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Chen F, Xie X, Cai D, Yan P, Ding C, Wen Y, Xu Y, Gao F, Zhou C, Li G, Mai Q. Knowledge-embedded spatio-temporal analysis for euploidy embryos identification in couples with chromosomal rearrangements. Chin Med J (Engl) 2024; 137:694-703. [PMID: 37640743 PMCID: PMC10950137 DOI: 10.1097/cm9.0000000000002803] [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: 12/11/2022] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The goal of the assisted reproductive treatment is to transfer one euploid blastocyst and to help infertile women giving birth one healthy neonate. Some algorithms have been used to assess the ploidy status of embryos derived from couples with normal chromosome, who subjected to preimplantation genetic testing for aneuploidy (PGT-A) treatment. However, it is currently unknown whether artificial intelligence model can be used to assess the euploidy status of blastocyst derived from populations with chromosomal rearrangement. METHODS From February 2020 to May 2021, we collected the whole raw time-lapse videos at multiple focal planes from in vitro cultured embryos, the clinical information of couples, and the comprehensive chromosome screening results of those blastocysts that had received PGT treatment. Initially, we developed a novel deep learning model called the Attentive Multi-Focus Selection Network (AMSNet) to analyze time-lapse videos in real time and predict blastocyst formation. Building upon AMSNet, we integrated additional clinically predictive variables and created a second deep learning model, the Attentive Multi-Focus Video and Clinical Information Fusion Network (AMCFNet), to assess the euploidy status of embryos. The efficacy of the AMCFNet was further tested in embryos with parental chromosomal rearrangements. The receiver operating characteristic curve (ROC) was used to evaluate the superiority of the model. RESULTS A total of 4112 embryos with complete time-lapse videos were enrolled for the blastocyst formation prediction task, and 1422 qualified blastocysts received PGT-A ( n = 589) or PGT for chromosomal structural rearrangement (PGT-SR, n = 833) were enrolled for the euploidy assessment task in this study. The AMSNet model using seven focal raw time-lapse videos has the best real-time accuracy. The real-time accuracy for AMSNet to predict blastocyst formation reached above 70% on the day 2 of embryo culture, and then increased to 80% on the day 4 of embryo culture. Combing with 4 clinical features of couples, the AUC of AMCFNet with 7 focal points increased to 0.729 in blastocysts derived from couples with chromosomal rearrangement. CONCLUSION Integrating seven focal raw time-lapse images of embryos and parental clinical information, AMCFNet model have the capability of assessing euploidy status in blastocysts derived from couples with chromosomal rearrangement.
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Affiliation(s)
- Fangying Chen
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong 510080, China
| | - Xiang Xie
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, Guangdong 510006, China
| | - Du Cai
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China
| | - Pengxiang Yan
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, Guangdong 510006, China
| | - Chenhui Ding
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong 510080, China
| | - Yangxing Wen
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong 510080, China
| | - Yanwen Xu
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong 510080, China
| | - Feng Gao
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, China
- Shanghai Artificial Intelligence Laboratory, Shanghai 200232, China
| | - Canquan Zhou
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong 510080, China
| | - Guanbin Li
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, Guangdong 510006, China
| | - Qingyun Mai
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, Guangdong 510080, China
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Bartolacci A, dell'Aquila M, Coticchio G, Intra G, Parodi F, Patria G, Zacà C, Borini A. Endometriosis affects the number of retrieved oocytes but not early embryonic development and live birth: a retrospective analysis of 716 IVF cycles. HUM FERTIL 2023; 26:1469-1476. [PMID: 37139851 DOI: 10.1080/14647273.2023.2200979] [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: 08/06/2022] [Accepted: 01/27/2023] [Indexed: 05/05/2023]
Abstract
To investigate the potential effect of endometriosis on embryo development and clinical outcomes, a retrospective analysis of 716 women undergoing their first standard in vitro fertilization (sIVF) cycles (205 endometriosis and 511 with tubal factor infertility) was performed. The endometriosis group included women with an ultrasonographic or surgical diagnosis. Control subjects were women diagnosed with tubal factor infertility by laparoscopy or hysterosalpingogram. The primary outcome of the study was live birth. Cumulative live birth was also assessed in a subgroups analysis. After adjusting for confounders we found no significant difference in fertilization rate, blastulation, top-quality blastocyst, live birth, cumulative live birth (subgroups analysis) and miscarriage rate. In the endometriosis group, the number of retrieved oocytes was smaller (6.94 ± 4.06 Vs 7.50 ± 4.6, adjusted p < 0.05). We observed a statistically significant difference in the percentage of day-3 embryos with ≥8 blastomeres (33.12 ± 22.72 endometriosis vs, 40.77 ± 27.62 tubal factor, adjusted p < 0.01) and a negative correlation between the presence of endometriomas and a number of retrieved oocytes [B coefficient =-1.41, 95%CI (-2.31-0.51), adjusted p = 0.002]. Our results suggest that endometriosis affects the number of retrieved oocytes but not embryo development and live birth.
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Herbert SL, Staib C, Wallner T, Löb S, Curtaz C, Schwab M, Wöckel A, Häusler S. Morphokinetic analysis of early human embryonic development and its relationship to endometriosis resection: a retrospective time-lapse study using the KIDScore™ D3 and D5 implantation data algorithm. Arch Gynecol Obstet 2023; 308:587-597. [PMID: 37179499 PMCID: PMC10293388 DOI: 10.1007/s00404-023-07008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/13/2023] [Indexed: 05/15/2023]
Abstract
RESEARCH QUESTION Does complete resection of endometriosis improve embryo quality as assessed by morphokinetic parameters using time-lapse microscopy? DESIGN For this retrospective study we analysed 237 fertilised, cultured and transferred embryos from 128 fresh IVF and/ or ICSI transfer cycles. Endometriosis was confirmed or excluded by laparoscopy. Patients were stimulated with recombinant FSH using GnRH agonist and antagonist protocols. After fertilisation, a time-lapse incubation system was used for observation. Embryo quality was assessed using the KIDScore™ D3 and D5 implantation data algorithm. RESULTS The analysis showed a median KIDScore™ D5 of 2.6 (on a scale of 1 to 9.9) for embryos from patients with endometriosis without complete resection. The control group without endometriosis achieved a score of 6.8 (p = 0.003). The median score for embryos from endometriosis patients with complete resection was 7.2, which was a significant increase compared to embryos from patients without complete resection (p = 0.002). We observed an effect size of r = 0.4 for complete resection versus no resection of endometriosis using the KIDScore™ D5. There were no differences in KIDScore™ D3 between the three patient groups. Pregnancy and miscarriage rates showed the same clinical trends. In three of our four case series of patients who underwent IVF/ ICSI cycles before and after complete resection, we found a marked improvement in embryo quality after complete resection. CONCLUSIONS Complete resection of endometriosis could significantly improve the otherwise poor embryo quality of patients undergoing IVF-procedures. The data, therefore, strongly support recommending surgery to patients with endometriosis prior to assisted reproduction.
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Affiliation(s)
- Saskia-Laureen Herbert
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany.
| | - Claudia Staib
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Theresa Wallner
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Sanja Löb
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Carolin Curtaz
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Michael Schwab
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
| | - Sebastian Häusler
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany
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Llarena NC, Hur CE, Yao M, Schwartz K, Falcone T, Desai N. The impact of endometriosis on embryo morphokinetics: embryos from endometriosis patients exhibit delayed cell cycle milestones and decreased blastulation rates. J Assist Reprod Genet 2022; 39:619-628. [PMID: 35099662 PMCID: PMC8995217 DOI: 10.1007/s10815-022-02406-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To compare morphokinetic parameters in embryos obtained from women with and without endometriosis. METHODS We evaluated a total of 3471 embryos resulting from 434 oocyte retrievals performed at a single academic center. One thousand seventy-eight embryos were obtained from women affected by endometriosis and 2393 came from unaffected controls. All embryos were cultured in a time-lapse incubator chamber for up to 6 days. IVF cycle outcomes and morphokinetic parameters collected prospectively were retrospectively reviewed. RESULTS Morphokinetic data suggest that embryo development is impaired in embryos obtained from women with endometriosis (EE). EE were slower to achieve the 2-8 cell stages compared to control embryos (CE) (p < 0.001); additionally, time to compaction was delayed compared to CE (p = 0.015). The timing of late developmental events, including morulation and blastulation was also delayed in the endometriosis cohort (p < 0.001). In addition to demonstrating delayed cell cycle milestones, EE were less likely than controls to progress to morula, blastocyst, and expanded blastocyst stages (p < 0.001). Furthermore, a smaller proportion of embryos in the endometriosis group fell into optimal kinetic ranges for cc2 (p = 0.003), t5 (p = 0.019), tSB (p < 0.001), and tEB (p = 0.007). There were no significant differences in clinical pregnancy or live birth rates between groups. CONCLUSION Embryos from endometriosis patients demonstrate impairments in both early and late developmental events, and progress to the morula, blastocyst, and expanded blastocyst stages at lower rates than control embryos. Despite these differences, IVF outcomes are similar for patients with and without endometriosis.
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Affiliation(s)
- Natalia C Llarena
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Women's Health Institute, Cleveland Clinic, 26,900 Cedar Road, Beachwood, OH, 44,122, USA
| | - Christine E Hur
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Women's Health Institute, Cleveland Clinic, 26,900 Cedar Road, Beachwood, OH, 44,122, USA
| | - Meng Yao
- Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Ave. JJN3, Cleveland, OH, 44,195, USA
| | - Kaia Schwartz
- Department of Obstetrics and Gynecology, Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH, 44,195, USA
| | - Tommaso Falcone
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Women's Health Institute, Cleveland Clinic, 26,900 Cedar Road, Beachwood, OH, 44,122, USA
- Cleveland Clinic London, , 40 Grosvenor Place, London, SW1X 7AW, UK
| | - Nina Desai
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Women's Health Institute, Cleveland Clinic, 26,900 Cedar Road, Beachwood, OH, 44,122, USA.
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Younis JS. Is Oocyte Quality Impaired in Cases With Ovarian Endometriosis? A Second Look Into the Clinical Setting. Front Endocrinol (Lausanne) 2022; 13:921032. [PMID: 35846314 PMCID: PMC9279608 DOI: 10.3389/fendo.2022.921032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Johnny S. Younis
- Reproductive Medicine, Department of Obstetrics and Gynecology, Baruch-Padeh Medical Center, Poriya, Israel
- Azrieili Faculty of Medicine in Galilee, Safed, Bar-Ilan University, Safed, Israel
- *Correspondence: Johnny S. Younis,
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Schmalbrock LJ, Weiss G, Rijntjes E, Reinschissler N, Sun Q, Schenk M, Schomburg L. Pronounced Trace Element Variation in Follicular Fluids of Subfertile Women Undergoing Assisted Reproduction. Nutrients 2021; 13:nu13114134. [PMID: 34836389 PMCID: PMC8619388 DOI: 10.3390/nu13114134] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 02/07/2023] Open
Abstract
Female subfertility is a growing concern, especially in view of an increasing prevalence of polycystic ovary syndrome (PCOS). Assisted reproductive technologies (ART) offer a perspective for pregnancy, but the outcome rate is still suboptimal. The trace elements (TE), copper (Cu), selenium (Se), and zinc (Zn) are essential for fertility and development. We hypothesized that TE concentrations are related to oocyte quality and growth and affect pregnancy outcomes in women undergoing ART. Concentrations of TE were measured by total reflection X-ray fluorescence. Extracellular glutathione peroxidase 3 (GPX3) and selenoprotein P (SELENOP) were determined as additional Se biomarkers. Corresponding serum and follicular fluid (FF) samples were available from women with (n = 20) and without (n = 20) PCOS diagnosis undergoing hormone treatment within the ART procedure, respectively, and FF samples were classified into five groups based on morphological assessment. Serum showed higher TE concentrations than FF, and TE levels correlated positively between both matrices. Individual FF from the same women showed surprisingly high variability in TE concentration, and follicles without oocytes displayed the lowest TE concentrations. Both Se biomarkers GPX3 and SELENOP were present in FF and correlated positively to Se concentrations. Some notable relationships were observed between morphokinetic parameters, TE concentrations, and GPX3 activity. A slightly depressed serum Zn concentration was observed in PCOS. Our results indicate a direct relationship between TE in serum and FF, positive correlations between the three Se biomarkers in FF, and high variability between the FF from the same woman with the lowest TE concentrations in the follicles with the poorest quality. The differences observed in relation to PCOS diagnoses appear relatively minor. Collectively, the data support the notion that TE assessment of follicles may contribute to optimal oocyte selection and subsequently influence ART success.
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Affiliation(s)
- Lilly Johanna Schmalbrock
- Cardiovascular–Metabolic–Renal (CMR)—Research Center, Institut für Experimentelle Endokrinologie, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hessische Straße 3-4, D-10115 Berlin, Germany; (L.J.S.); (E.R.); (Q.S.)
| | - Gregor Weiss
- Das Kinderwunsch Institut Schenk GmbH, Am Sendergrund 11, A-8143 Dobl, Austria; (G.W.); (N.R.)
| | - Eddy Rijntjes
- Cardiovascular–Metabolic–Renal (CMR)—Research Center, Institut für Experimentelle Endokrinologie, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hessische Straße 3-4, D-10115 Berlin, Germany; (L.J.S.); (E.R.); (Q.S.)
| | - Nina Reinschissler
- Das Kinderwunsch Institut Schenk GmbH, Am Sendergrund 11, A-8143 Dobl, Austria; (G.W.); (N.R.)
| | - Qian Sun
- Cardiovascular–Metabolic–Renal (CMR)—Research Center, Institut für Experimentelle Endokrinologie, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hessische Straße 3-4, D-10115 Berlin, Germany; (L.J.S.); (E.R.); (Q.S.)
| | - Michael Schenk
- Das Kinderwunsch Institut Schenk GmbH, Am Sendergrund 11, A-8143 Dobl, Austria; (G.W.); (N.R.)
- Correspondence: (M.S.); (L.S.)
| | - Lutz Schomburg
- Cardiovascular–Metabolic–Renal (CMR)—Research Center, Institut für Experimentelle Endokrinologie, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hessische Straße 3-4, D-10115 Berlin, Germany; (L.J.S.); (E.R.); (Q.S.)
- Correspondence: (M.S.); (L.S.)
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Ferraretto X, Hammas K, Llabador MA, Gricourt S, Labrosse J, Lousqui J, Epelboin S, Tubiana S, Patrat C. Early embryo development anomalies identified by time-lapse system: prevalence and impacting factors. Reprod Biomed Online 2021; 43:627-636. [PMID: 34474978 DOI: 10.1016/j.rbmo.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/17/2021] [Accepted: 06/11/2021] [Indexed: 11/19/2022]
Abstract
RESEARCH QUESTION What is the prevalence of embryo abnormal early cleavage (ACL) identified by time lapse and factors related to patients and treatment that explain ACL occurrence? DESIGN A single-centre, retrospective cohort study. Data were collected on all IVF cycles for which embryos were observed in the EmbryoScope® between December 2015 and August 2017. Only diploid zygotes cleaved on day 2 were included. The study included 318 cycles (250 couples and 1343 embryos). Embryo videos were retrospectively analysed for ACL. The prevalence of each type of ACL was recorded. The influence of clinical factors (whether they were intrinsic to patients or specific to IVF treatment) on ACL occurrence was analysed in multivariate multilevel mixed-effect logistic regression analysis. RESULTS A high prevalence of ACL was observed: 37.6% (505/1343) of embryos presented at least one ACL, 22.8% (306/1343) a trichotomous mitosis, 25.8% (347/1343) a rapid cleavage, 6.7% (90/1343) a cell fusion and two or more ACL (16.1%). Part of the variation (12-25%) in ACL occurrence could be explained by embryo origin. Trichotomous mitosis and two or more ACL phenotypes were less likely to occur in women with endometriosis or tubal pathology and tubal pathology alone, respectively. No factor related to IVF cycles was found to be statistically associated with ACL occurrence. CONCLUSIONS Our findings emphasize the importance of considering embryo origin when interpreting studies focusing on embryo characteristics and factors that could affect their quality. The present study is limited by a small sample size of known embryo implantations and monocentric criterion.
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Affiliation(s)
- Xavier Ferraretto
- Service de Biologie de la Reproduction, AP-HP.Nord - Université de Paris, Hôpital Bichat, Paris 75018, France
| | - Karima Hammas
- Departement d'Epidemiologie, Biostatistiques et Recherche Clinique, AP-HP.Nord -Université de Paris 75018, Hôpital Bichat, Paris, France; Inserm, CIC-EC 1425, Hôpital Bichat Claude Bernard, Paris 75018, France
| | - Marie-Astrid Llabador
- Service de Biologie de la Reproduction, AP-HP.Nord - Université de Paris, Hôpital Bichat, Paris 75018, France
| | - Solenne Gricourt
- Service de Gynécologie, Obstétrique et Reproduction, AP-HP.Nord - Université de Paris, Hôpital Bichat, Paris 75018, France
| | - Julie Labrosse
- Service de Gynécologie, Obstétrique et Reproduction, AP-HP.Nord - Université de Paris, Hôpital Bichat, Paris 75018, France
| | - Johanna Lousqui
- Service de Biologie de la Reproduction, AP-HP.Nord - Université de Paris, Hôpital Bichat, Paris 75018, France
| | - Sylvie Epelboin
- Service de Gynécologie, Obstétrique et Reproduction, AP-HP.Nord - Université de Paris, Hôpital Bichat, Paris 75018, France
| | - Sarah Tubiana
- Departement d'Epidemiologie, Biostatistiques et Recherche Clinique, AP-HP.Nord -Université de Paris 75018, Hôpital Bichat, Paris, France; Inserm, CIC-EC 1425, Hôpital Bichat Claude Bernard, Paris 75018, France
| | - Catherine Patrat
- Service de Biologie de la Reproduction-CECOS, AP-HP.Centre - Université de Paris, Hôpital Cochin, Paris 75014, France; Université de Paris, Institut Cochin, U1016-CNRS UMR8104, Paris 75014, France.
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Endometriosis Lowers the Cumulative Live Birth Rates in IVF by Decreasing the Number of Embryos but Not Their Quality. J Clin Med 2020; 9:jcm9082478. [PMID: 32752267 PMCID: PMC7464781 DOI: 10.3390/jcm9082478] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/11/2022] Open
Abstract
Endometriosis and infertility are closely linked, but the underlying mechanisms are still poorly understood. This study aimed to evaluate the impact of endometriosis on in vitro fertilization (IVF) parameters, especially on embryo quality and IVF outcomes. A total of 1124 cycles with intracytoplasmic sperm injection were retrospectively evaluated, including 155 cycles with endometriosis and 969 cycles without endometriosis. Women with endometriosis had significantly lower ovarian reserve markers (AMH and AFC), regardless of previous ovarian surgery. Despite receiving significantly higher doses of exogenous gonadotropins, they had significantly fewer oocytes, mature oocytes, embryos, and top-quality embryos than women in the control group. Multivariate analysis did not reveal any association between endometriosis and the proportion of top-quality embryo (OR = 0.87; 95% CI [0.66-1.12]; p = 0.3). The implantation rate and the live birth rate per cycle were comparable between the two groups (p = 0.05), but the cumulative live births rate was significantly lower in in the endometriosis group (32.1% versus 50.7%, p = 0.001), as a consequence of the lower number of frozen embryos. In conclusion, endometriosis lowers the cumulative live birth rates by decreasing the number of embryos available to transfer, but not their quality.
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Duan R, Wang Y, Lin A, Lian L, Cao H, Gu W, Li T, Sun Q. Expression of nm23-H1, p53, and integrin β1 in endometriosis and their clinical significance. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2020; 13:1024-1029. [PMID: 32509074 PMCID: PMC7270686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
To investigate the expression and clinical significance of nucleoside diphosphate kinase A (nm23-H1), p53, and integrin β1 in endometriosis, normal and ectopic endometrial tissues were collected and the levels of nm23-H1, p53, and integrin β1 proteins were detected by western blotting. We also measured the mRNA expression of nm23-H1, p53, and integrin β1 in endometrial epithelial cells by droplet digital PCR, based on endometrial tissues using laser capture microdissection. Moreover, primary stromal cells from normal and ectopic endometrial tissues were also cultured and treated with different concentrations of estrogen. We assessed the mRNA levels of nm23-H1, p53, and integrin β1 by quantitative PCR. Compared with normal endometrial tissue, the levels of nm23-H1 and p53 proteins were significantly downregulated in ectopic endometrial tissues, while integrin β1 protein was upregulated. The same expression trend in the mRNA levels of nm23-H1, p53, and integrin β1 was also observed in both endometrial epithelial cells and stromal cells. In addition, with increasing estrogen concentration, nm23-H1 and p53 mRNA levels gradually decreased, while integrin β1 mRNA expression increased. Nm23-H1 and p53 may inhibit the progression of endometriosis, while integrin β1 has a promoting effect, and estrogen is involved in this process.
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Affiliation(s)
- Renjie Duan
- School of Preclinical Medicine, Wannan Medical CollegeWuhu, Anhui, China
| | - Yue Wang
- School of Preclinical Medicine, Wannan Medical CollegeWuhu, Anhui, China
| | - Aiqin Lin
- School of Preclinical Medicine, Wannan Medical CollegeWuhu, Anhui, China
| | - Likai Lian
- School of Preclinical Medicine, Wannan Medical CollegeWuhu, Anhui, China
| | - Huiru Cao
- School of Preclinical Medicine, Wannan Medical CollegeWuhu, Anhui, China
| | - Wenjie Gu
- School of Preclinical Medicine, Wannan Medical CollegeWuhu, Anhui, China
| | - Tiechen Li
- School of Preclinical Medicine, Wannan Medical CollegeWuhu, Anhui, China
| | - Qing Sun
- Department of Gynaecology and Obstetrics, Yijishan Hospital of Wannan Medical CollegeWuhu, Anhui, China
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