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Canon C, Thurman A, Li A, Hernandez-Nieto C, Lee JA, Roth RM, Slifkin R, Briton-Jones C, Stein D, Copperman AB. Assessing the clinical viability of micro 3 pronuclei zygotes. J Assist Reprod Genet 2023:10.1007/s10815-023-02830-y. [PMID: 37227570 DOI: 10.1007/s10815-023-02830-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 05/09/2023] [Indexed: 05/26/2023] Open
Abstract
PURPOSE What is the rate of euploidy and clinical viability of embryos resulting from micro 3 pronuclei zygotes? METHODS Retrospective cohort analysis in a single, academic in vitro fertilization (IVF) center from March 2018 to June 2021. Cohorts were separated by fertilization as either a 2 pronuclear zygote (2PN) or micro 3 pronuclear zygote (micro 3PN). PGT-A was performed to identify embryonic ploidy rates in embryos created from micro 3PN zygotes. The clinical outcomes of all transferred euploid micro 3PN zygotes were evaluated from frozen embryo transfer (FET) cycles. RESULTS During the designated study period, 75,903 mature oocytes were retrieved and underwent ICSI. Of these, 60,161 were fertilized as 2PN zygotes (79.3%) and 183 fertilized as micro 3PN zygotes (0.24%). Of the micro 3PN-derived embryos that underwent biopsy, 27.5% (n=11/42) were deemed euploid by PGT-A, compared to 51.4% (n=12,301/23,923) of 2PN-derived embryos, p=0.06. Four micro 3PN-derived embryos were transferred in subsequent single euploid FET cycles, which includes one live birth and one ongoing pregnancy. CONCLUSION Micro 3PN zygotes that develop to the blastocyst stage and meet the criteria for embryo biopsy have the potential to be euploid by preimplantation genetic testing for aneuploidy (PGT-A) and if selected for transfer can achieve a live birth. Although there are a significantly lower number of micro 3PN embryos that make it to blastocyst biopsy, the potential to continue to culture abnormally fertilized oocytes may give these patients a chance at pregnancy that they previously did not have.
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Affiliation(s)
- Chelsea Canon
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, 9th Floor, 1176 Fifth Avenue, New York, NY, 10029, USA.
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA.
| | - Anabel Thurman
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Albert Li
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Carlos Hernandez-Nieto
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Joseph A Lee
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Rose Marie Roth
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Richard Slifkin
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Christine Briton-Jones
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Daniel Stein
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, 9th Floor, 1176 Fifth Avenue, New York, NY, 10029, USA
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
| | - Alan B Copperman
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, 9th Floor, 1176 Fifth Avenue, New York, NY, 10029, USA
- Reproductive Medicine Associates of New York, 635 Madison Avenue, 10th Floor, New York, NY, 10022, USA
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Shelley DL, Hernandez-Nieto C, Gounko D, Lee JA, Bar-Chama N, Roth RM, Briton-Jones C, Copperman AB, Slifkin RE. A RETROSPECTIVE ANALYSIS OF CHYMOTRYPSIN USE FOR IVF SPERM PREPARATION AND ITS EFFECTS ON FERTILIZATION, BLASTULATON AND PLOIDY. Fertil Steril 2022. [DOI: 10.1016/j.fertnstert.2022.08.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hernandez-Nieto C, Lee J, Alkon-Meadows T, Briton-Jones C, Sandler B, Copperman A, Mukherjee T. Biological relevance of trophectoderm morphology: initial β-hCG measurements correlate with trophectoderm grading on euploid frozen embryo transfers. J Assist Reprod Genet 2022; 39:2051-2059. [PMID: 35751829 PMCID: PMC9475011 DOI: 10.1007/s10815-022-02553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/07/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To analyze the correlation between TE grading and initial β-hCG serum level after single euploid embryo transfer. Secondarily, to explore the association between TE grading with subsequent IVF outcomes. DESIGN Retrospective cohort analysis. SETTING Single, academic, private infertility and assisted reproductive care institute. PATIENTS OR OTHER PARTICIPANTS Infertility patients who underwent a single euploid embryo transfer that resulted in a positive pregnancy test. INTERVENTION(S) β-hCG measurements. MAIN OUTCOME MEASURE(S) Correlation between TE grade with first β-hCG measurement. Second outcome measurements included ongoing pregnancy, biochemical pregnancy loss, and clinical pregnancy loss rates. RESULTS 2,798 cases were analyzed. A significant difference in initial β-hCG measurement among groups (TE A: median 143.4 mIU/mL IQR 79.2-211.2; TE B: 119 mIU/mL IQR 57.1-177.8; TE C: 82.4 mIU/mL IQR 36.3-136.4, p ≤ 0.0001) was observed. There was a significant correlation found between the TE grade and β-hCG measurements (p ≤ 0.0001, r2 = 0.10). TE grade was not associated with higher odds of biochemical pregnancy loss (TE A vs. TE B: aOR 1.01 CI95% 0.97-1.05; TE A vs. TE C: aOR 1.03 CI95% 0.98-1.08), or higher odds of clinical pregnancy loss (TE A vs. TE B: aOR 1.02 CI95% 0.98-1.05; TE A vs. TE C: aOR 1.03 CI95% 0.98-1.07). CONCLUSIONS In patients with euploid embryos, TE grade correlates with the first pregnancy test measurement of β-hCG. We propose this finding helps to appoint a relevant link between morphology assessment and early embryo development in vivo.
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Affiliation(s)
- Carlos Hernandez-Nieto
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA.
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Joseph Lee
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tamar Alkon-Meadows
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christine Briton-Jones
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin Sandler
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan Copperman
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tanmoy Mukherjee
- Reproductive Medicine Associates of New York, 635 Madison Ave, Floor 10th, New York City, NY, 10022, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Friedenthal J, Pan S, Gounko D, Briton-Jones C, Lee J, Copperman A. Rate of Post-Fertilization Mitotic Activity Predicts Embryonic Competence via Next Generation Sequencing: An Analysis of 39,301 Cleavage Stage Embryos. JBRA Assist Reprod 2021; 25:586-591. [PMID: 34542251 PMCID: PMC8489816 DOI: 10.5935/1518-0557.20210051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective To investigate the association between cleavage stage development, embryonic competence, and euploidy in patients undergoing in vitro fertilization (IVF) with subsequent next generation sequencing. Methods The retrospective cohort study included patients at an academic fertility center who underwent IVF with at least one cleavage stage embryo from 2016 to 2019. Embryos were analyzed as slow (<6 cells), intermediate (6-8 cells), or fast (>8 cells); day 3 cell count was also analyzed as a continuous variable. Primary outcomes were blastulation rate, biopsied blastocyst rate, and euploid rate. Odds of blastulation, biopsy, and euploidy were also calculated. Additionally, we modeled the predicted probability of an embryo reaching blastulation, biopsy, and euploidy based on cleavage stage development. Results When compared with intermediate and slow cohorts, fast cleaving embryos had significantly higher rates of blastulation (82.70% vs. 75.13 vs. 42.48%), biopsy (55.04% vs. 44.00% vs. 14.98%), and euploidy (50.65% vs. 47.93% vs. 48.05%). After adjustment for covariates, there was a significant association between cleavage stage development and odds of blastulation (OR 1.38, 95% CI 1.29-1.48), biopsy (OR 1.42, 95% CI 1.34-1.51), and euploidy (OR 1.08, 95% CI 1.01-1.17). Finally, we observed significant associations between cleavage stage development and predicted probability of reaching blastulation (OR 1.29, 95% CI 1.27-1.32), biopsy (OR 1.24, 95% CI 1.22-1.26), and euploidy (OR 1.02, 95% CI 1.01-1.04). Conclusions Cleavage stage embryos with greater mitotic activity perform as well as or better than intermediate or slower cleaving embryos. Rapidly cleaving embryos have high rates of euploidy and significant clinical potential.
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Affiliation(s)
- Jenna Friedenthal
- Department of Obstetrics, Gynecology, and Reproductive Science. Icahn School of Medicine at Mount Sinai. New York, NY 10029, USA
| | - Stephanie Pan
- Department of Obstetrics, Gynecology, and Reproductive Science. Icahn School of Medicine at Mount Sinai. New York, NY 10029, USA
| | - Dmitry Gounko
- Reproductive Medicine Associates of New York. New York, NY 10022, USA
| | - Christine Briton-Jones
- Department of Obstetrics, Gynecology, and Reproductive Science. Icahn School of Medicine at Mount Sinai. New York, NY 10029, USA
| | - Joseph Lee
- Reproductive Medicine Associates of New York. New York, NY 10022, USA
| | - Alan Copperman
- Department of Obstetrics, Gynecology, and Reproductive Science. Icahn School of Medicine at Mount Sinai. New York, NY 10029, USA
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Friedenthal J, Ellis E, Lee JA, Briton-Jones C, Buyuk E, Beaumont K, Sebra RP, Schadt E, Copperman AB. SINGLE CELL DNA SEQUENCING OF WHOLE HUMAN BLASTOCYSTS: NOVEL INSIGHTS INTO THE PHENOMENON OF EMBRYONIC MOSAICISM. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Oliva M, Briton-Jones C, Gounko D, Lee JA, Copperman AB, Sekhon L. Factors associated with vitrification-warming survival in 6167 euploid blastocysts. J Assist Reprod Genet 2021; 38:2671-2678. [PMID: 34309745 DOI: 10.1007/s10815-021-02284-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To understand the clinical factors associated with embryo survival after vitrification in a cohort of human blastocysts screened by preimplantation genetic testing for aneuploidy (PGT-A). METHODS Patient demographic, embryo, and cycle characteristics associated with failed euploid blastocyst survival were compared in a cohort of women (n = 6167) who underwent IVF-PGT-A. RESULTS Compared to those that survived warming, vitrified euploid embryos that failed to survive after warming came from IVF cycles with significantly higher estradiol levels at time of surge (2754.8 ± 1390.2 vs. 2523.1 ± 1190.6 pg/mL, p = 0.03), number of oocytes retrieved (19.6 ± 10.7 vs. 17.5 ± 9.8, p = 0.005), and basal antral follicle count (BAFC) (15.3 ± 8.5 vs. 13.9 ± 7.2, p = 0.05). Euploid embryos were less likely to survive warming if they came from cycles before 2015 (24.6% vs. 13.2%, p < 0.001), were cryopreserved on day 7 versus day 5 or 6 (9.1% vs. 3.0%, p < 0.001), underwent two trophectoderm biopsies (6.9% vs. 2.3%, p < 0.001), had a grade C inner cell mass (15.4% vs. 7.7%, p < 0.001), or were fully hatched (41.1% vs. 12.2%, p < 0.001). In the multivariate model, which controlled for relevant confounders, the association between decreased survival and increased BAFC, year of IVF cycle, double trophectoderm biopsy, and fully hatched blastocysts remained statistically significant. CONCLUSION Euploid embryos that are fully hatched at time of vitrification, come from patients with high ovarian reserve, or require repeat trophectoderm biopsy are less likely to survive vitrification-warming. Our results provide a framework for reproductive counseling and offer realistic expectations to patients about the number of embryos needed to achieve family building goals.
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Affiliation(s)
- Margeaux Oliva
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, Klingenstein Pavilion, 1176 Fifth Ave., 9th Floor, New York, NY, 10029, USA.
| | - Christine Briton-Jones
- Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Dmitry Gounko
- Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Joseph A Lee
- Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Alan B Copperman
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, Klingenstein Pavilion, 1176 Fifth Ave., 9th Floor, New York, NY, 10029, USA.,Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
| | - Lucky Sekhon
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, Klingenstein Pavilion, 1176 Fifth Ave., 9th Floor, New York, NY, 10029, USA.,Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA
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Briton-Jones C, Copperman AB, Chang S, Lee JA, Steffan S, Sinha AU, Buyuk E. X INACTIVE SPECIFIC TRANSCRIPT (XIST) AND ANTISENSE TSIX EXPRESSION IN SIBLING EUPLOID HUMAN BLASTOCYSTS: INSIGHTS INTO HUMAN X CHROMOSOME INACTIVATION. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Briton-Jones C, Sekhon L, Allette K, Ellis E, Wang YC, Lee JA, Smith ML, Schadt E, Sebra RP, Copperman AB. SEPT12 EXPRESSION IN HUMAN TROPHECTODERM CELLS: INSIGHT INTO EMBRYONIC ARREST. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Briton-Jones C, Buyuk E, Chang S, Lee JA, Steffan S, Sinha AU, Copperman AB. TRANSCRIPTOMIC EVIDENCE OF SEXUAL DIMORPHISM IN EARLY HUMAN BLASTOCYSTS. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Friedenthal J, Lee JA, Caswell W, Stratton MO, Briton-Jones C, Copperman AB. DOES SHIPPING IMPACT CRYO-SURVIVAL OR USABLE EMBRYO RATES DERIVED FROM VITRIFIED DONOR OOCYTES? Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Aharon D, Gounko D, Roth RM, Slifkin R, Briton-Jones C, Lee JA, Copperman AB. PREDICTORS AND CLINICAL SIGNIFICANCE OF RETAINED SINGLE EUPLOID EMBRYOS. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hernandez-Nieto C, Lee JA, Alkon T, Luna-Rojas M, Briton-Jones C, Bar-Chama N, Copperman AB, Sandler B. Sedimentation versus surgery: testicular and ejaculated sperm result in similar IVF outcomes in patients with cryptozoospermia. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hernandez-Nieto C, Briton-Jones C, Stein DE, Mukherjee T, Sandler B, Copperman AB. Enhancing reproductive opportunities: the biologic potential of vitrified in-vitro matured oocytes. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Briton-Jones C, Friedenthal J, Chang S, Nazem TG, Gounko D, Lee JA, Copperman AB. Proportion of patients detected with subclinical hypothyroidism is independent of time of blood draw. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.1328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nazem TG, Beaumont K, Briton-Jones C, Lee JA, Sebra RP, Copperman AB. Single-cell mitochondrial staining of human blastocysts. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Briton-Jones C, Sekhon L, Ellis E, Lee JA, Schadt EE, Sebra RP, Copperman AB. Characterizing meiotic and mitotic errors in the inner cell mass and trophectoderm of poor quality preimplantation embryos. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Friedenthal J, Gounko D, Lee JA, Briton-Jones C, Copperman AB, Grunfeld L. Is the number of blastocyct morphologic evaluations (BMA) on day 6 correlated with day 7 embryonic competence? Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hernandez-Nieto C, Lee JA, Luna-Rojas M, Alkon T, Briton-Jones C, Bar-Chama N, Copperman AB, Sandler B. Surgical sperm extraction vs. semen centrifugation: method of spermatozoa recovery does not correlate with euploidy rates in patients with cryptozoospermia. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Friedenthal J, Gounko D, Lee JA, Briton-Jones C, Copperman AB. Paternal contribution to early embryonic development in severe male factor patients. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hernandez-Nieto C, Lee JA, Briton-Jones C, Bar-Chama N, Sandler B, Copperman AB. Sperm DNA fragmentation indices are not correlated with blastulation or euploidy rates in patients undergoing IVF with PGT-A. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sekhon L, Feuerstein J, Pan S, Overbey J, Lee JA, Briton-Jones C, Flisser E, Stein DE, Mukherjee T, Grunfeld L, Sandler B, Copperman AB. Endometrial preparation before the transfer of single, vitrified-warmed, euploid blastocysts: does the duration of estradiol treatment influence clinical outcome? Fertil Steril 2019; 111:1177-1185.e3. [PMID: 31029432 DOI: 10.1016/j.fertnstert.2019.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate whether the duration of estrogen administration before euploid embryo transfer affects clinical outcome. DESIGN Retrospective cohort study. SETTING Private, academic fertility center. PATIENT(S) Patients (n = 1,439) undergoing autologous freeze-only in vitro fertilization with preimplantation genetic testing (PGT) followed by endometrial preparation with estrogen and progesterone in a frozen, euploid blastocyst transfer cycle. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Primary outcome was live birth, and secondary outcomes included implantation, clinical pregnancy, early pregnancy loss, live birth, infant birthweight, low birth weight, infant gestational age at delivery, and preterm birth. RESULT(S) The duration of estrogen administration (mean: 17.5 ± 2.9 days; range: 10-36 days) before frozen embryo transfer did not impact implantation (odds ratio [OR] 0.99; 95% confidence interval [CI], 0.95-1.03), clinical pregnancy (OR 0.98; 95% CI, 0.94-1.01), early pregnancy loss (OR 1.03; 95% CI, 0.95-1.12), or live birth (OR 0.99; 95% CI, 0.95-1.03). The duration of estrogen exposure did not affect infant birthweight (in grams) (β= -10.65 ± 8.91) or the odds of low birth weight (OR 0.87; 95% CI, 0.68-1.13). For every additional day of estrogen administration, we observed a reduction in gestational age at delivery (in weeks) (β= -0.07 ± 0.03), but the odds of preterm delivery were not affected (OR 1.05; 95% CI, 0.95-1.17). CONCLUSION(S) Variation in the duration of estradiol supplementation before progesterone initiation does not impact frozen, euploid blastocyst transfer outcome. The duration of estrogen administration was inversely correlated with gestational age at delivery, but this did not translate into an increase in preterm delivery. Further studies are required on the downstream effects of endometrial preparation on the placental-endometrium interface.
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Affiliation(s)
- Lucky Sekhon
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York.
| | | | - Stephanie Pan
- Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Jessica Overbey
- Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Joseph A Lee
- Reproductive Medicine Associates of New York, New York, New York
| | | | - Eric Flisser
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Daniel E Stein
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Tanmoy Mukherjee
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Lawrence Grunfeld
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Benjamin Sandler
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
| | - Alan B Copperman
- Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics and Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai West, New York, New York
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Nazem TG, Chang S, Lee JA, Briton-Jones C, Copperman AB, McAvey B. Understanding the Reproductive Experience and Pregnancy Outcomes of Lesbian Women Undergoing Donor Intrauterine Insemination. LGBT Health 2019; 6:62-67. [PMID: 30848719 DOI: 10.1089/lgbt.2018.0151] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The study purpose was to evaluate the reproductive experience, specifically cycle characteristics and treatment outcomes, of lesbian women. In addition, we aimed to determine whether there are differences in pregnancy outcomes when comparing lesbian women undergoing ovulation induction (OI) versus natural cycles with donor intrauterine insemination (IUI), as well as lesbian and heterosexual women undergoing the same assisted reproductive technology treatment. METHODS This was a retrospective cohort study including women who underwent an IUI with cryopreserved sperm between 2006 and 2018. The primary outcome of interest was clinical pregnancy (CP) rate. RESULTS A total of 216 lesbian women (451 natural cycles and 441 OI cycles) and 584 heterosexual women (1177 natural cycles and 1238 OI cycles) were included in the study. Thirty percent of lesbian women had a hysterosalpingogram as part of their initial workup. Approximately 40% of lesbian women who underwent OI/IUI had previously undergone at least one natural cycle/IUI. There was no significant difference in CP rate when comparing lesbian women and heterosexual women undergoing natural or OI/IUI, or when comparing lesbian women who underwent natural versus OI/IUI cycles. However, there was a significantly higher multiple gestation rate among lesbian women undergoing OI compared with those undergoing natural cycles (11.8% vs. 0%, p = 0.01). CONCLUSION This large study showed that while pregnancy outcomes were similar between groups, the multiple gestation rate was higher in lesbian women undergoing OI compared with lesbian women undergoing natural cycles.
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Affiliation(s)
- Taraneh Gharib Nazem
- 1 Reproductive Medicine Associates of New York, New York, New York.,2 Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sydney Chang
- 1 Reproductive Medicine Associates of New York, New York, New York.,2 Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joseph A Lee
- 1 Reproductive Medicine Associates of New York, New York, New York
| | | | - Alan B Copperman
- 1 Reproductive Medicine Associates of New York, New York, New York.,2 Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Beth McAvey
- 1 Reproductive Medicine Associates of New York, New York, New York.,3 Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai West, New York, New York
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Nazem TG, Sekhon L, Lee JA, Overbey J, Pan S, Duke M, Briton-Jones C, Whitehouse M, Copperman AB, Stein DE. The correlation between morphology and implantation of euploid human blastocysts. Reprod Biomed Online 2019; 38:169-176. [DOI: 10.1016/j.rbmo.2018.10.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 10/04/2018] [Accepted: 10/09/2018] [Indexed: 11/29/2022]
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Sekhon L, Allette K, Ellis E, Wang Y, Lee J, Briton-Jones C, Schadt E, Sebra R, Copperman A. The morula stage transcriptome is characterized by marked upregulation of genes that mediate key mitochondrial functions. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sekhon L, Lee J, Wang Y, Briton-Jones C, Schadt E, Sebra R, Copperman A. Normal growth versus early developmental arrest of the human embryo: understanding molecular network perturbations. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nazem T, Sekhon L, Lee J, Briton-Jones C, Bar-Chama N, Copperman A. Seasonal variation of semen quality from over 100,000 analyzed samples. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nazem T, Beaumont K, Briton-Jones C, Lee J, Sebra R, Copperman A. Single-cell mitochondrial staining and ribonucleic acid (RNA) sequencing of human blastocysts. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sekhon L, Ellis E, Nazem T, Wang Y, Lee J, Briton-Jones C, Schadt E, Sebra R, Copperman A. Understanding the scope and significance of mosaicism in human preimplantation embryos. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sekhon L, Hernandez-Nieto C, Nazem T, Chang S, Lee J, Briton-Jones C, Copperman A. Molecular evidence demonstrates that anti-mullerian hormone predicts quantity, not quality, of oocytes. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sekhon L, Feuerstein J, Nazem T, Briton-Jones C, Lee J, Grunfeld L, Copperman A. The incidence of mosaicism is not associated with advanced maternal age or diminished ovarian reserve. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sekhon L, Nazem T, Lee J, Briton-Jones C, McAvey B, Copperman A. The association between aneuploidy and the rate of blastocyst development is age dependent. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Briton-Jones C, Sekhon L, Lee J, Feuerstein J, Slifkin R, Duke M, Copperman A. Targeted next generation sequencing (NGS) identifies higher proportions of monosomies in the larger chromosome groups than QPCR. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sekhon L, Briton-Jones C, Lee J, Slifkin R, Duke M, Copperman A, Mukherjee T. Blastocyst collapse and downgrading of inner cell mass morphology score after vitrification-warming is predictive of reduced implantation and increased early pregnancy loss. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sekhon L, Lee J, Duke M, Briton-Jones C, Flisser E, Copperman A. The duration of cryostorage of biopsied embryos neither impacts implantation potential nor surrogate markers of placentation. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Briton-Jones C, Sekhon L, Lee J, Feuerstein J, Moschini R, Duke M, Copperman A. The mechanics of aneuploidy: chromosome structure and patient age. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nazem T, Sekhon L, Hernandez-Nieto C, Lee J, Briton-Jones C, Copperman A, Stein D. Chronological age is better than physiological age at predicting likelihood of producing euploid embryos. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nazem T, Sekhon L, Lee J, Overbey J, Pan S, Whitehouse M, Duke M, Briton-Jones C, Copperman A, Stein D. How does morphologic assessment correlate with implantation of euploid embryos? Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rodriguez-Purata J, Gingold J, Lee J, Whitehouse M, Slifkin R, Briton-Jones C, Copperman A, Sandler B. Hatching status before embryo transfer is not correlated with implantation rate in chromosomally screened blastocysts. Hum Reprod 2016; 31:2458-2470. [PMID: 27619770 DOI: 10.1093/humrep/dew205] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/03/2016] [Accepted: 07/21/2016] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do the reproductive outcomes from the transfer of fully hatched (FH) blastocysts differ from those of not fully hatched (NFH) blastocysts? SUMMARY ANSWER Biochemical pregnancy rate (BPR), implantation rate (IR), live birth rate (LBR) and early pregnancy loss (EPL) rate are similar in FH and NFH single euploid blastocyst embryo transfers. WHAT IS KNOWN ALREADY The use of extended culture and PGS often leads to transfer of an embryo that is well developed and frequently FH from the zona pellucida. Without the protection of the zona, an FH embryo could be vulnerable to trauma during the transfer procedure. To date, no other study has evaluated the reproductive competence of an FH blastocyst transfer. STUDY DESIGN, SIZE, DURATION The retrospective study included 808 patients who underwent 808 cycles performed between September 2013 and July 2015 at a private academic IVF center. Of these, 436 cycles entailed transfer of a NFH blastocyst (n = 123 fresh transfer, n = 313 frozen/thawed embryo transfer (FET)) and 372 cycles entailed transfer of an FH blastocyst (n = 132 fresh, 240 FET). Fresh and FET cycles and associated clinical outcomes were considered separately. LBR was defined as the delivery of a live infant after 24 weeks of gestation. PARTICIPANTS/MATERIALS, SETTING, METHOD Trophectoderm biopsies were performed on Day 5 (d5) or 6 (d6) for embryos meeting morphology eligibility criteria (set at ≥3BC). Morphologic grading was determined using a modified Gardner-Schoolcraft scale prior to transfer. A single euploid embryo was selected for transfer per cycle on either the morning of d6, for fresh transfers or 5 days after progesterone supplementation for patients with transfer in an FET cycle. Embryos were classified as NFH (expansion Grade 3, 4 or 5) or FH (expansion Grade 6) cohorts. The main outcome measure was IR. MAIN RESULTS AND THE ROLE OF CHANCE In the fresh transfer group, IR was similar between NFH and FH cycles (53.7% versus 55.3%, P = 0.99, odds ratio (OR) 0.9; 95% confidence interval (CI) 0.6-1.5). Secondary outcomes were also statistically similar between groups: BPR (65.9% versus 66.7%, OR 1.0; 95% CI: 0.6-1.6), LBR (43.1% versus 47.7%, P = 0.45, OR 1.2; 95% CI: 0.7-1.9) and EPL rate (22.8% versus 18.2%, OR 1.3; 95% CI: 0.7-2.4). After adjusting for age, BMI, endometrial thickness at the LH surge and oocytes retrieved in a logistic regression (LR) model, the hatching status remained not associated with IR (P > 0.05). In the FET cycles, IR was similar between NFH and FH cycles (62.6% versus 61.7%, OR 1.0; 95% CI: 0.7-1.5). Secondary outcomes were similar between groups: BPR (74.1% versus 72.9%, respectively, OR 1.1; 95% CI: 0.7-1.6), LBR (55.0% versus 50.0%, OR 0.8; 95% CI: 0.6-1.1) and EPL rate (18.9% versus 22.9%, respectively, OR 0.8; 95% CI: 0.5-1.2). After adjusting for age, BMI, endometrial thickness at the LH surge and oocytes retrieved in an LR model, the hatching status was not shown to be associated with implantation (P > 0.05). LIMITATIONS, REASONS FOR CAUTION Limitations include the retrospective design and data from a single institution. Additionally, the study was limited to patients that developed high-quality blastocysts suitable for biopsy. WIDER IMPLICATIONS OF THE FINDINGS The results suggest that FH embryos are not more fragile or less likely to implant when compared to NFH counterparts. We found no evidence of altered IR or other clinical outcomes in the transfer of FH euploid embryos. STUDY FUNDING/COMPETING INTERESTS JG is funded by MSTP grant T32 GM007280 (NIH). No additional funding was received. There are no conflicts of interest to declare..
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Affiliation(s)
- Jorge Rodriguez-Purata
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA
| | - Julian Gingold
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA
| | - Joseph Lee
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA
| | - Michael Whitehouse
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA
| | - Richard Slifkin
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA
| | - Christine Briton-Jones
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA
| | - Alan Copperman
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA.,Obstetrics, Gynecology and Re productive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, 1176 Fifth Avenue, 9th Floor, New York, NY 10029, USA
| | - Benjamin Sandler
- Reproductive Medicine Associates of New York, 635 Madison Ave 10th Floor, New York, NY 10022, USA.,Obstetrics, Gynecology and Re productive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, 1176 Fifth Avenue, 9th Floor, New York, NY 10029, USA
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Nonez H, Rodriguez-Purata J, Lee J, Whitehouse M, Slifkin R, Moschini R, Duke M, Copperman A, Sandler B, Briton-Jones C. Aneuploidy rates are not increased in patients with recurrent pregnancy loss. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.1086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sekhon L, Rodriguez-Purata J, Lee J, Briton-Jones C, Copperman A. Are reproductively competent blastocysts with poor morphological grade at an increased risk for adverse perinatal outcome? Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kudesia R, Bhasin D, Lee J, Briton-Jones C, Daneyko M, Collura B, Copperman A. How can we make a good experience even better: ways to enhance the fertility journey. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rodriguez-Purata J, Sekhon L, Lee J, Whitehouse M, Slifkin R, Duke M, Briton-Jones C, Copperman A, Sandler B. Fertilization rates are not improved by use of ICSI versus conventional insemination in IVF cases using donor sperm. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ribeiro MA, Gameiro LFO, Scarano WR, Briton-Jones C, Kapoor A, Rosa MB, El Dib R. Aromatase inhibitors in the treatment of oligozoospermic or azoospermic men: a systematic review of randomized controlled trials. JBRA Assist Reprod 2016; 20:82-8. [PMID: 27244767 DOI: 10.5935/1518-0557.20160019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study as to analyze published evidence regarding the effectiveness of aromatase inhibitor therapy on improving spermatogenesis in infertile men. We carried out a systematic review of randomized controlled trials. The date of the most recent search was October 4, 2015. Two authors independently selected relevant clinical trials, assessing their methodological quality and extracting data. Three studies were included in this review with a total of 100 participants; however, we were able to include data from only 54 participants in the analysis. In the representation of meta-analysis with a single study comparing testolactone versus placebo, related to the hormone concentrations, there was a statistically significance difference favoring the use of testolactone for Luteinizing Hormone (LH); Estrogen (E2); free Testosterone (free T); free Estrogen (free E2); 17-Hydroxyprogesterone (17OHP); prolactin (PRL). In another analysis from a single study comparing letrozole versus anastrozole, there was also a statistically significance difference favoring the use of letrozole for the increase in both the sperm count and LH. There is only low quality evidence regarding the effectiveness of aromatase inhibitor therapy in infertile men. Further trials are needed with standardized interventions and outcomes.
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Affiliation(s)
- Mariana A Ribeiro
- Department of Morphology, Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Luís F O Gameiro
- Physiotherapy Service School of Medicine, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Wellerson R Scarano
- Department of Morphology, Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | | | - Anil Kapoor
- Genito-Urinary Oncology Program, Juravinski Cancer Centre, Hamilton, ON, Canada.,McMaster Institute of Urology, at St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Mauro B Rosa
- Hospital do Coração (HCOR), Sao Paulo,SP, Brazil
| | - Regina El Dib
- McMaster Institute of Urology, at St. Joseph's Healthcare, Hamilton, ON, Canada.,Department of Anesthesiology, Faculdade de Medicina de Botucatu (FMB), Sao Paulo State University, UNESP, Botucatu, SP, Brazil
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Sekhon L, Mukherjee T, Moschini RM, Lee JA, Briton-Jones C, Copperman AB. Preimplantation genetic testing of embryos in donor egg cycles is associated with a decrease in the number of embryos transferred and an improved implantation rate. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2015.12.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Briton-Jones C, Conway D, Davis P, Bayles A, Foulk R, Gurtcheff S. Elective single embryo transfer (eSET) usage in patients at high risk of multiple pregnancies is dependent on the treating physician. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ribeiro MA, dos Reis MB, de Moraes LN, Briton-Jones C, Rainho CA, Scarano WR. Defining suitable reference genes for RT-qPCR analysis on human sertoli cells after 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure. Mol Biol Rep 2014; 41:7063-6. [DOI: 10.1007/s11033-014-3637-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 07/21/2014] [Indexed: 10/25/2022]
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Amin M, Simerman A, Cho M, Singh P, Briton-Jones C, Hill D, Grogan T, Elashoff D, Clarke NJ, Chazenbalk GD, Dumesic DA. 21-Hydroxylase-derived steroids in follicles of nonobese women undergoing ovarian stimulation for in vitro fertilization (IVF) positively correlate with lipid content of luteinized granulosa cells (LGCs) as a source of cholesterol for steroid synthesis. J Clin Endocrinol Metab 2014; 99:1299-306. [PMID: 24423334 PMCID: PMC3973780 DOI: 10.1210/jc.2013-3204] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Mineralocorticoid synthesis by the nonhuman primate periovulatory follicle enhances luteinization. Whether a similar event occurs in women undergoing in vitro fertilization (IVF) is unknown. OBJECTIVE The objective of the study was to determine whether human luteinized granulosa cells (LGCs) produce mineralocorticoids derived from 21-hydroxylase activity and also express mRNA for 21-hydroxylase and the mineralocorticoid receptor. DESIGN This was a prospective cohort study. SETTING The study was conducted at an academic center. PATIENTS LGC lipid content and follicle fluid (FF) hormone analysis was performed on 27 nonobese IVF women. LGCs from six additional nonobese IVF women were used for gene expression studies. INTERVENTION At oocyte retrieval, FF was aspirated from the first follicle (≥16 mm in size) of each ovary and pooled LGCs were collected. MAIN OUTCOME MEASURES FF steroid analysis was performed by liquid chromatography-tandem mass spectrometry. LGCs were stained with lipid fluorescent dye BODIPY FL C16 to estimate lipid content by confocal microscopy as a cholesterol source for steroidogenesis in vivo. Quantitative real-time PCR was performed using LGCs to detect 21-hydroxylase and mineralocorticoid receptor mRNA expression. Pearson correlation coefficients determined associations between FF steroid levels and LGC lipid content. RESULTS FF levels of the 21-hydroxylase-derived steroids, 11-deoxycorticosterone [DOC, 39.97, median (13.94-63.02) ng/mL] and 11-deoxycortisol [11DOC, 2.07 (0.69-5.01) ng/mL], along with the 21-hydroxylase precursor 17-hydroxyprogesterone [1268.21 (493.26-3558.39) ng/mL], positively correlated with LGC lipid content (84 ± 43 fluorescent units/sample) (P ≤ .05, all steroids). 21-Hydroxylase and mineralocorticoid receptor mRNA expression was detected in LGCs. CONCLUSIONS Human LGCs likely synthesize 21-hydroxylase-derived mineralocorticoids from cholesterol-containing lipid in vivo to promote postovulatory luteinization via mineralocorticoid receptor-mediated events.
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Affiliation(s)
- Marli Amin
- Department of Obstetrics and Gynecology (M.A., A.S., M.C., P.S., G.D.C., D.A.D.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California 90024; Department of Medicine Statistics Core (T.G., D.E.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, Los Angeles, California 90095; Quest Diagnostics Nichols Institute (N.J.C.), San Juan Capistrano, California 92675; and ART Reproductive Center (C.B.-J., D.H.), Beverly Hills, California 90210
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Amin M, Singh P, Briton-Jones C, Hill D, Chazenbalk G, Dumesic D. Mineralocorticoid production by mural granulosa cells (MGCs) as a modulator of steroidogenesis during ovarian stimulation for in vitro fertilization (IVF). Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Conway D, Foulk R, Gurtcheff S, Bayles A, Davis P, Briton-Jones C. The effect of high estradiol levels on pregnancy outcomes during in-vitro fertilization. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cook H, Briton-Jones C, Hill D. Low utilization of extra embryos in donor oocyte in vitro fertilization cycles: an ethical dilemma to donor management. J Assist Reprod Genet 2013; 30:1031-4. [PMID: 23812846 DOI: 10.1007/s10815-013-0038-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/20/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To explore outcomes of donor In Vitro Fertilization (IVF) cycles with regards to cryopreservation and utilization of extra embryos after fresh transfer. METHODS A database search was performed to identify all consecutive fresh donor oocyte cycles from January 1, 2000 to December 31, 2010 at a private fertility laboratory. Parameters analyzed included: number of oocytes retrieved, number of patients choosing embryo cryopreservation, number of patients returning for frozen embryo transfer (FET), and pregnancy outcomes. RESULTS A total of 1070 fresh oocyte donor cycles were identified. Average number of oocytes retrieved was 16.9 ± 7.9, and average number of embryos transferred was 2.3 ± 0.96. Sixty-six percent of patients cryopreserved excess embryos following fresh transfer, and only 40 % of these patients ultimately returned for FET. Patients who conceived in their fresh cycle were much less likely to return for FET than those who did not (25 % v 65 %, p < 0.001), however chance of conceiving with FET was no different between these two groups (38 % v 38 %, NS). CONCLUSIONS An unexpectedly low number of patients undergoing a donor oocyte IVF cycle will ultimately return to utilize extra embryos from their fresh cycle. This is concerning considering the high numbers of oocytes retrieved and the known complications from hyperstimulation, especially in light of the relatively high pregnancy rates associated with donor cycles. This raises concerns not only for donor management, but also raises ethical dilemmas when considering the large numbers of remaining embryos that will never be utilized.
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Affiliation(s)
- Heather Cook
- UCLA David Geffen School of Medicine, 10833 Le Conte Ave, Box 951740, Los Angeles, CA, 90095, USA,
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