less detrimental for embryo yield. Impaired development was linked to slow cleavages, lower lag-phase incidence, and increased early embryonic arrest. Typically, less than 15% of the embryos produced from vitrified oocytes reached more than eight cells. Interestingly, the rate of abnormal first cleavage events was not affected by oocyte vitrification. In conclusion, time to first cleavage, the presence of a lag-phase, and the absence of aberrant zygotic cleavage were the best predictors of bovine blastocyst development for both fresh and vitrified oocytes.
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Affiliation(s)
- Daniel Angel-Velez
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium.
- Research Group in Animal Sciences - INCA-CES, Universidad CES, Medellin, Colombia.
| | - Tine De Coster
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
| | - Nima Azari-Dolatabad
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
| | - Andrea Fernández-Montoro
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
| | - Camilla Benedetti
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
| | - Krishna Pavani
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
- Department for Reproductive Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Gent, Belgium
| | - Ann Van Soom
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
| | - Osvaldo Bogado Pascottini
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
| | - Katrien Smits
- Department of Internal Medicine, Reproduction, and Population Medicine, Ghent University, Merelbeke, Belgium
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Gu R, Ge N, Huang B, Fu J, Zhang Y, Wang N, Xu Y, Li L, Peng X, Zou Y, Sun Y, Sun X. Impacts of vitrification on the transcriptome of human ovarian tissue in patients with gynecological cancer. Front Genet 2023; 14:1114650. [PMID: 37007967 PMCID: PMC10063885 DOI: 10.3389/fgene.2023.1114650] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/24/2023] [Indexed: 03/19/2023] Open
Abstract
Objective: This study investigated the effects of a vitrification/warming procedure on the mRNA transcriptome of human ovarian tissues.Design: Human ovarian tissues were collected and processed through vitrification (T-group) and then subjected to RNA sequencing (RNA-seq) analysis, HE, TdT-mediated dUTP nick-end labeling (TUNEL), and real-time quantitative PCR, and the results were compared to those of the fresh group (CK).Results: A total of 12 patients, aged 15–36 years old, with a mean anti-Müllerian hormone level of 4.57 ± 3.31 ng/mL were enrolled in this study. According to the HE and TUNEL results, vitrification effectively preserved human ovarian tissue. A total of 452 significantly dysregulated genes (|log2FoldChange| > 1 and p < 0.05) were identified between the CK and T groups. Among these, 329 were upregulated and 123 were downregulated. A total of 372 genes were highly enriched for 43 pathways (p < 0.05), which were mainly related to systemic lupus erythematous, cytokine–cytokine receptor interaction, the TNF signaling pathway, and the MAPK signaling pathway. IL10, AQP7, CCL2, FSTL3, and IRF7 were significantly upregulated (p < 0.01), while IL1RN, FCGBP, VEGFA, ACTA2, and ASPN were significantly downregulated in the T-group (p < 0.05) compared to the CK group, which agreed with the results of the RNA-seq analysis.Conclusion: These results showed (for the first time to the authors’ knowledge) that vitrification can induce changes in mRNA expression in human ovarian tissues. Further molecular studies on human ovarian tissues are required to determine whether altered gene expression could result in any downstream consequences.
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Affiliation(s)
- Ruihuan Gu
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Naidong Ge
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Bin Huang
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Jing Fu
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Ying Zhang
- Department of Female Fertility Preservation, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ningyi Wang
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yan Xu
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Lu Li
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiandong Peng
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yaoyu Zou
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yijuan Sun
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- *Correspondence: Yijuan Sun, ; Xiaoxi Sun,
| | - Xiaoxi Sun
- Department of Shanghai Ji’ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- *Correspondence: Yijuan Sun, ; Xiaoxi Sun,
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Ni Y, Tong C, Xu L, Qian W, Huang L, Zhang A, Fang Q. Prevalence and associated factors of medication adherence among infertile women undergoing frozen-thawed embryo transfer cycle: A cross-sectional study. Front Pharmacol 2023; 14:1148867. [PMID: 37007001 PMCID: PMC10064053 DOI: 10.3389/fphar.2023.1148867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
Objective: This study aimed to explore the prevalence and associated factors of medication adherence among infertile women undergoing frozen-thawed embryo transfer (FET) cycle.Methods: A cross-sectional study was conducted with 556 infertile women undergoing FET cycle in total. The Self-efficacy for Appropriate Medication Use Scale (SEAMS), Herth Hope Index (HHI) scale, and Social Support Rating Scale (SSRS) were used to evaluate the patients. Data were described by univariate and multivariate analyses. Logistic regression method was performed to analyse the factors potentially associated with medication adherence.Results: The average score of Self-efficacy for Appropriate Medication Use Scale (SEAMS) was 30.38 ± 6.65, and 65.3% of participants showed non-adherence. Multiple regression analysis indicated that first-time FET cycle, treatment stage, methods of daily medication, social support and hope level were the main associated factors of the medication adherence among infertile women undergoing FET cycle (p < 0.001).Conclusion: This study revealed the medication adherence is at medium level among infertile women undergoing FET cycle, especially in patients with repeated FET cycles. The study also suggested that improving the hope level and social support of infertile women undergoing FET cycle may increase medication adherence.
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Affiliation(s)
- Ying Ni
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenye Tong
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianying Xu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Qian
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Limin Huang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aijun Zhang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Qiong Fang, ; Aijun Zhang,
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Qiong Fang, ; Aijun Zhang,
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Köroğlu N, Aydın T. Oocyte vitrification for oncological and social reasons. Turk J Obstet Gynecol 2023; 20:59-63. [PMID: 36908095 PMCID: PMC10013077 DOI: 10.4274/tjod.galenos.2022.59827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
The aim of this review is to present information related to oocyte cryopreservation, and particularly oocyte vitrification, performed to preserve fertility in oncologic and social indications. The success rates of oocyte cryopreservation have increased with the widespread use of the vitrification technique and are currently similar to those of in vitro fertilization performed with fresh oocytes. Vitrification is the most successful technique for oocyte cryopreservation. The most important factors that influence the success rate are the patient's age at the time of vitrification and the number of mature oocytes frozen. Thus, live birth rates differ for each age depending on the number of oocytes thawed and the freezing method. The American Society of Reproductive Medicine and the American Society of Clinical Oncology recommend presenting the option of oocyte cryopreservation for fertility preservation in cancer patients. Besides cancer patients, use of oocyte vitrification is increasing in women who wish to postpone pregnancy age and to have reproductive freedom with the development of the cryopreservation technique and the achievement of pregnancy rates similar to the use of fresh oocytes. Patients are provided consultancy service in terms of indication, the success rates by age, and the total number of oocytes frozen. It should be emphasized that this procedure is not a type of insurance policy for fertility, especially in elective oocyte cryopreservation.
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Affiliation(s)
- Nadiye Köroğlu
- Acıbadem Atakent Hospital, Clinic of Obstetrics and Gynecology, In Vitro Fertilization Unit, İstanbul, Turkey
| | - Turgut Aydın
- Acıbadem Mehmet Ali Aydınlar University, Atakent Hospital, Clinic of Obstetrics and Gynecology, In Vitro Fertilization Unit, İstanbul, Turkey
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Kieu V, Polyakov A, Rozen G, Lantsberg D, Stern C, Tinn Teh W. Live birth rates in day 5 fresh versus vitrified single blastocyst transfer cycles: A cross-sectional analysis. Int J Reprod Biomed 2023; 21:245-254. [PMID: 37122887 PMCID: PMC10133739 DOI: 10.18502/ijrm.v21i3.13200] [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: 07/11/2022] [Revised: 12/01/2022] [Accepted: 02/14/2023] [Indexed: 05/02/2023] Open
Abstract
Background The use of frozen embryo transfers (FET) in assisted reproduction has increased worldwide. Controlled ovarian hyperstimulation in a fresh transfer may impair endometrial-embryo synchronicity. However, there is conflicting evidence on live birth rates (LBR) and clinical pregnancy rates (CPR). Objective To compare LBRs and CPRs between single autologous day 5 fresh vs. vitrified blastocyst transfer cycles, to investigate the impact of controlled ovarian hyperstimulation on embryo-endometrium asynchrony. Materials and Methods A large cross-sectional analysis of 6002 embryo transfers (ET) comprised 3774 fresh and 2228 FET cycles from 2016 to 2019. Multivariate and subgroup analysis were performed for high responders ( > 20 oocytes). Results Univariate analysis showed no difference in LBR (28.3% vs. 27.4%, p = 0.43) and CPR (32.2% vs. 30.9%, p = 0.30); however, multivariate analysis demonstrated significantly lower LBR (OR 0.864, p = 0.046, 95% CI 0.749-0.997) and CPR (OR 0.852, p = 0.024, 95% CI 0.742-0.979) in FET compared to fresh ETs. Younger participant age, previous in vitro fertilization pregnancy, advanced blastocyst expansion, higher trophectoderm quality, and lower cumulative number of ETs all improved the odds of LBR and CPR. Conventional in vitro fertilization, rather than intracytoplasmic sperm injection, improved CPR but not LBR. Body mass index affected neither LBR nor CPR. In the subgroup, multivariate analysis of high responders showed no difference in LBR or CPR. Conclusion This study demonstrates relatively higher LBR and CPR of nearly 14% for fresh ETs compared to FETs, in multivariate analysis. A universal freeze-all strategy, without appropriate indication, may lead to suboptimal outcomes. In high responders, freeze-all cycles may be beneficial, as outcomes appear similar.
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Affiliation(s)
- Violet Kieu
- Reproductive Services Unit, Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne IVF, Melbourne, VIC, Australia
| | - Alex Polyakov
- Reproductive Services Unit, Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne IVF, Melbourne, VIC, Australia
| | - Genia Rozen
- Reproductive Services Unit, Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne IVF, Melbourne, VIC, Australia
| | - Daniel Lantsberg
- Reproductive Services Unit, Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne IVF, Melbourne, VIC, Australia
| | - Catharyn Stern
- Reproductive Services Unit, Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne IVF, Melbourne, VIC, Australia
| | - Wan Tinn Teh
- Reproductive Services Unit, Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne IVF, Melbourne, VIC, Australia
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H Petersen S, Westvik-Johari K, Spangmose AL, Pinborg A, Romundstad LB, Bergh C, Åsvold BO, Gissler M, Tiitinen A, Wennerholm UB, Opdahl S. Risk of Hypertensive Disorders in Pregnancy After Fresh and Frozen Embryo Transfer in Assisted Reproduction: A Population-Based Cohort Study With Within-Sibship Analysis. Hypertension 2023; 80:e6-e16. [PMID: 36154568 DOI: 10.1161/hypertensionaha.122.19689] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Frozen embryo transfer (frozen-ET) is increasingly common because of improved cryopreservation methods and elective freezing of all embryos. Frozen-ET is associated with higher risk of hypertensive disorders in pregnancy than both natural conception and fresh embryo transfer (fresh-ET), but whether this is attributable to parental factors or treatment is unknown. METHODS Using the Medical Birth Registries of Denmark (1994-2014), Norway, and Sweden (1988-2015), linked to data from national quality registries and databases on assisted reproduction, we designed a population-based cohort study with within-sibship comparison. We included 4 426 691 naturally conceived, 78 300 fresh-ET, and 18 037 frozen-ET singleton pregnancies, of which 33 209 sibships were conceived using different conception methods. Adjusted odds ratios (aOR) of hypertensive disorders in pregnancy for fresh-ET and frozen-ET versus natural conception with 95% CI were estimated using multilevel logistic regression, where random effects provided conventional population-level estimates and fixed effects gave within-sibship estimates. Main models included adjustment for birth year, maternal age, parity, and country. RESULTS Risk of hypertensive disorders in pregnancy was higher after frozen-ET compared to natural conception, both at population-level (7.4% versus 4.3%, aOR, 1.74 [95% CI, 1.61-1.89]) and within sibships (aOR, 2.02 [95% CI, 1.72-2.39]). For fresh-ET, risk was similar to natural conception, both at population-level (aOR, 1.02 [95% CI, 0.98-1.07]) and within sibships (aOR, 0.99 [95% CI, 0.89-1.09]). CONCLUSIONS Frozen-ET was associated with substantially higher risk of hypertensive disorders in pregnancy, even after accounting for shared parental factors within sibships.
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Affiliation(s)
- Sindre H Petersen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences (S.H.P., K.W.-J., S.O.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjersti Westvik-Johari
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences (S.H.P., K.W.-J., S.O.), Norwegian University of Science and Technology, Trondheim, Norway.,Department of Fertility, Women and Children's Centre, St. Olavs Hospital, Trondheim, Norway (K.W.-J.)
| | - Anne Lærke Spangmose
- Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark (A.L.S., A.P.)
| | - Anja Pinborg
- Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark (A.L.S., A.P.)
| | - Liv Bente Romundstad
- Spiren Fertility Clinic, Trondheim, Norway (L.B.R.).,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo (L.B.R.)
| | - Christina Bergh
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Sweden (C.B., U.-B.W.)
| | - Bjørn Olav Åsvold
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences (B.O.A.), Norwegian University of Science and Technology, Trondheim, Norway.,HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger (B.A.O.).,Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Norway (B.O.A.)
| | - Mika Gissler
- THL Finnish Institute for Health and Welfare, Department of Knowledge Brokers, Helsinki, Finland (M.G.).,Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden (M.G.)
| | - Aila Tiitinen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Finland (A.T.)
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Sweden (C.B., U.-B.W.)
| | - Signe Opdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences (S.H.P., K.W.-J., S.O.), Norwegian University of Science and Technology, Trondheim, Norway
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[The impact of oocyte cryopreservation time in oocyte donation on the clinical success rate]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2023; 51:206-211. [PMID: 36731823 DOI: 10.1016/j.gofs.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To evaluate the impact of the cryopreservation time of vitrified oocytes on the success rates in oocyte donation cycles. METHODS A retrospective study was carried out on 156 cycles with donated oocytes from January 2012 to September 2021. All the cycles were sorted according to the storage time of the oocytes (25 in the group 1:<3 months, 32 in the group 2: between 3 and 6 months, 39 in the group 3: between 6 and 12 months, 38 in the group 4: between 12 and 24 months and 22 in the group 5:>24 months). Clinical outcomes after ART, survival rates at thawing and oocyte fertilization rates were compared between the different cohorts stratified according to oocyte storage duration. A binary multivariate logistic regression was performed adjusting for the identified confounders. RESULTS Prolonged storage time of vitrified oocytes had an effect on their survival post-thawing rates, but no significant effect was identified on fertilization rates or clinical outcomes. After adjusting for the confounders, the relationships between clinical outcomes and oocytes storage time did not reach statistical significance. Our study was characterized by a limited cohort with data from a single ART center. CONCLUSIONS Our study doesn't highlight any significant difference in the use of long-stored vitrified oocytes (more than 2 years) on clinical issues in ART. The conclusion of our study needs to be verified in further studies with larger cohorts.
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Makieva S, Stähli C, Xie M, Gil AV, Sachs MK, Leeners B. The impact of zygote vitrification timing on pregnancy rate in frozen-thawed IVF/ICSI cycles. Front Cell Dev Biol 2023; 11:1095069. [PMID: 36711030 PMCID: PMC9880319 DOI: 10.3389/fcell.2023.1095069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
Introduction: Cryopreservation of bipronuclear (2PN) stage zygotes is an integral part of IVF laboratory practice in countries with strict embryo culture legislation. Vitrification of zygotes is compatible with several strategies in infertility treatments holding a freeze-all indication and allows for effective workload management in settings with limited resources. Although it yields high survival rates and clinical outcomes, the ideal timing to commence vitrification of zygotes is elusive while it is empirically practiced in the window between 17 and 21 h post-insemination (hpi). We aimed to deduce the association between pregnancy rate and the time interval from insemination (IVF and ICSI) to vitrification to contribute to the standardization ofzygote cryopreservation. Methods: A retrospective analysis of data on vitrification timings and pregnancy outcomes collected between 2011 and 2019 was performed. All included women received an embryo transfer after warming of vitrified zygotes at the 2PN stage. Results: A total of 468 embryo transfers were included of which 182 (38.9%) resulted in pregnancy and 286 (61.1%) not. Vitrification was on average performed 18.74 ±0.63 hpi in the pregnant group and 18.62 ± 0.64 hpi in the non-pregnant group (OR 1.36, 95% CI 1.01; 1.83, p = 0.045). A multivariate analysis controlling for uterine pathologies, maternal age, AMH, the number of MII oocytes, previous history of pregnancy success, endometriosis, AFC, nicotine intake and male factor infertility showed no predictive value of vitrification timing on pregnancy rate. Three time intervals between insemination and vitrification were defined: 17:00 to 18:00 hpi (Group A), 18:01 to 19:00 hpi (Group B) and 19:01 to 21:00 hpi (Group C). Pregnancy occurred in 40/130 women (30.80%) in Group A, in 115/281 women (40.90%) in Group B and in 27/57 women (47.40%) in Group C. Univariate but not multivariate analysis showed a significantly higher pregnancy rate after the latest time interval between insemination and 2PN vitrification when compared to the earliest (Group C vs. A, OR 2.03, 95% CI 1.07; 3.84, p = 0.031). Discussion: These findings encourage further investigation on the impact of vitrification timing on clinical outcomes and hold the potential to standardize cryopreservation of zygotes from IVF/ICSI cycles to eventually improve the quality of long-term ART outcomes.
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Affiliation(s)
- Sofia Makieva
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland,*Correspondence: Sofia Makieva,
| | - Celine Stähli
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Min Xie
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Ana Velasco Gil
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Maike Katja Sachs
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
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Sänger N, Menabrito M, Di Spiezo Sardo A, Estadella J, Verguts J. Fertility preservation counselling for women with endometriosis: a European online survey. Arch Gynecol Obstet 2023; 307:73-85. [PMID: 35829767 DOI: 10.1007/s00404-022-06616-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Endometriosis is a common cause for infertility. Decreased ovarian reserve due to pathology or surgical management can reduce the chances of natural pregnancy and limit the effectiveness of controlled ovarian stimulation during fertility treatment. Cryopreservation of oocytes or ovarian cortex prior to surgery or before loss of follicular capital is a strategy to preserve fecundity. METHODS An online survey was sent to reproductive specialists and gynecological surgeons representing major centers of reproductive medicine in Europe to investigate current fertility preservation practices for endometriosis patients. RESULTS Of 58 responses, 45 (77.6%) in 11/13 countries reported the existence of endometriosis management guidelines, of which 37/45 (82.2%) included treatment recommendations for infertile patients. Most centers (51.7%) reserved fertility counselling for severe endometriosis (large endometriomas with or without deep endometriosis) while 15.5% of centers did not offer fertility preservation for endometriosis. CONCLUSIONS To address non-uniformity in available guidelines and the diversity in fertility preservation practices, we propose an algorithm for managing patients with severe endometriosis most likely to be impacted by reduced ovarian reserve. Improved awareness about the possibilities of fertility preservation and clear communication between gynaecological surgeons and reproductive medicine specialists is mandatory to address the unmet clinical need of preventing infertility in women with endometriosis.
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Affiliation(s)
- Nicole Sänger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Marco Menabrito
- Gedeon Richter Plc/PregLem S.A., 41A Route de Frontenex, 1207, Geneva, Switzerland
| | - Attilio Di Spiezo Sardo
- Department of Public Health, University Federico II of Naples, Corso Umberto I, 80131, Naples, Italy
| | - Josep Estadella
- Department of Obstetrics and Gynecology, Hospital de La Santa Creu I Sant Pau-Universitat Autònoma de Barcelona, Carrer de Sant Quintí 89, 08025, Barcelona, Spain
| | - Jasper Verguts
- Department of Obstetrics and Gynecology, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium. .,University Hasselt, Martelarenlaan 42, 3500, Hasselt, Belgium.
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Ovarian Reserve Disorders, Can We Prevent Them? A Review. Int J Mol Sci 2022; 23:ijms232315426. [PMID: 36499748 PMCID: PMC9737352 DOI: 10.3390/ijms232315426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
The ovarian reserve is finite and begins declining from its peak at mid-gestation until only residual follicles remain as women approach menopause. Reduced ovarian reserve, or its extreme form, premature ovarian insufficiency, stems from multiple factors, including developmental, genetic, environmental exposures, autoimmune disease, or medical/surgical treatment. In many cases, the cause remains unknown and resulting infertility is not ultimately addressed by assisted reproductive technologies. Deciphering the mechanisms that underlie disorders of ovarian reserve could improve the outcomes for patients struggling with infertility, but these disorders are diverse and can be categorized in multiple ways. In this review, we will explore the topic from a perspective that emphasizes the prevention or mitigation of ovarian damage. The most desirable mode of fertoprotection is primary prevention (intervening before ablative influence occurs), as identifying toxic influences and deciphering the mechanisms by which they exert their effect can reduce or eliminate exposure and damage. Secondary prevention in the form of screening is not recommended broadly. Nevertheless, in some instances where a known genetic background exists in discrete families, screening is advised. As part of prenatal care, screening panels include some genetic diseases that can lead to infertility or subfertility. In these patients, early diagnosis could enable fertility preservation or changes in family-building plans. Finally, Tertiary Prevention (managing disease post-diagnosis) is critical. Reduced ovarian reserve has a major influence on physiology beyond fertility, including delayed/absent puberty or premature menopause. In these instances, proper diagnosis and medical therapy can reduce adverse effects. Here, we elaborate on these modes of prevention as well as proposed mechanisms that underlie ovarian reserve disorders.
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