P-763 effect of duration of cryo-storage of vitrified embryos on obstetric and perinatal outcomes

Study question

Does the duration of cryo-storage of vitrified embryos affect obstetric and perinatal outcomes?

Summary answer

Duration of cryo-storage with an open vitrification system did not affect obstetric and perinatal outcomes.

What is known already

Frozen-thawed blastocyst transfer has been performed widely with improvement of embryo culture conditions and cryopreservation techniques. Although blastocyst vitrification has become an essential method to improve clinical outcomes of IVF, there has been little study into the relationship between a long duration of cryo-storage in liquid nitrogen and obstetric and perinatal outcomes.

Study design, size, duration

This retrospective study was conducted at Kyono ART Clinic from January 2007 to December 2020. This study includes a total of 1053 singletons derived from 2461 frozen-thawed blastocyst transfers in 2461 patients. Steel’s multiple comparison test was performed for clinical and perinatal outcomes with cases of cryo-storage of less than 3 months as a control group. P < 0.05 was considered statistically significant.

Participants/materials, setting, methods

The subjects are patients who underwent their first single frozen-thawed blastocyst transfer (FBT) with an open vitrification system. Females >40 years old at cryopreservation and those who underwent preimplantation genetic testing were excluded. According to cryo-storage duration, patients were grouped as follows: group A, 0-3 months (1255 cycles); group B, 3-6 months (1008 cycles); group C, 6-12 months (162 cycles), group D, 12-24 months (36 cycles).

Main results and the role of chance

Both the mean maternal age at blastocyst cryopreservation (A: 33.7±3.6, B: 34.1±3.5, C: 34.8±3.2, D: 35.1±3.3) and the mean maternal age at FBT (A: 33.8±3.6, B: 34.4±3.5, C: 35.5±3.1, D: 36.4±3.3) in groups B, C, and D were significantly higher compared to those in group A.. There was no significant difference in the survival rate after blastocyst thawing [A: 97.4% (1256/1290), B: 98.3% (1010/1027), C: 99.4% (163/164), D: 97.2% (35/36)]. The pregnancy rate in group C was significantly lower compared to group A [A: 60.0% (752/1254), B: 61.4% (619/1008), C: 48.1% (78/162), D: 63.9% (23/36)] The gestational age of group C was significantly lower compared to group A (A: 39.5±1.8, B: 39.4±1.8, C: 38.4±3.1, D: 39.8±1.6), but there were no significant differences in live birth weight or height. There were no significant differences in congenital abnormality rate [A: 1.3% (7/541), B: 2.5% (11/440), C: 1.8% (1/56), D: 0.0% (0/16)], placental abnormalities such as placenta previa [A: 1.3% (7/541), B: 1.6% (7/440), C: 1.8% (1/56), D: 0.0% (0/16)], perinatal abnormalities such as hypertensive disorders of pregnancy or gestational diabetes [A: 6.1% (33/541), B: 8.6% (38/440), C: 1.8% (1/56), D: 6.3% (1/16)] among the four groups.

Limitations, reasons for caution

We could not provide sufficient information on confounding factors such as smoking habits, and the sample size was too small for multivariate analysis. The safety of longer storage will need to be verified as this has not been clarified in this study.

Wider implications of the findings

The pregnancy rate in group C was significantly lower than that in group A, but the effect was small: 0.065, power of 0.78. Our data suggested that the duration of cryopreservation with an open vitrification system in liquid nitrogen did not affect obstetric or perinatal outcomes.

Trial registration number

not applicable

A transportation network for human ovarian tissue is indispensable to success for fertility preservation

PURPOSE

The purpose of this study was to examine the efficacy of an ovarian tissue transportation network for fertility preservation (FP) for cancer patients in Japan.

METHODS

PubMed was searched for papers on transportation of human ovarian tissue for FP. We analyzed population, area, number of cancer patients for ovarian tissue cryopreservation (OTC), quality control/assessment and safety, cost of a cryopreservation center for the building for 30 years, and medical fees of cancer patients (operation, cryopreservation, and storage of ovarian tissue).

RESULTS

More than twenty babies have been born in Denmark and Germany through a transportation system. Up to 400 new patients a year need OTC. The fees for removal, cryopreservation, and storage for 5 years, and transplantation of ovarian tissue are around €5,000, €4,000, and €5,000, respectively. It costs more than €5 million to establish and maintain one cryopreservation center for 30 years. If we have a few cryopreservation centers in Japan, we can cryopreserve 400 patients' ovarian tissue per year by safer slow freezing and maintain quality control/assessment. We need to lighten the patients' burden for easy to use FP by a government subsidy and medical insurance coverage.

CONCLUSIONS

This model has been termed the Danish model ("the woman stays - the tissue moves"). This is truly patient-centered medicine. We can have maximum effects with the minimum burden. A transportation network like those of Denmark and Germany is the best strategy for FP in Japan. It may be the best system for cancer patients, medical staff, and the Ministry of Health, Labor, and Welfare.

Estrogen and raloxifene induce apoptosis by activating p38 mitogen-activated protein kinase cascade in synthetic vascular smooth muscle cells

Proliferation of vascular smooth muscle cells (VSMC) plays a major role as an initiating event of atherosclerosis. Although estrogen directly inhibits the proliferation of VSMC, the mechanism has not been firmly established. In addition, the effect of raloxifene on VSMC remains unknown. 17Beta-estradiol (E(2)) and raloxifene significantly inhibited the growth of VSMC under growth-stimulated conditions. Since mitogen-activated protein (MAP) kinases have been implicated in VSMC proliferation, the role of MAP kinases in both the E(2)- and raloxifene-induced growth inhibition of VSMC was studied. Both E(2) and raloxifene caused rapid, transient phosphorylation and activation of p38 that was not affected by actinomycin D and was blocked by ICI 182,780. In contrast with p38 phosphorylation, extracellular signal-regulated protein kinase (ERK) phosphorylation was significantly inhibited and c-Jun N-terminal kinase (JNK) phosphorylation was not changed by E(2). Because VSMC expressed both estrogen receptor (ER) alpha and ERbeta, it is not known which of them mediates the E(2)-induced phosphorylation of p38. Although E(2) did not affect the p38 phosphorylation in A10 smooth muscle cells, which express ERbeta but not ERalpha, transfection of ERalpha expression vector into A10 cells rendered them susceptible to induction of p38 phosphorylation by E(2). We then examined whether E(2) and raloxifene induce apoptosis through a p38 cascade. Both E(2) and raloxifene induced apoptosis under growth-stimulated conditions. The p38 inhibitor SB 203580 completely blocked the E(2)-induced apoptosis. Our findings suggest that both E(2)- and raloxifene-induced inhibition of VSMC growth is due to induction of apoptosis through a p38 cascade whose activation is mediated by ERalpha via a nongenomic mechanism.

Identification and functional analysis of the gene for type I myosin in fission yeast

BACKGROUND

Type I myosin is highly conserved among eukaryotes, and apparently plays important roles in a number of cellular processes. In the budding yeast, two myosin I species have been identified and their role in F-actin assembly has been inferred.

RESULTS

We cloned the fission yeast myo1 gene, which apparently encoded a myosin I protein. Disruption of myo1 was not lethal, but it caused growth retardation at high and low temperatures, sensitivity to a high concentration of KCl, and aberrance in cell morphology associated with an abnormal distribution of F-actin patches. An abnormal deposition of cell wall materials was also seen. Homothallic myo1Delta cells could mate, but heterothallic myo1Delta cells were poor in conjugation. Myo1p was necessary for the encapsulation of spores. The tail domain of Myo1p was pivotal for its function. Calmodulin could bind to Myo1p through the IQ domain at the neck.

CONCLUSIONS

Myo1p appears to control the redistribution of F-actin patches during the cell cycle. Loss of Myo1p function is likely to slow down the actin assembly/disassembly process, which results in a failure of the actin cycle to catch up with other events in both the mitotic and meiotic cell cycles, including extension of the conjugation tubes.

Hyaluronic acid inhibits apoptosis in granulosa cells via CD44

PURPOSE

This study was designed to examine whether hyaluronic acid (HA) inhibits apoptosis in cumulus and mural granulosa cells and to examine whether this effect of HA was mediated through CD44.

METHODS

Mural and cumulus granulosa cells were obtained from in vitro fertilization patients. The cells were cultured with various concentrations of HA or HA plus various concentrations of anti-CD44 antibody without serum supplement. After 24 hr of culture, the cells were fixed and stained with Hoechst 33258. One thousand granulosa cells of each conditions were observed by fluorescence microscopy.

RESULTS

HA inhibited apoptosis in both kinds of granulosa cells, and anti-CD44 antibody prevented this effect of HA.

CONCLUSIONS

The incidence of apoptotic granulosa cells with fragmented condensed nuclei was reduced by HA via CD44.

Moderate and severe endometriosis is associated with alterations in the cell cycle of granulosa cells in patients undergoing in vitro fertilization and embryo transfer

OBJECTIVE

To determine whether folliculogenesis is impaired in patients with endometriosis.

DESIGN

Prospective study.

SETTING

Yamagata University School of Medicine, Yamagata, Japan.

PATIENT(S)

Thirty women participating in an IVF program.

INTERVENTION(S)

The patients were divided into four groups according to the cause of their infertility: tubal factor (T), n = 7; male factor (M), n = 7; idiopathic (I), n = 7; and endometriosis (E), n = 9. Granulosa cells were obtained from the follicular fluid of each patient and analyzed by flow cytometry.

MAIN OUTCOME MEASURE(S)

The percentage of granulosa cells in each cell-cycle stage.

RESULT(S)

The mean (+/- SD) rate of apoptosis in the granulosa cells obtained from the patients with endometriosis was the highest among the four groups (T = 11.7% +/- 3.3%; M = 5.6% +/- 3.8%; I = 9.6% +/- 5.1%; and E = 18.6% +/- 9.6%). The percentage of S-phase granulosa cells was significantly higher in the patients with endometriosis than in all the other patients combined (E = 12.5% +/- 6%; T + M + I = 9.3% +/- 2.9%). The percentage of G2/M-phase granulosa cells was significantly lower in the endometriosis group than in the other three groups combined (E = 2.3% +/- 2.5%; T + M + I = 4.6% +/- 2.1%).

CONCLUSION(S)

Endometriosis impairs the cell cycle in granulosa cells. This phenomenon may have a detrimental effect on folliculogenesis.

Fission yeast Pob1p, which is homologous to budding yeast Boi proteins and exhibits subcellular localization close to actin patches, is essential for cell elongation and separation

The fission yeast pob1 gene encodes a protein of 871 amino acids carrying an SH3 domain, a SAM domain, and a PH domain. Gene disruption and construction of a temperature-sensitive pob1 mutant indicated that pob1 is essential for cell growth. Loss of its function leads to quick cessation of cellular elongation. Pob1p is homologous to two functionally redundant Saccharomyces cerevisiae proteins, Boi1p and Boi2p, which are necessary for cell growth and relevant to bud formation. Overexpression of pob1 inhibits cell growth, causing the host cells to become round and swollen. In growing cells, Pob1p locates at cell tips during interphase and translocates near the division plane at cytokinesis. Thus, this protein exhibits intracellular dynamics similar to F-actin patches. However, Pob1p constitutes a layer, rather than patches, at growing cell tips. It generates two split discs flanking the septum at cytokinesis. The pob1-defective cells no longer elongate but swell gradually at the middle, eventually assuming a lemon-like morphology. Analysis using the pob1-ts allele revealed that Pob1p is also essential for cell separation. We speculate that Pob1p is located on growing plasma membrane, possibly through the function of actin patches, and may recruit proteins required for the synthesis of cell wall.

Fission yeast protein kinase C gene homologues are required for protoplast regeneration: a functional link between cell wall formation and cell shape control

Two novel protein kinase C (n PKC) gene homologues, pck1+ and pck2+ were isolated from the fission yeast Schizosaccharomyces pombe (Toda et al. (1993) EMBO J. 12, 1987). We examined the functional differences of pck1+ and pck2+ in cell wall formation and actin organization of S. pombe. Regenerating protoplasts of a wild-type strain, single gene disruptants of pck1+ (delta pck1) and pck2+ (delta pck2) were used as a simple model to examine the functional links between PKC, cell wall formation and actin organization. Protoplasts of the wild-type strain and those of delta pck1 reverted to intact cells in osmotically stabilized liquid medium. A close spatial association between new cell wall formation and actin was observed in these two strains. In delta pck2, protoplasts did not revert to intact cells: (1) scarcely any new cell wall material was formed; (2) actin was not reorganized; and (3) nuclear division and an increase in the amount of cytoplasm were observed in the regenerating protoplasts. These findings demonstrate that the pck2+ gene has a function essential for protoplast regeneration but the pck1+ gene does not. Involvement of n PKCs in cell wall formation and actin organization was also clarified. The effect of staurosporine (a potent inhibitor of protein kinases) on regenerating protoplasts of the three strains confirmed the assumption that the pck2 protein is an in vivo target of staurosporine in the fission yeast.

[Fertility study of cefpirome sulfate in rats]

A fertility study was performed in rats by intraperitoneal administration of cefpirome sulfate (CPR) at dose levels of 0 (control), 200, 400 and 800 mg/kg/day. Male rats were treated for 60 days before mating and during the mating period. Female rats were administrated the substance from 14 days before mating to day 7 of pregnancy. The females were sacrificed on day 21 of pregnancy for examination of their fetuses. No animal died during the administration period. Loose feces were observed in both male and female animals in the 400 and 800 mg/kg/day groups. Body weight gain was suppressed in both male and female animals in the 800 mg/kg/day group and in male animals in the 400 mg/kg/day group. There were no significant differences in food and water intakes between treated and control groups. Autopsy revealed the enlargement of the caecum in males in the 200, 400 and 800 mg/kg/day groups. The kidney and adrenal weights were significantly increased in males in the 200, 400 and 800 mg/kg/day groups. Fertility and reproductive ability in both sexes, and estrus cycles in female rats were not affected by administration of CPR. There were no lethal effect and growth-inhibiting or teratogenic effects on the embryos and the fetuses. The results suggest that the non-effective dose level of CPR was lower than 200 and 200 mg/kg/day for general toxicity in male and female parent animals respectively, 800 mg/kg/day for reproductive ability in parent animals and in embryos and fetuses.

[Perinatal and postnatal study of cefpirome sulfate in rats]

A perinatal and postnatal study was performed in rats by intraperitoneal administration of cefpirome sulfate (CPR) at dose levels of 0 (control), 200, 400 and 800 mg/kg/day to dams from day 17 of pregnancy to day 21 after delivery. Twenty one or twenty two dams in each group were allowed to deliver for the postnatal examination of their offsprings. No animal died. Loose feces were observed in the 800 mg/kg/day group. Body weight gain of the dams was retarded in the 800 mg/kg/day group in the early stage of treatment. Food intake was reduced simultaneously in the 200, 400 and 800 mg/kg/day groups. Autopsy revealed the enlargement of caecum in the 800 mg/kg/day. The adrenal weight was increased in the 400 and 800 mg/kg/day groups, and the kidney weight was increased in the 800 mg/kg/day group. The body weight of pups at birth in the 800 mg/kg/day group was slightly lower than that in the control group. The body weight of male pups in the 800 mg/kg/day group decreased transiently during rearing period. However, CPR had no adverse effects on the postnatal development such as viability, differentiation, emotionality, learning ability or reproductive performance. The results suggest that the non-effective dose level of CPR is lower than 200 mg/kg/day for general toxicity, 800 mg/kg/day for reproductive ability in maternal animals and 400 mg/kg/day in offsprings respectively.

[Teratological study of cefpirome sulfate in rats]

A teratogenicity study was performed in rats by intraperitoneal or intravenous administration of cefpirome sulfate (CPR) at dose level of 0 (control), 200, 400 and 800 mg/kg/day to dams from day 7 to day 17 of pregnancy. Twenty one to twenty eight female rats in each intraperitoneal and intravenous administrated group were sacrificed on day 21 of pregnancy for examination of their fetuses, and ten to thirteen female rats in each intraperitoneal administrated group were allowed to deliver for the postnatal examination of their offsprings. In the 800 mg/kg/day intravenous administrated group, two dams out of twenty four died during administration period, however no animal died in any intraperitoneal administrated group. The doses of 400 and 800 mg/kg/day caused piloerection, diarrhea or loose feces in the both administration routes, and accelerated breathing, a decrease in spontaneous activity, systemic spasms, cataleptic symptoms and wild running in the intravenous route. The suppression of body weight gain was detected in the 800 mg/kg/day intraperitoneal administrated group and 200, 400 and 800 mg/kg/day intravenous administrated groups, however there were no significant differences in food and water intakes between treated and control groups. At autopsy, enlargement of caecum and an increase in adrenal weight were detected in the 800 mg/kg/day groups of both administration routes. Body weight of the fetuses was decreased in both sexes in the 800 mg/kg/day group and in male fetuses in the 400 mg/kg/day group, and placental weight was decreased in the 800 mg/kg/day group, in the both administration routes respectively. However, embryonal or fetal mortality and incidences of external or visceral anomalies were not increased. In offspring, the dose of 800 mg/kg/day caused very slight suppression of body weight gain, however CPR had no adverse effects on the postnatal development such as viability, differentiation, emotionality, learning ability or reproductive performance. The results suggest that the non-effective dose level of CPR is 200 mg/kg/day in maternal animals and fetuses, 400 mg/kg/day in offsprings in intraperitoneal route, lower than 200 mg/kg/day in maternal animals and 200 mg/kg/day in fetuses in intravenous route respectively.