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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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Omelchenko AN, Igonina TN, Brusentsev EY, Okotrub KA, Amstislavsky SY, Surovtsev NV. Cryopreservation increases accumulation of exogenous stearic acid in mouse embryos. Cryobiology 2022; 109:44-52. [PMID: 36179820 DOI: 10.1016/j.cryobiol.2022.09.005] [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: 03/03/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 01/16/2023]
Abstract
Cryopreservation of preimplantation embryos is a widely used technique, but this procedure might impact the subsequent embryo development. The effect of slow freezing and vitrification on the lipid metabolism in preimplantation mammalian embryos is not well studied. In this work, we applied Raman spectroscopy of isotopically labeled molecules to address the effects of cryopreservation on fatty acid accumulation in mouse embryos. Embryos after slow freezing or vitrification were cultured for 20 h in a medium supplemented with bovine serum albumin saturated with deuterated stearic acid (dSA). After this period the concentration of dSA estimated from Raman spectra of frozen-thawed and vitrified-warmed embryos at the morula stage was almost twice higher compared to non-cryopreserved morulas. At the same time, frozen-thawed and vitrified-warmed 4-cell embryos did not demonstrate any difference in the level of stearic acid uptake from non-cryopreserved embryos of the same stage. After an additional 24 h culture, cryopreserved and non-cryopreserved embryos demonstrated similar dSA uptake.
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Affiliation(s)
- A N Omelchenko
- Novosibirsk State University, Novosibirsk, 630090, Russia; Institute of Automation and Electrometry, Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - T N Igonina
- Institute of Cytology and Genetics, Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - E Y Brusentsev
- Institute of Cytology and Genetics, Russian Academy of Sciences, Novosibirsk, 630090, Russia; Institute of Automation and Electrometry, Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - K A Okotrub
- Institute of Automation and Electrometry, Russian Academy of Sciences, Novosibirsk, 630090, Russia.
| | - S Y Amstislavsky
- Institute of Cytology and Genetics, Russian Academy of Sciences, Novosibirsk, 630090, Russia; Institute of Automation and Electrometry, Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - N V Surovtsev
- Institute of Automation and Electrometry, Russian Academy of Sciences, Novosibirsk, 630090, Russia
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Devroe J, Peeraer K, Verbeke G, Spiessens C, Vriens J, Dancet E. Predicting the chance on live birth per cycle at each step of the IVF journey: external validation and update of the van Loendersloot multivariable prognostic model. BMJ Open 2020; 10:e037289. [PMID: 33033089 PMCID: PMC7545639 DOI: 10.1136/bmjopen-2020-037289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To study the performance of the 'van Loendersloot' prognostic model for our clinic's in vitro fertilisation (IVF) in its original version, the refitted version and in an adapted version replacing previous by current cycle IVF laboratory variables. METHODS This retrospective cohort study in our academic tertiary fertility clinic analysed 1281 IVF cycles of 591 couples, who completed at least one 2nd-6th IVF cycle with own fresh gametes after a previous IVF cycle with the same partner in our clinic between 2010 and 2018. The outcome of interest was the chance on a live birth after one complete IVF cycle (including all fresh and frozen embryo transfers from the same episode of ovarian stimulation). Model performance was expressed in terms of discrimination (c-statistics) and calibration (calibration model, comparison of prognosis to observed ratios of five disjoint groups formed by the quintiles of the IVF prognoses and a calibration plot). RESULTS A total of 344 live births were obtained (26.9%). External validation of the original van Loendersloot model showed a poor c-statistic of 0.64 (95% CI: 0.61 to 0.68) and an underestimation of IVF success. The refitted and the adapted models showed c-statistics of respectively 0.68 (95% CI: 0.65 to 0.71) and 0.74 (95% CI: 0.70 to 0.77). Similar c-statistics were found with cross-validation. Both models showed a good calibration model; refitted model: intercept=0.00 (95% CI: -0.23 to 0.23) and slope=1.00 (95% CI: 0.79 to 1.21); adapted model: intercept=0.00 (95% CI: -0.18 to 0.18) and slope=1.00 (95% CI: 0.83 to 1.17). Prognoses and observed success rates of the disjoint groups matched well for the refitted model and even better for the adapted model. CONCLUSION External validation of the original van Loendersloot model indicated that model updating was recommended. The good performance of the refitted and adapted models allows informing couples about their IVF prognosis prior to an IVF cycle and at the time of embryo transfer. Whether this has an impact on couple's expected success rates, distress and IVF discontinuation can now be studied.
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Affiliation(s)
- Johanna Devroe
- Leuven University Fertility Centre, University Hospital Leuven, Leuven, Belgium
- Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, Leuven, Belgium
| | - Karen Peeraer
- Leuven University Fertility Centre, University Hospital Leuven, Leuven, Belgium
- Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, Leuven, Belgium
| | - Geert Verbeke
- Public Health and Primary Care, Leuven Biostatistics and statistical Bioinformatics Centre, Leuven, Belgium
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Leuven, Belgium
| | - Carl Spiessens
- Leuven University Fertility Centre, University Hospital Leuven, Leuven, Belgium
| | - Joris Vriens
- Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, Leuven, Belgium
| | - Eline Dancet
- Leuven University Fertility Centre, University Hospital Leuven, Leuven, Belgium
- Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, Leuven, Belgium
- Postdoctoral fellow, Research Foundation, Flanders, Belgium
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Tocci A. The unknown human trophectoderm: implication for biopsy at the blastocyst stage. J Assist Reprod Genet 2020; 37:2699-2711. [PMID: 32892265 DOI: 10.1007/s10815-020-01925-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/11/2020] [Indexed: 11/30/2022] Open
Abstract
Trophectoderm biopsy is increasingly performed for pre-implantation genetic testing of aneuploidies and considered a safe procedure on short-term clinical outcome, without strong assessment of long-term consequences. Poor biological information on human trophectoderm is available due to ethical restrictions. Therefore, most studies have been conducted in vitro (choriocarcinoma cell lines, embryonic and pluripotent stem cells) and on murine models that nevertheless poorly reflect the human counterpart. Polarization, compaction, and blastomere differentiation (e.g., the basis to ascertain trophectoderm origin) are poorly known in humans. In addition, the trophectoderm function is poorly known from a biological point of view, although a panoply of questionable and controversial microarray studies suggest that important genes overexpressed in trophectoderm are involved in pluripotency, metabolism, cell cycle, endocrine function, and implantation. The intercellular communication system between the trophectoderm cells and the inner cell mass, modulated by cell junctions and filopodia in the murine model, is obscure in humans. For the purpose of this paper, data mainly on primary cells from human and murine embryos has been reviewed. This review suggests that the trophectoderm origin and functions have been insufficiently ascertained in humans so far. Therefore, trophectoderm biopsy should be considered an experimental procedure to be undertaken only under approved rigorous experimental protocols in academic contexts.
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Affiliation(s)
- Angelo Tocci
- Reproductive Medicine Unit, Gruppo Donnamed, Via Giuseppe Silla 12, Rome, Italy.
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Capodanno F, Daolio J, De Feo G, Falbo A, Morini D, Nicoli A, Braglia L, Villani M, La Sala GB, Parmegiani L, Aguzzoli L. A monocentric analysis of the efficacy of extracellular cryoprotectants in unfrozen solutions for cleavage stage embryos. Reprod Biol Endocrinol 2019; 17:84. [PMID: 31656205 PMCID: PMC6815413 DOI: 10.1186/s12958-019-0519-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the absence of international guidelines indicating the usage of vitrification rather than slow-freezing, the study aim was to analyze a large cohort of slow-frozen/thawed embryos to produce a rationale supporting the standardization of IVF cryopreservation policy. METHODS This retrospective analysis included 4779 cleavage stage embryos cryopreserved by slow-freezing/thawing from September 2009 to April 2017 at a single Center. Biological and clinical outcomes of three different commercial kits adopted sequentially, i.e. Vitrolife Cleave Kit® from Vitrolife (kit 1) vs. K-SICS-5000 Kit® and K-SITS-5000 Kit® from Cook Medical (kit 2) and Freeze/Thaw 1™ Kit® from Vitrolife (kit 3) were collected and compared in the light of cryoprotectants composition. RESULTS Kit 3 compared to kit 1 and kit 2 showed significantly (P < 0.001) higher embryo survival (79.9% vs. 75.6 and 68.1%, respectively) and frozen embryo replacement (91.5% vs. 86.5 and 83.3%, respectively) rates, and significantly (P < 0.001) lower blastomere degeneration rate (41.5% vs. 43.6 and 52.4%, respectively). No significant difference for clinical outcomes was observed among kits. Only a slight positive trend was observed for kit 3 vs. kit 1 and kit 2 on delivery rate per thawing cycle (7.12% vs. 4.19 and 4.51%, respectively; P < 0.058) and live birth rate (3.07% vs. 2.59 and 1.93%, respectively, P < 0.069). Thawing solutions of kit 3 were similar to those of any warming protocol. CONCLUSIONS A defined concentration of extracellular cryoprotectants in thawing/warming solutions had a beneficial effect on the embryo cryosurvival rate. Results could provide the rationale for the adoption of a single standardized warming protocol.
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Affiliation(s)
- Francesco Capodanno
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Jessica Daolio
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Gaetano De Feo
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Angela Falbo
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Daria Morini
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Alessia Nicoli
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Luca Braglia
- Research and Statistics Infrastructure, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - MariaTeresa Villani
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Giovanni B. La Sala
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Lodovico Parmegiani
- Reproductive Medicine Unit, GynePro Medical Centers and NextClinics International, Via Tranquillo Cremona 8, 40137 Bologna, Italy
| | - Lorenzo Aguzzoli
- Center of Reproductive Medicine “P. Bertocchi”, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
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Advances in the slow freezing cryopreservation of microencapsulated cells. J Control Release 2018; 281:119-138. [PMID: 29782945 DOI: 10.1016/j.jconrel.2018.05.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/12/2018] [Accepted: 05/15/2018] [Indexed: 12/20/2022]
Abstract
Over the past few decades, the use of cell microencapsulation technology has been promoted for a wide range of applications as sustained drug delivery systems or as cells containing biosystems for regenerative medicine. However, difficulty in their preservation and storage has limited their availability to healthcare centers. Because the preservation in cryogenic temperatures poses many biological and biophysical challenges and that the technology has not been well understood, the slow cooling cryopreservation, which is the most used technique worldwide, has not given full measure of its full potential application yet. This review will discuss the different steps that should be understood and taken into account to preserve microencapsulated cells by slow freezing in a successful and simple manner. Moreover, it will review the slow freezing preservation of alginate-based microencapsulated cells and discuss some recommendations that the research community may pursue to optimize the preservation of microencapsulated cells, enabling the therapy translate from bench to the clinic.
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