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Kim JH, Park EA, Yoon TK, Kim MJ, Lee JH, Lee KA, Hur YJ, Choi SY, Jo EH, Kim YS. In vitro Fertilization Outcomes of Frozen-thawed Embryo Transfer with Hatched Blastocysts versus with Hatching Blastocysts. Reprod Sci 2024:10.1007/s43032-024-01499-7. [PMID: 38811454 DOI: 10.1007/s43032-024-01499-7] [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: 06/06/2023] [Accepted: 02/09/2024] [Indexed: 05/31/2024]
Abstract
This study aimed to elucidate the effect of hatching status on in vitro fertilization (IVF) outcomes in frozen-thawed blastocyst transfer cycles. Frozen-thawed embryo transfer (FET) cycles performed at a single fertility center between 2016 and 2021 were retrospectively assessed. Analyses were restricted to 6,821 frozen-thawed blastocyst transfers in women aged 24-47 years. For optimal comparability, double embryo transfer (ET) cycles consisting of one hatching and one hatched blastocyst were excluded. The implantation and pregnancy rates were evaluated and compared between the hatching and hatched blastocyst transfer groups based on patients' age (<38 vs. ≥38 years), blastocyst grade (good vs. bad grade), and the number of transferred embryos (single ET vs. double ET). Hatched blastocyst transfer was associated with higher implantation and clinical pregnancy rates in the single ET group (15.7% and 15.6%, respectively; p<0.001). The transfer of two hatched blastocysts had higher implantation and clinical pregnancy rates compared to the transfer of two hatching blastocysts (19.5% and 20.4%, respectively; p<0.001) in the double ET group. In the hatched blastocyst transfer group, the clinical pregnancy and implantation rates were higher, regardless of each woman's age and embryo quality. The IVF treatment outcomes were improved when the blastocysts were hatched during FET cycles. Hence, hatched blastocyst transfer in FET cycles could be considered a superior method in IVF practice.
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Affiliation(s)
- Ji Hye Kim
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Eun A Park
- Fertility laboratory, CHA Fertility Center Seoul Station, Seoul, Republic of Korea
- Department of Biomedical Science, College of Life Science, CHA University, Gyeonggi-do, Republic of Korea
| | - Tae Ki Yoon
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Myung Joo Kim
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Jung Hyun Lee
- Fertility laboratory, CHA Fertility Center Seoul Station, Seoul, Republic of Korea
| | - Kyung-Ah Lee
- Department of Biomedical Science, College of Life Science, CHA University, Gyeonggi-do, Republic of Korea
| | - Yun Jung Hur
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Seung Young Choi
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
| | - Eun-Hye Jo
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
| | - You Shin Kim
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea.
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea.
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Kim JW, Lee SY, Hur CY, Lim JH, Park CK. Clinical outcomes of preimplantation genetic testing for aneuploidy in high-risk patients: a retrospective cohort study. Clin Exp Reprod Med 2024; 51:75-84. [PMID: 38148475 PMCID: PMC10914495 DOI: 10.5653/cerm.2023.06394] [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: 07/28/2023] [Revised: 09/19/2023] [Accepted: 10/05/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. METHODS This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). RESULTS PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. CONCLUSION PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.
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Affiliation(s)
- Jun Woo Kim
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
- Department of Applied Animal Science, College of Animal Life Sciences, Kangwon National University, Chuncheon, Republic of Korea
| | - So Young Lee
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
| | - Chang Young Hur
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
| | - Jin Ho Lim
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
| | - Choon Keun Park
- Department of Applied Animal Science, College of Animal Life Sciences, Kangwon National University, Chuncheon, Republic of Korea
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Ma M, Zhang L, Liu Z, Teng Y, Li M, Peng X, An L. Effect of blastocyst development on hatching and embryo implantation. Theriogenology 2024; 214:66-72. [PMID: 37857152 DOI: 10.1016/j.theriogenology.2023.10.011] [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: 07/30/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
The mammalian zygote, formed after a sperm fertilizes an egg, undergoes several rounds of mitosis and morphogenesis to form the blastocyst. During the peri-implantation period, the blastocyst hatches out of the zona pellucida (ZP) and invades the receptive uterine endometrium. This process promotes maternal-fetal dialogue at the physiological and molecular level, thereby initiating the implantation process. Blastocyst hatching is a consequence of elevated osmotic pressure due to active Na+/K+ ion transporter in the blastocyst cavity, as well as proteases produced by trophectoderm (TE) that hydrolyze the ZP. This review summarizes the process underpinning blastocyst hatching, such as the hatching schedule, the location of TEs during initial hatching out of the ZP, the molecules involved in blastocyst hatching, and how these processes affect implantation events. Additionally, we focus on identifying crucial molecules that may influence the quality of implantation and predict the outcome of embryo implantation. Further understanding the mechanism of these molecules may help us to improve the efficiency of Assisted reproductive technology (ART) in livestock breeding. This review provides insight into embryonic development, specifically during the short-term process of blastocyst hatching and its effects on the following implantation.
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Affiliation(s)
- Meixiang Ma
- Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science and Technology, Xinjiang University, Urumqi, 830046, China
| | - Liang Zhang
- Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science and Technology, Xinjiang University, Urumqi, 830046, China
| | - Zihan Liu
- Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science and Technology, Xinjiang University, Urumqi, 830046, China
| | - Yadi Teng
- Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science and Technology, Xinjiang University, Urumqi, 830046, China
| | - Miaolong Li
- Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science and Technology, Xinjiang University, Urumqi, 830046, China
| | - Xinrong Peng
- Institute of Animal Biotechnology, Xinjiang Academy of Animal Science, Urumqi, 830011, China.
| | - Liyou An
- Xinjiang Key Laboratory of Biological Resources and Genetic Engineering, College of Life Science and Technology, Xinjiang University, Urumqi, 830046, China.
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Kim JW, Lee SY, Hur CY, Lim JH, Park CK. Comparison of clinical and preimplantation genetic testing for aneuploidy outcomes between in vitro fertilization and intracytoplasmic sperm injection in sibling mature oocytes from high-risk patients: A retrospective study. J Obstet Gynaecol Res 2023; 49:2343-2350. [PMID: 37365000 DOI: 10.1111/jog.15731] [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: 01/08/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023]
Abstract
AIM To evaluate the influence of insemination methods on clinical outcomes by assessing preimplantation genetic testing for aneuploidy (PGT-A) outcomes in embryos obtained using in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling mature oocytes from high-risk patients. METHODS This retrospective study involved 108 couples with nonmale or mild male factor infertility who underwent split insemination cycles from January 2018 to December 2021. PGT-A was performed using trophectoderm biopsy, array comparative genome hybridization, or next-generation sequencing with 24-chromosome screening. RESULTS Mature oocytes were divided into IVF (n = 660) and ICSI (n = 1028) groups. The normal fertilization incidence was similar between the groups (81.1% vs. 84.6%). The total number of blastocysts biopsied was significantly higher in the IVF group than in the ICSI group (59.3% vs. 52.6%; p = 0.018). However, euploidy (34.4% vs. 31.9%) and aneuploidy (63.4% vs. 66.2%) rates per biopsy and clinical pregnancy rates (60.0% vs. 58.8%) were similar between the groups. Implantation (45.6% vs. 50.8%) and live birth or ongoing pregnancy (52.0% vs 58.8%) rates were slightly higher in the ICSI group than in the IVF group and miscarriage rate per transfer was slightly higher in the IVF group than in the ICSI group (12.0% vs 5.9%); however no significant difference was observed. CONCLUSIONS IVF and ICSI using sibling mature oocytes had similar clinical outcomes, and euploidy and aneuploidy rates in couples with nonmale and mild male factor infertility. These results suggest that IVF is a useful option, along with ICSI, as an insemination method in PGT-A cycles, especially in high-risk patients.
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Affiliation(s)
- Jun-Woo Kim
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
- Department of Applied Animal Science, College of Animal Life Sciences, Kangwon National University, Chuncheon, Republic of Korea
| | - So-Young Lee
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
| | - Chang-Young Hur
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
| | - Jin-Ho Lim
- In Vitro Fertilization Center, Maria S Fertility Hospital, Seoul, Republic of Korea
| | - Choon-Keun Park
- Department of Applied Animal Science, College of Animal Life Sciences, Kangwon National University, Chuncheon, Republic of Korea
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Chen Q, Du S, Lin Y, Zheng B. Controlled ovarian stimulation for endometriosis patients with ultra-long GnRH-agonist or GnRH-antagonist protocols: A retrospective study by propensity score matching. J Obstet Gynaecol Res 2023; 49:1366-1374. [PMID: 36780873 DOI: 10.1111/jog.15570] [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: 09/29/2022] [Accepted: 01/17/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES Although in vitro fertilization with embryo transfer is the most effective treatment for infertile patients with endometriosis, ovarian stimulation protocols are controversial. STUDY DESIGN We recruited 639 patients with endometriosis from January 2016 to June 2020; 111 and 528 patients were treated with the gonadotropin-releasing hormone (GnRH) antagonist and ultra-long GnRH agonist protocols, respectively. Potential baseline differences between the regimens were adjusted by propensity score matching. Clinical and laboratory data, including the cumulative clinical pregnancy rate (CCPR) and cumulative live birth rate (CLBR), were compared. RESULTS Ovulation induction required significantly longer use of gonadotropins in the GnRH agonist group. However, the GnRH agonist group had a lower starting dose of gonadotropin (all p < 0.05). Furthermore, significantly lower clinical pregnancy, implantation, and live birth rates were observed in the GnRH antagonist group receiving fresh assisted reproductive technology cycles (all p < 0.05); however, pregnancy outcomes using the subsequent freeze-thaw cycles for the same oocyte retrieval were not significantly different. CCPR and CLBR for the oocyte retrieval cycles of the antagonist and ultra-long agonist protocols were similar. The ultra-long agonist protocol resulted in more favorable implantation of fresh embryos and improved clinical outcomes of the fresh cycle. CONCLUSIONS This novel strategy could be appropriate for endometriosis patients who are temporarily unsuitable for fresh embryo transfer. The GnRH antagonist protocol can be combined with the whole embryo freezing strategy to achieve CCPR and CLBR similar to the ultra-long agonist regimen, thus simultaneously avoiding the long pre-treatment duration of GnRH agonists during the ultra-long agonist protocol.
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Affiliation(s)
- Qingfen Chen
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, P.R. China
| | - Shengrong Du
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, P.R. China
| | - Yunhong Lin
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, P.R. China
| | - Beihong Zheng
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, P.R. China
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Endo Y, Mitsuhata S, Hayashi M, Fujii Y, Motoyama H. Laser-assisted hatching on clinical and neonatal outcomes in patients undergoing single vitrified Blastocyst transfer: A propensity score-matched study. Reprod Med Biol 2021; 20:182-189. [PMID: 33850451 PMCID: PMC8022098 DOI: 10.1002/rmb2.12366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study determined the effect of laser-assisted hatching on the clinical and neonatal outcomes of single vitrified blastocyst transfer. METHODS From June 2014 to March 2018, 289 matched pairs after propensity score matching were analyzed. During the blastocyst warming procedure, a small section of the zona pellucida area in the empty perivitelline space was sliced off using multiple laser beams. The clinical and neonatal outcomes of the laser-treated group and non-treatment control were analyzed. RESULTS In the laser-assisted hatching group, significantly higher rates of clinical pregnancy (40.8% vs 29.4%, P < .01) and live delivery (34.3% vs 22.5%, P < .01) were observed compared to the control group. Other variables such as the average gestational weeks, the sex of the baby, birthweight, or congenital malformations were found to have no significant differences in neonatal outcomes. Moreover, all babies were singleton live births. CONCLUSIONS Single vitrified blastocyst transfer treated with laser-assisted hatching increases the live birth rate and has no adverse effects on neonatal outcomes.
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Affiliation(s)
- Yuji Endo
- IVF CenterKurashiki Medical ClinicKurashikiJapan
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Lou H, Li N, Zhang X, Sun L, Wang X, Hao D, Cui S. Does the sex ratio of singleton births after frozen single blastocyst transfer differ in relation to blastocyst development? Reprod Biol Endocrinol 2020; 18:72. [PMID: 32669110 PMCID: PMC7362517 DOI: 10.1186/s12958-020-00623-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/16/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To investigate the associations between blastocyst development and the sex ratio (male:female) among singleton live births resulting from single-blastocyst frozen embryo transfer (FET) cycles. METHODS Patients with singleton live births following the first autologous single FET of non- preimplantation genetic testing (PGT) blastocysts in a single reproductive medicine department between January 2015 and February 2019 were included in this retrospective study. The primary outcome measure was the singleton sex ratio. Multivariable logistic regression models were used to estimate the associations between blastocyst quality and singleton sex ratio after adjustment for some potential confounders. RESULTS There were 638 high-quality and 572 poor-quality single blastocyst FETs, and the blastocysts were conceived via 855 IVF and 355 ICSI treatments. A total of 1210 singleton live births were assessed. High-quality single blastocyst FET resulted in a significantly higher sex ratio than did poor-quality single blastocyst FET (60% vs. 49.7%, P < 0.001). The infertility cause was not associated with sex ratio among singleton live births (P = 0.537). The results of a multivariate analysis revealed that a high-quality blastocyst has a 150% higher probability of being male than a poor-quality blastocyst (adjusted odds ratio (aOR) 1.57; 95% CI 1.24-2, P < 0.001). Among the three blastocyst morphological parameters, Grade B trophectoderm was significantly associated with a higher sex ratio than Grade C (aOR 1.71; 95% CI 1.33-2.21. P < 0.001). Neither expansion degree nor inner cell mass degree were significantly associated with the singleton sex ratio. CONCLUSIONS A single high-quality blastocyst FET has a higher chance of resulting in a male infant than a female infant. The results demonstrate that grade B trophectoderm confers benefits in improving the implantation potential of male blastocysts.
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Affiliation(s)
- Hua Lou
- grid.412719.8Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan Province China
| | - Na Li
- grid.412719.8Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan Province China
| | - Xiaoke Zhang
- grid.412719.8Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan Province China
| | - Ling Sun
- grid.412719.8Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan Province China
| | - Xingling Wang
- grid.412719.8Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan Province China
| | - Dayong Hao
- grid.412719.8Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan Province China
| | - Shihong Cui
- grid.412719.8Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan Province China
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Hong YH, Lee JM, Kim SK, Youm HW, Jee BC. Associations of post-warming embryo or blastocyst development with clinical pregnancy in vitrified embryo or blastocyst transfer cycles. Clin Exp Reprod Med 2020; 47:140-146. [PMID: 32456411 PMCID: PMC7315863 DOI: 10.5653/cerm.2019.03321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/05/2019] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate whether the degree of post-warming embryo or blastocyst development is associated with clinical pregnancy in vitrified embryo or blastocyst transfer cycles. Methods Ninety-six vitrified cleavage-stage embryos and 58 vitrified blastocyst transfer cycles were selected. All transfer cycles were performed from February 2011 to March 2019, and all vitrified embryos or blastocysts were warmed from 4 PM to 6 PM and then transferred the next morning from 9 AM to 10 AM. The scores of the cleavage-stage embryos and blastocysts were assessed at warming and at transfer using the modified Steer method and the Gardner method, respectively. The mean embryo or blastocyst score, score of the single top-quality embryo or blastocyst, and the difference in the score between warming and transfer were compared between nonpregnant and pregnant women. Results In the cleavage-stage embryo transfer cycles, both the top-quality embryo score at transfer and the difference in the score between warming and transfer were significantly associated with clinical pregnancy. A top-quality embryo score at transfer of ≥60.0 (area under the curve [AUC], 0.673; 95% confidence interval [CI], 0.531–0.815) and a difference in the score between warming and transfer of ≥23.0 (AUC, 0.675; 95% CI, 0.514–0.835) were significant predictors of clinical pregnancy. In blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor associated with clinical pregnancy. A top-quality blastocyst score at transfer of ≥38.3 was a significant predictor of clinical pregnancy (AUC, 0.666; 95% CI, 0.525–0.807). Conclusion The top-quality embryo score at transfer and the degree of post-warming embryo development were associated with clinical pregnancy in vitrified cleavage-stage embryo transfer cycles. In vitrified blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor affecting clinical pregnancy.
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Affiliation(s)
- Yeon Hee Hong
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jang Mi Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Won Youm
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
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Cell number considerations for blastocyst transfer in younger patients. J Assist Reprod Genet 2020; 37:619-627. [PMID: 31901111 DOI: 10.1007/s10815-019-01681-w] [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: 06/19/2019] [Accepted: 12/27/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To investigate the role of the cell number at day 3 in blastocyst selection. DESIGN Observational, retrospective, single-center clinical study. PATIENT(S) In part 1, 1211 single vitrified-warmed blastocyst transfer (SVBT) cycles were identified and reviewed. All the cycles were conventional in vitro fertilization (IVF) cycles and the first embryo transfer cycles. Most of patients had a risk of ovarian hyperstimulation syndrome and were young. In part 2, 864 IVF-derived blastocysts from 292 infertile couples underwent trophectoderm (TE) biopsy for preimplantation genetic testing for aneuploidies (PGT-A). INTERVENTION(S) No patient intervention. MAIN OUTCOME MEASURE(S) The first part was an analysis of the correlation between the cell number at day 3 and live birth rate (LBR) after SVBT, and the second part was an analysis of the correlation between the cell number at day 3 and euploid rate (ER) of blastocysts. RESULT(S) In part 1, after correcting for the effects of other confounders, the cell number at day 3 had no significant effect on the LBR (OR 1.001, 95% CI 0.938-1.068). In part 2, after correcting for the effects of other confounders, the cell number at day 3 had no significant effect on the ER (OR 0.960, 95% CI 0.866-1.063). CONCLUSION(S) When the vitrified-warmed blastocysts obtained by conventional IVF are transferred into young patients, the cell number at day 3 is not a strong predictor of the LBR. In addition, the cell number at day 3 is not a strong predictor of ER of IVF-derived blastocysts too.
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Hur YS, Ryu EK, Hyun CS, Yang SH, Yoon SH, Lim KS, Lee WD, Lim JH. Retrospective study of single vitrified-warmed blastocyst transfer cycles according to the presence of morphokinetic variables. Clin Exp Reprod Med 2018; 45:52-55. [PMID: 29662827 PMCID: PMC5897249 DOI: 10.5653/cerm.2018.45.1.52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/29/2017] [Accepted: 01/15/2018] [Indexed: 11/29/2022] Open
Abstract
This study retrospectively assessed whether time-lapse data relating to developmental timing and morphology were associated with clinical outcomes, with the eventual goal of using morphokinetic variables to select embryos prospectively for cryopreservation. In this study, we examined the clinical outcomes of single vitrified-warmed blastocyst transfer cycles that were cultured in a time-lapse incubation system. The morphokinetic variables included uneven pronuclei, an uneven blastomere, multinucleation, and direct, rapid, and irregular division. A total of 164 single vitrified-warmed blastocyst transfer cycles were analyzed (102 cycles of regularly developed blastocysts and 62 cycles of blastocysts with morphokinetic variables). No significant differences in the age of females or the standard blastocyst morphology were found between these two groups. The regularly developed blastocysts showed significantly higher implantation and clinical pregnancy rates than the blastocysts exhibiting morphokinetic variables (30.4% vs. 9.7% and 37.3% vs. 14.5%, respectively; p<0.01). The blastocysts that exhibited morphokinetic variables showed different mean development times compared with the regularly developed blastocysts. Although morphokinetic variables are known to have fatal impacts on embryonic development, a considerable number of embryos developed to the blastocyst stage. Morphokinetic variables had negative effects on the implantation and clinical pregnancy rates in vitrified-warmed blastocyst transfer cycles. These findings suggest that blastocysts cultured in a time-lapse incubation system should be considered for selective cryopreservation according to morphokinetic variables.
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Kaye L, Will EA, Bartolucci A, Nulsen J, Benadiva C, Engmann L. Pregnancy rates for single embryo transfer (SET) of day 5 and day 6 blastocysts after cryopreservation by vitrification and slow freeze. J Assist Reprod Genet 2017; 34:913-919. [PMID: 28500451 DOI: 10.1007/s10815-017-0940-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 04/30/2017] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The purpose of this study was to compare clinical and ongoing pregnancy rates in cycles with single embryo transfer (SET) of blastocysts cryopreserved on day 5 or day 6. Our aim was to determine whether day 6 blastocysts perform adequately to recommend SET. METHODS Retrospective cohort study including 468 transfer cycles for 392 women younger than age 38 undergoing SET at a university-affiliated IVF clinic in the USA. A total of 261 day 5 blastocysts and 207 day 6 blastocysts for frozen-thawed SET between 2010 and 2016 were analyzed. Data included cryopreservation by both a slow freeze method and vitrification. RESULTS In total, 59.0% of day 5 SET cycles resulted in a clinical pregnancy compared to 54.1% of day 6 blastocysts (p = 0.54). Ongoing pregnancy rates from day 5 frozen-thawed blastocysts (51.7%) were comparable to day 6 (44.9%, p = 0.14). When looking at vitrified blastocysts only, there were no significant differences between day 5 and day 6 blastocysts, with a clinical pregnancy rate of 69.2% for day 5 and 72.5% for day 6 (p = 0.68). CONCLUSIONS SETs of day 6 cryopreserved blastocysts resulted in similar clinical and ongoing pregnancy rates compared to day 5, particularly after vitrification.
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Affiliation(s)
- Leah Kaye
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Road, Farmington, CT, 06032-6224, USA
| | - Erica Anspach Will
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Road, Farmington, CT, 06032-6224, USA
| | - Alison Bartolucci
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Road, Farmington, CT, 06032-6224, USA
| | - John Nulsen
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Road, Farmington, CT, 06032-6224, USA
| | - Claudio Benadiva
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Road, Farmington, CT, 06032-6224, USA
| | - Lawrence Engmann
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Road, Farmington, CT, 06032-6224, USA.
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