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Liperis G, Makieva S, Serdarogullari M, Uraji J, Ali ZE, Pisaturo V, Cuevas-Saiz I, Scarica C, Sharma K, Fraire-Zamora JJ. Agree to disagree: reaching consensus amongst embryologists on the clinical management of low-quality blastocysts. Hum Reprod 2024:deae083. [PMID: 38670550 DOI: 10.1093/humrep/deae083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Affiliation(s)
- George Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia
- Embryorigin Fertility Centre, Larnaca, Cyprus
| | - Sofia Makieva
- Kinderwunschzentrum, Klinik für Reproduktions-Endokrinologie, Universitätsspital Zürich, Zurich, Switzerland
| | - Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Nicosia, Turkey
| | - Julia Uraji
- IVF Laboratory, TFP Düsseldorf GmbH, Düsseldorf, Germany
| | - Zoya Enakshi Ali
- Research & Development Department, Hertility Health Limited, London, UK
| | - Valerio Pisaturo
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | | | - Catello Scarica
- European Hospital, New Fertility Group Centre for Reproductive Medicine, Rome, Italy
| | - Kashish Sharma
- HealthPlus Fertility Center, HealthPlus Network of Specialty Centers, Abu Dhabi, United Arab Emirates
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Xu W, Yu Y, Li S. Dual laser-assisted hatching: an effective technique to salvage low-grade cleavage-stage embryos and harvest day 7 blastocysts. Lasers Med Sci 2023; 38:226. [PMID: 37776389 PMCID: PMC10543824 DOI: 10.1007/s10103-023-03898-9] [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: 03/30/2023] [Accepted: 09/26/2023] [Indexed: 10/02/2023]
Abstract
To investigate whether repeating laser-assisted hatching (LAH) procedure on day 6 low-grade cleavage-stage embryos (LGCEs) helps blastulation. A total of 579 cycles with LGCEs from 2019 to 2022 was retrospectively reviewed. In 323 cycles, single LAH producing small holes (10 μm) was performed on LGCEs on day 4 (D4-LAH). In 256 cycles with persistent LGCEs despite D4-LAH, a repeat LAH procedure was performed on day 6 (Dual-LAH) with a bigger hole (30 μm). We compared day 7 blastocyst formation rate, usable blastocyst rate, and good grade blastocyst rate from these day 6 LGCEs between the two groups. Compared to the D4-LAH group, the Dual-LAH group had both higher day 7 blastocyst formation rate (9.4% vs. 3.0%, p < 0.001) and higher day 7 usable blastocyst rates (7.4% vs. 2.1%, p < 0.001). For persistent LGCEs despite single LAH, performing a repeat LAH on day 6 increased day 7 blastocyst formation rate.
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Affiliation(s)
- Weihai Xu
- Center for Reproductive Medicine, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, People's Republic of China
| | - Yiqi Yu
- Center for Reproductive Medicine, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, People's Republic of China
| | - Shishi Li
- Center for Reproductive Medicine, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, People's Republic of China.
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Geng L, Lin X, Liu R, Wu J, Luo Y, Sun H, Hou Z, Zhang Q, Xu C, Li X, Cao C, Wang T, Xia X. Clinical Outcome of Day-3 Cleavage Slow-Growing Embryos at Different Cleavage Rates after Overnight Culture: A Cohort Retrospective Study. J Clin Med 2022; 11:4417. [PMID: 35956032 PMCID: PMC9369477 DOI: 10.3390/jcm11154417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION We explored the association between clinical outcomes and the cleavage rate of day-3 cleavage slow-growing embryos after overnight culture. METHODS The data collected from 303 frozen embryo transfer (FET) cycles with 606 4-cell or 5-cell embryos cultured overnight (18-22 h) after thawing were analyzed. Based on the growth rate after the overnight culture, the embryos were divided into three groups: no embryo reaching eight cells (Group I), either one of the two embryos reaching eight cells (Group II), and both two embryos reaching eight cells or more (Group III). A statistical analysis of the different clinical outcomes from the three groups was performed. RESULTS Biochemical pregnancy rate (OR 3.22; p = 0.001), implantation rate (OR 2.44; p = 0.002), clinical pregnancy rate (OR 3.04; p = 0.001), ongoing pregnancy rate (OR 3.14; p = 0.001), and live birth rate (OR 2.78; p = 0.004) were significantly higher in Group III as compared to Group I. Group II had a significantly higher biochemical pregnancy rate (OR 2.02; p = 0.013) and implantation rate (OR 1.77; p = 0.019) than Group I. CONCLUSIONS The capability of day-3 cleavage slow-growing embryos to reach eight cells, especially that of two embryos reaching eight cells by overnight culture, appear to result in a better pregnancy outcome.
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Affiliation(s)
- Lan Geng
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Xinran Lin
- Medical College, Shantou University Medical College, Shantou 515063, China
| | - Rang Liu
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Jiahui Wu
- Department of Gynecology, Shenzhen Maternity &
- Child Healthcare Hospital, Shenzhen 518000, China
| | - Yongsheng Luo
- Quality Control Department, The Second People’s Hospital of Futian District, Shenzhen 518000, China
| | - Hongmei Sun
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Zhenhui Hou
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Qiuju Zhang
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Chang Xu
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Xiao Li
- Shenzhen Health Capacity Building and Continuing Education Center, Shenzhen 518000, China
| | - Canhui Cao
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Tianren Wang
- Center for Reproductive Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
| | - Xi Xia
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen 518000, China
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Xu W, Zhang L, Zhang L, Jin Z, Wu L, Li S, Shu J. Laser-assisted hatching in lower grade cleavage stage embryos improves blastocyst formation: results from a retrospective study. J Ovarian Res 2021; 14:94. [PMID: 34261510 PMCID: PMC8281458 DOI: 10.1186/s13048-021-00844-7] [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: 12/24/2020] [Accepted: 07/02/2021] [Indexed: 11/17/2022] Open
Abstract
Background Laser-assisted hatching (LAH) has been widely applied to facilitate blastocyst hatching in IVF-ET treatment, however, the effect of LAH on subsequent development and clinical outcomes of the lower grade cleavage stage embryos (LGCE) remains unknown. Our study aimed at evaluating the effect of LAH on blastocyst formation and the clinical pregnancy outcomes of LGCE embryos after transfer. Methods A total of 608 cycles of IVF/ICSI treatment from November 2017 to September 2019 were included in our study as follows: 296 in the LAH group and 312 in the N-LAH group. The total blastocyst rate, usable blastocyst rate, good-grade blastocyst rate and clinical pregnancy rate were statistically compared between the two groups. Results The total blastocyst rate (50.7% vs 40.2%, P < 0.001), usable blastocyst rate (31.0% vs 18.6%, P < 0.001) were significantly higher in the LAH group than those in the N-LAH group. After analysis of generalized estimating equations, LAH was positively correlated with the blastocyst rate (B = 0.201, OR 95% CI = 1.074–1.393, P = 0.002), usable blastocyst rate (B = 0.478, OR 95% CI = 1.331–1.955, P < 0.001). However, the clinical pregnancy rate after blastocyst transfer did not differ between LAH group and N-LAH group (49.4% vs 40.0%, P > 0.05, respectively). Conclusions A higher proportion of total blastocysts and usable blastocysts can be obtained by LAH in LGCE, which may be beneficial to the outcome of the IVF/ICSI-ET cycle.
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Affiliation(s)
- Weihai Xu
- Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310000, Hangzhou, P.R. China
| | - Ling Zhang
- Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310000, Hangzhou, P.R. China
| | - Lin Zhang
- Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310000, Hangzhou, P.R. China
| | - Zhen Jin
- Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310000, Hangzhou, P.R. China
| | - Limei Wu
- Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310000, Hangzhou, P.R. China
| | - Shishi Li
- Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310000, Hangzhou, P.R. China.
| | - Jing Shu
- Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 310000, Hangzhou, P.R. China.
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Lin PY, Lin CY, Tsai NC, Huang FJ, Chiang HJ, Lin YJ, Su YT, Lan KC. Disposition of embryos from women who only produced morphologically poor embryos on day three. Biomed J 2021; 45:190-199. [PMID: 35148259 PMCID: PMC9133239 DOI: 10.1016/j.bj.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/17/2020] [Accepted: 01/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background The presence of only morphologically poor embryos (MPEs) on day3 is common in autologous in vitro fertilization (IVF), particularly among p Tel: 886-7-7317123 Ext. 8916. Fax: 886-7-7322915.atients who have advanced maternal age or are poor responders. However, there are limited data regarding the disposition of embryos from patients who only produced MPEs on day3. The present study was designed to investigate the possible benefits of extended culturing MPEs. Try to detect whether the extended culture (day4 or day5 culture) can improve the live birth rate per cycle? Methods This retrospective, observational, single-center, cohort study examined 224 IVF/intracytoplasmic sperm injection (ICSI) cycles between January 2010 and June 2015, in which women only produced MPEs on day3. A total of 544 MPEs were analyzed. The defines a day3 embryo as an MPE if it fails to develop to eight cells, blastomeres of equal size, and less than 20% cytoplasmic fragments. Of the 224 cycles, 89 (39.7%) underwent fresh embryo transfer on day3, and 135 (60.3%) underwent extended culture. Of the 135 extended cultures, 54 cycles (40.0%) experienced day4, or day5 embryo transfer, 16 cycles (11.9%) had all embryos frozen, and 65 cycles (48.1%) had total embryo arrest. Results Analysis of patient baseline demographic data, cycle characteristics, and cycle outcomes for day3 transfer group and extended culture group indicated that a higher body mass index in the day3 transfer group was the only significant difference (p = 0.006). Both fresh transfer groups had low live birth rates (LBRs) (4.5% vs. 7.4% p = 0.46). After extended culture, 65 cycles (48.1%) were cancelled because the embryos exhibited developmental arrest and 70 cycles (51.9%) grew to day4 or day5. Thirteen frozen embryo transfer (FET) cycles and 22 frozen blastocysts derived from MPEs were thawed. There were more high-quality embryos (p < 0.001), higher implantation rates (IRs) (p = 0.038), and higher LBRs (p = 0.042) for embryos that underwent FET cycles. MPES in extended culture transfer have favorable survival than MPES in day3 transfer. Conclusion The extended culture of MPEs in fresh transfer cycles did not increase the LBR. However, younger females with the extended culture of MPEs followed by FET resulted in significantly higher LBRs and may be a feasible strategy to improve outcomes for patients with poor embryo quality. However, day3 embryo transfer may be a better choice if a fresh transfer is unrestricted and avoid the cycle cancellation. Extended culture may decrease to the transfer of developmental potential arrest embryos to patients.
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Affiliation(s)
- Pin-Yao Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Lee Womens' Hospital, Taichung, Taiwan
| | - Chia-Yun Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ni-Chin Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Jen Huang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsin-Ju Chiang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ju Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ting Su
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuo-Chung Lan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Center for Menopause and Reproductive Medicine Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Li B, Huang J, Li L, He X, Wang M, Zhang H, He Y, Kang B, Shi Y, Chen S, Wang X. Improving the clinical outcomes by extended culture of day 3 embryos with low blastomere number to blastocyst stage following frozen-thawed embryo transfer. Arch Gynecol Obstet 2020; 303:573-580. [PMID: 33033867 PMCID: PMC7858202 DOI: 10.1007/s00404-020-05774-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022]
Abstract
Purpose This study aimed to investigate whether the extended culture of day 3 (D3) embryos with low blastomere number to blastocyst following frozen–thawed embryo transfer improved the clinical outcomes. Methods This was a retrospective study of clinical data of women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles in the Tangdu Hospital. The patients were divided into groups with 4–5, 6, 7–9 and > 9 cells based on the blastomere number of D3 embryos. The clinical outcomes were compared. Results In fresh transfer cycles, the implantation and clinical pregnancy rates significantly decreased, while the abortion rate significantly increased in the groups with 4–5 and 6 cells compared with those with 7–9 and > 9 cells. In frozen–thawed transfer cycles, the clinical pregnancy and implantation rates for a single blastocyst transfer cycle showed no significant differences in the groups with 4–5 and 6 cells compared with those with 7–9 and > 9 cells. However, the abortion rate was significantly higher in the group with 4–5 cells than in that with 7–9 and > 9 cells. In the double blastocyst transfer cycle, the clinical pregnancy rate showed no significant differences among the groups with 4–5, 6, and 7–9 cells. Conclusion The implantation and clinical pregnancy rates of D3 embryos with 6 cells significantly decreased; these embryos were not considered as high-quality embryos. Extended culture of D3 embryos with ≤ 6 blastomeres to blastocysts, particularly 6-cell embryos, resulted in a similar clinical pregnancy rate as that of blastocysts derived from D3 embryos with ≥ 7 blastomeres.
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Affiliation(s)
- Bo Li
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Jianlei Huang
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Li Li
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Xiao He
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Ming Wang
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Hengde Zhang
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Yuping He
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Bin Kang
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Yongqian Shi
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Shuqiang Chen
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
| | - Xiaohong Wang
- Department of Obstetrics and Gynecology, Tangdu Hospital, The Air Force Military Medical University, Xi’an, 710038 China
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Taheri F, Khalili MA, Kalantar SM, Fesahat F, Montazeri F, Palmerini MG, Woodward B. Generation of viable blastocysts from discarded human cleavage embryos. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020. [DOI: 10.1186/s43043-020-00028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
While a relationship between embryo morphology, developmental ability, and genetic integrity exists, the selection of embryos with higher implantation potential remains a major challenge in assisted reproductive technology (ART). This study investigated blastocyst developmental competence and euploidy status in human embryos that had been classed as too poor quality to transfer (ET) or cryopreserve at the cleavage stage.
Embryos were divided into three groups. Group 1 (n = 41) included good quality embryos from candidates of preimplantation genetic testing for aneuploidy (PGT-A). Groups II and III were the “rejected” supernumerary embryos, defined as suboptimal for ET or vitrification after morphological examination, with embryos randomly divided between the groups. Group II embryos (n = 31) were cultured up to the day 3 cleavage stage, when they were biopsied and fixed. Group III embryos (n = 27) were cultured up to the day 5 blastocyst stage, when they were evaluated for morphology and chromosomal status. Chromosomal status in all groups was assessed by multi-color fluorescence in situ hybridization (FISH) for chromosomes 13, 18, 21, X, and Y.
Results
Euploidy rates in groups I, II, and III were 56.1%, 38.7%, and 55.5 %, respectively. Among the blastocysts that developed from “rejected” embryos, 59.3% were classed as good quality. The most frequent chromosomal aneuploidy was related to the sex chromosome (22.2%). The mosaicism rate was not significantly different between the group II and III embryos (25.8% vs. 37.0%, p = 0.28).
Conclusion
In conclusion, surplus poor-quality embryos rejected from clinical utilization at the cleavage stage may develop into viable blastocysts with normal chromosomal status for at least 5 chromosomes. Recovery of euploidy during poor-quality embryo transition from cleavage stage to blastocyst could provide an alternative choice for ET.
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Xia L, Zhao S, Xu H, Wu X, Zhang A, Niu Z. Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos. Front Endocrinol (Lausanne) 2020; 11:561085. [PMID: 33042021 PMCID: PMC7525122 DOI: 10.3389/fendo.2020.561085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/17/2020] [Indexed: 11/30/2022] Open
Abstract
Embryos with low morphological scores can still develop to the blastocyst stage and result in good clinical outcomes. However, no studies have reported the possible effects of transferring cryopreserved blastocysts developed from poor-quality cleavage stage embryos on pregnancy and perinatal outcomes. In this retrospective study, the clinical value of transferring blastocysts derived from day 3 poor-quality cleavage stage embryos during in vitro fertilization and embryo transfer procedures was evaluated. According to the quality of embryos on day 3 from which the transferred blastocyst originated, patients were divided into three groups: poor-quality (111 cycles, group A), good-quality (235 cycles, group B), and top-quality (119 cycles, group C). Group A experienced the highest miscarriage rate (30.2%) which was increased when compared to group C (12.5%) (P = 0.03). The clinical pregnancy rates and live birth rates were not significantly different among the three groups. However, good blastocyst originating from top day 3 embryos resulted in higher live birth rate. Of the 218 live births, no differences in obstetric and perinatal outcomes were noted among the three groups. The results showed that extended culture of poor-quality cleavage stage embryos could resulted in favorable clinical pregnancy rates but at a higher incidence of miscarriages. Meanwhile, the risk of adverse perinatal outcomes was not increased.
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Tubbing A, Shaw-Jackson C, Ameye L, Colin J, Rozenberg S, Autin C. Increased live births after day 5 versus day 6 transfers of vitrified-warmed blastocysts. J Assist Reprod Genet 2017; 35:417-424. [PMID: 29204868 DOI: 10.1007/s10815-017-1097-x] [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: 09/19/2017] [Accepted: 11/27/2017] [Indexed: 01/28/2023] Open
Abstract
PURPOSE An investigation into the clinical implications of delayed blastulation (day 5 versus day 6) was carried out for cryo cycles, as heterogeneous results persist in the current literature. METHODS We performed a retrospective study comparing clinical pregnancies and live births between 178 blastocysts vitrified and warmed on day 5 versus 149 on day 6. The stage of blastocyst development was taken into account and adjustment for confounding factors was performed. RESULTS Our results demonstrate a significant difference in clinical pregnancy (43 versus 23% p value < 0.001) and live birth rates (34 versus 16% p value < 0.001) regarding the day of vitrification, in favour of day 5. This difference persisted after adjustment for confounding factors. The adjusted odds ratio for clinical pregnancies and deliveries for the day 5 group compared to that of the day 6 group was 2.83 (95%CI, 1.48 to 5.41) and 2.94 (95%CI, 1.39 to 6.22), respectively. When the stage of development of the blastocyst was taken into consideration, we still observed a significant advantage of day 5 versus day 6 vitrification. CONCLUSIONS Day of vitrification (day 5 versus day 6) appears to be an independent predictor of clinical outcomes. Stratification of our cohort was carried out according to the developmental stage, and significant differences persisted. Although the transfer of day 6 cryopreserved embryos remains a viable option, giving priority to a day 5 embryo would reduce the time to pregnancy.
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Affiliation(s)
- Alice Tubbing
- Department of Gynaecology, CHU St-Pierre (Université Libre de Bruxelles), Rue Haute 322, 1000, Brussels, Belgium
| | - Chloë Shaw-Jackson
- Department of Gynaecology, CHU St-Pierre (Université Libre de Bruxelles), Rue Haute 322, 1000, Brussels, Belgium.
| | - Lieveke Ameye
- Data Centre, Jules Bordet Institute (Université Libre de Bruxelles), Rue Hégèr Bordet 1, 1000, Brussels, Belgium
| | - Jérôme Colin
- Department of Gynaecology, CHU St-Pierre (Université Libre de Bruxelles), Rue Haute 322, 1000, Brussels, Belgium
| | - Serge Rozenberg
- Department of Gynaecology, CHU St-Pierre (Université Libre de Bruxelles), Rue Haute 322, 1000, Brussels, Belgium
| | - Candice Autin
- Department of Gynaecology, CHU St-Pierre (Université Libre de Bruxelles), Rue Haute 322, 1000, Brussels, Belgium
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Extended culture of poor-quality supernumerary embryos improves ART outcomes. J Assist Reprod Genet 2017; 35:311-319. [PMID: 29047006 DOI: 10.1007/s10815-017-1063-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The aims of this study were to investigate the possible benefits of extending the culture of poor-quality day-2 embryos (PQE) versus good-quality embryos (GQE) and to identify factors associated with pregnancy and live birth when transferring frozen-thawed blastocysts originating from GQE and PQE. METHODS This is a retrospective cohort follow-up study performed between November 2012 and February 2015 at the IVF Laboratory Unit of Cochin University Hospital (Paris, France) including 3108 day-2 supernumerary embryos resulting from 1237 IVF/ICSI cycles. RESULTS Total blastulation rate was 67.2% from GQE and 48.7% from PQE. Percentage of good-quality blastocysts was 60.7 and 47.9% respectively including 14.7 and 7.3% top-quality blastocysts. A total of 150 blastocysts originating from GQE and 729 from PQE were frozen, and then, 37 and 164 were thawed and transferred respectively resulting in 19 (51.4%) and 61 (37.9%) clinical pregnancies with 13 (35.1%) deliveries from GQE and 32 (19.9%) from PQE (p = 0.046) without any difference in neonatal outcomes. Quality of blastocysts that resulted in live birth was similar in the two groups. Women < 35 years old and day-5 blastocyst expansion were predictive of pregnancy and live birth. CONCLUSIONS (i) PQE are able to reach the blastocyst stage, to implant, and to give healthy babies and (ii) women age and day of blastocyst expansion are predictive of pregnancy and live birth.
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Yu L, Jia C, Lan Y, Song R, Zhou L, Li Y, Liang Y, Wang S. Analysis of embryo intactness and developmental potential following slow freezing and vitrification. Syst Biol Reprod Med 2017; 63:285-293. [PMID: 28795845 DOI: 10.1080/19396368.2017.1362060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to identify the parameters that are related to intactness and developmental potential of a day 3 embryo after warming to improve the selection criteria used to cryopreserve and transfer embryos. We also sought to compare slow freezing and vitrification methods of cryopreservation and to evaluate the viability of non-intact embryos. Embryos warmed following slow freezing (n=220) or vitrification (n=522) were divided into 3 groups according to the proportion of surviving blastomeres (I<50%; II=50-99%; and III=100%). The developmental potential of embryos, including the mitosis resumption rate, blastocyst formation rate, and formation rate of grade A blastocysts (i.e., fully expanded blastocysts with an inner cell mass and grade A or B trophectoderm) were retrospectively assessed in embryos. Cleavage-stage embryos with <50% blastomere survival were analyzed using next-generation sequencing (NGS). Logistic regression analysis showed that vitrification and grade 1 were independent predictive factors of embryo intactness and developmental potential (all p<0.05). On day 3, embryos with 4-6 cells or blastomere damage had lower developmental potential than those with 7-9 cells or intact blastomeres (all p<0.05). NGS results showed that the chromosomal status was completely normal in 8 embryos that developed into expanded blastocysts, whereas 4 out of 5 embryos in which development was arrested were abnormal. The results of this study suggest that vitrification is a better choice than slow freezing for embryo cryopreservation. Embryos showing poor quality (fragmentation >30% and/or a non-stage-specific cell size) and lower cell numbers (4-6 cells) on day 3 should be cultured to the blastocyst stage and then vitrified if they develop into good-quality blastocysts. The developmental potential of non-intact embryos is lower than that of intact embryos; however, after they are cultured to the fully expanded blastocyst stage, embryos with <50% blastomere survival appear to be better candidates for transfer. Abbreviations ART: assisted reproductive technology; grade A blastocyst: fully expanded blastocyst with an inner cell mass and grade A or B trophectoderm; NGS: next-generation sequencing; IVF: in vitro fertilization; ICSI: intracytoplasmic sperm injection; FET: frozen-thawed embryo transfer.
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Affiliation(s)
- Lan Yu
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Chanwei Jia
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Yonglian Lan
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Rui Song
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Liying Zhou
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Ying Li
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Yu Liang
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
| | - Shuyu Wang
- a Department of Reproductive Medicine , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China
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Le Bras A, Hesters L, Gallot V, Tallet C, Tachdjian G, Frydman N. Shortening gametes co-incubation time improves live birth rate for couples with a history of fragmented embryos. Syst Biol Reprod Med 2017. [DOI: 10.1080/19396368.2017.1336581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Anne Le Bras
- AP-HP, Antoine Béclère Hospital, Reproductive Biology Unit, Clamar, France
| | - Laetitia Hesters
- AP-HP, Antoine Béclère Hospital, Reproductive Biology Unit, Clamar, France
| | | | - Cathie Tallet
- AP-HP, Antoine Béclère Hospital, Reproductive Biology Unit, Clamar, France
| | - Gerard Tachdjian
- AP-HP, Antoine Béclère Hospital, Reproductive Biology Unit, Clamar, France
| | - Nelly Frydman
- AP-HP, Antoine Béclère Hospital, Reproductive Biology Unit, Clamar, France
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Vankerkem P, Manigart Y, Delvigne A, Ameye L, Konopnicki D, Shaw-Jackson C, Rozenberg S, Autin C. In vitro fertilization when men, women, or both partners are positive for HIV: a case-control study. Arch Gynecol Obstet 2017; 295:1493-1507. [PMID: 28444513 DOI: 10.1007/s00404-017-4374-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/18/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to compare the outcomes of in vitro fertilization (IVF) for couples where one or both partners were positive for the human immunodeficiency virus (HIV) to matched control couples. METHODS A matched case-control retrospective study was performed. Data for 104 couples where the woman was HIV-positive; for 90 couples where the man was HIV-positive; and for 33 couples where both partners were HIV-positive were prospectively analyzed in comparison to matched controls treated in our center during the same period. The main outcomes were clinical pregnancy and live birth rates. RESULTS For couples involving an HIV-positive man, clinical outcomes were comparable to controls and resulted in the birth of 18 healthy babies after 90 cycles. When the woman was affected, cycle cancelation, number of retrieved oocytes, and on-going clinical pregnancy rates per transfer were statistically reduced. Implantation rates were comparable to those of non-affected controls. Seven healthy babies for 104 cycles were obtained. For a couple in which both partners were HIV-positive, only one healthy birth occurred after 33 cycles. Pregnancy rates were systematically reduced though not significantly probably due to sample size. CONCLUSIONS Our data suggest that IVF outcomes were similar to controls when men were HIV-positive and remain acceptable when women were HIV-positive. IVF outcomes were severely reduced in our sero-concordant couples; however, many patients had severe HIV disease previously, and therefore, these results should be reassessed in patients treated early in their disease.
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Affiliation(s)
- Pauline Vankerkem
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Yannick Manigart
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Annick Delvigne
- Department of Gynaecology, Clinique St Vincent, Rue François Lefèbvre 207, 4000, Rocourt, Belgium
| | - Lieveke Ameye
- Data centre, Jules Bordet Institute, Université Libre de Bruxelles, rue Hégèr Bordet 1, 1000, Brussels, Belgium
| | - Deborah Konopnicki
- Department of Infectious Diseases, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Chloë Shaw-Jackson
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium.
| | - Serge Rozenberg
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Candice Autin
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
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In vitro fertilization for women infected by hepatitis C virus: a matched case-control study and a systematic literature review. J Assist Reprod Genet 2017; 34:587-597. [PMID: 28236107 DOI: 10.1007/s10815-017-0892-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 02/07/2017] [Indexed: 01/18/2023] Open
Abstract
PURPOSE The aim of this study was to investigate whether infection of women by the hepatitis C virus (HCV) reduces the chance of conceiving after in vitro fertilization (IVF). METHODS We performed a retrospective blind matched case-control study where IVF outcomes for the first 37 cycles of HCV sero-positive women were compared to those of 107 cycles of an uninfected control group. Our results were included in a systematic literature review. RESULTS Out of five eligible studies, ours included, three observed an impact of HCV infection, though at various levels including response to stimulation, fertilization, implantation, and pregnancy rates. Two studies differentiated results for patients with confirmed active viral replication. Matching criteria and populations studied varied between studies. CONCLUSIONS More and larger studies with well-defined groups are needed to clarify the eventual impact of the HCV on IVF outcomes. Data concerning the infectious status of a patient as well as her health state should be systematically recorded. A multi-disciplinary approach as well as a thorough knowledge of the patient's general health state might prove useful in the management and counseling of these patients in terms of success in conceiving.
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Petrussa L, Van de Velde H, De Rycke M. Similar kinetics for 5-methylcytosine and 5-hydroxymethylcytosine during human preimplantation development in vitro. Mol Reprod Dev 2016; 83:594-605. [PMID: 27163211 DOI: 10.1002/mrd.22656] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/07/2016] [Indexed: 12/22/2022]
Abstract
After fertilization, the mammalian embryo undergoes epigenetic reprogramming with genome-wide DNA demethylation and subsequent remethylation. Oxidation of 5-methylcytosine (5mC) into 5-hydroxymethylcytosine (5hmC) was suggested to be an intermediate step in the DNA demethylation pathway. Other evidence, such as the stability of 5hmC in specific tissues, suggests that 5hmC constitutes a new epigenetic modification with its own biological function. Since few studies have been conducted on human material compared to animal models and species-specific epigenetic differences have been reported, we studied global DNA methylation and hydroxymethylation patterns in human in vitro preimplantation embryos using immunocytochemistry, comparing these patterns in good-quality and abnormally developing embryos. Our data showed that DNA methylation and hydroxymethylation modifications co-exist. 5mC and 5hmC signals were found in oocytes and in paternal and maternal pronuclei of zygotes, present in non-reciprocal patterns-which contrasts published data for the mouse. These two epigenetic modifications are present between Days 1 and 7 of in vitro development, with 5mC levels declining over cell divisions without noticeable remethylation during this period. A main decline in 5mC and 5hmC occurred as the embryo progressed from compaction to the blastocyst stage. No difference in (hydroxy)methylation was found between the inner cell mass and trophectoderm. When comparing normally and abnormally developing embryos, DNA (hydroxy)methylation reprogramming was abnormal in poor-quality embryos, especially during the first cleavages. Mol. Reprod. Dev. 83: 594-605, 2016 © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Laetitia Petrussa
- Department of Reproduction and Genetics (REGE), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Brussels, Belgium
| | - Hilde Van de Velde
- Department of Reproduction and Genetics (REGE), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Brussels, Belgium.,Centre for Reproductive Medicine (CRM), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - Martine De Rycke
- Department of Reproduction and Genetics (REGE), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, Brussels, Belgium.,Centre for Medical Genetics (CMG), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
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Oocytes affected by smooth endoplasmic reticulum aggregates: to discard or not to discard? Arch Gynecol Obstet 2016; 294:175-84. [PMID: 26983832 DOI: 10.1007/s00404-016-4066-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 03/01/2016] [Indexed: 01/25/2023]
Abstract
PURPOSE Oocytes containing smooth endoplasmic reticulum aggregates (SERa) have been associated with reduced fertilization and clinical pregnancy rates as well as compromised neonatal outcomes. It was therefore recommended by an Alpha-ESHRE Consensus to discard oocytes presenting this dysmorphism. The data in the literature are nevertheless conflicting and healthy babies have recently been obtained from affected oocytes. The objectives of this study were to compare clinical outcomes between ICSI cycles with and without oocytes affected by smooth endoplasmic reticulum aggregates and to confirm whether affected oocytes can produce healthy babies. METHODS A prospective observational study was performed comparing 714 SERa- ICSI cycles to 112 SERa+ cycles. Among the SERa+ cycles, 518 SERa- oocytes and 213 SERa+ oocytes were analyzed. Fertilization, embryo quality, and pregnancy rates as well as neonatal outcomes were compared between SERa+ and SERa- cycles as well as between SERa+ and SERa- oocytes. RESULTS The presence of SERa was not associated with an adverse effect on embryological, clinical or neonatal data for SERa+ cycles and oocytes. Seven healthy babies were born from embryos originating from SERa+ oocytes. CONCLUSIONS These results are encouraging and might contribute in the future to a revision of the Alpha-ESHRE Consensus. Larger studies, including a correlation between frequency and size of SERa, clinical outcomes and malformation rates, as well as the follow-up of babies born are nevertheless necessary. In the meantime, the currently conflicting data requires caution when considering transfers of embryos affected by SERa.
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Neyer A, Zintz M, Stecher A, Bach M, Wirleitner B, Zech NH, Vanderzwalmen P. The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging-a retrospective observational study. J Assist Reprod Genet 2015; 32:1607-14. [PMID: 26286759 DOI: 10.1007/s10815-015-0558-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/06/2015] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Various time-lapse studies have postulated embryo selection criteria based on early morphokinetic markers. However, late paternal effects are mostly not visible before embryonic genome activation. The primary objective of this retrospective study was to investigate whether those early morphokinetic algorithms investigated by time-lapse imaging are reliable enough to allow for the accurate selection of those embryos that develop into blastocysts, while of course taking into account the correlation with the type of injected spermatozoa. METHODS During a period of 18 months, a total of 461 MII oocytes from 43 couples with severe male factor infertility and previous "external" IVF failures after cleavage-stage embryo transfer (ET) were fertilized by intracytoplasmic morphologically selected sperm injection (IMSI). Thereof, 373 embryos were monitored in a time-lapse incubator until ET on day 5. Blastocyst outcome in combination with three previously postulated MKc (cc2: t3-t2, 5-12 h; t3, 35-40 h; t5, 48-56 h) and the morphology of the selected sperm were analyzed. RESULTS A significant increase in the rate of blastocysts (54.0 vs. 36.3 %; P < 0.01) and top blastocysts (25.3 vs. 10.8 %; P < 0.001) was observed in the group of those meeting all three morphokinetic criteria (MKc3). However, MKc3 were only met in 23.3 % of all embryos. Moreover, TBR was influenced by the type of injected spermatozoa. In both groups, TBR decreased dramatically (MKc3, 35.0 vs. 17.0 %; MKc < 3, 14.2 vs. 8.4 %) when class II/III sperm instead of class I were injected. CONCLUSION Early morphokinetic parameters might give some predictive information but fail to serve as a feasible selective tool for the prediction of blastocyst development given the influence of the type of spermatozoa injected.
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Affiliation(s)
- Anton Neyer
- IVF Centers Prof. Zech-Bregenz, Römerstrasse 2, 6900, Bregenz, Austria.
| | - Martin Zintz
- IVF Centers Prof. Zech-Bregenz, Römerstrasse 2, 6900, Bregenz, Austria
| | - Astrid Stecher
- IVF Centers Prof. Zech-Bregenz, Römerstrasse 2, 6900, Bregenz, Austria
| | - Magnus Bach
- IVF Centers Prof. Zech-Bregenz, Römerstrasse 2, 6900, Bregenz, Austria
| | | | - Nicolas H Zech
- IVF Centers Prof. Zech-Bregenz, Römerstrasse 2, 6900, Bregenz, Austria
| | - Pierre Vanderzwalmen
- IVF Centers Prof. Zech-Bregenz, Römerstrasse 2, 6900, Bregenz, Austria
- Centre Hospitalier Interrégional Edith Cavell (CHIREC), Braine-l'Alleud, Brussels, Belgium
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Kaartinen N, Das P, Kananen K, Huhtala H, Tinkanen H. Can repeated IVF-ICSI-cycles be avoided by using blastocysts developing from poor-quality cleavage stage embryos? Reprod Biomed Online 2014; 30:241-7. [PMID: 25596905 DOI: 10.1016/j.rbmo.2014.11.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/24/2014] [Accepted: 11/27/2014] [Indexed: 11/24/2022]
Abstract
In many clinics, good-quality embryos are selected for embryo transfer and cryopreservation at the cleavage stage, and poor-quality embryos are discarded. The aim of this retrospective study was to examine how many repeated IVF cycles could be avoided by culturing the cleavage stage poor-quality embryos to blastocyst stage and transferring them after vitrification and warming (604 IVF and intracytoplasmic sperm injection [IVF-ICSI] cycles were included). Poor-quality cleavage stage embryos not eligible for transfer or cryopreservation were cultured until day 5 or 6, and those developing to the blastocyst stage were vitrified. The rate of vitrified blastocysts and clinical pregnancy and delivery rate of the warmed blastocysts was evaluated. The effect of the extended culture on the cumulative delivery rate, and the number of avoided new treatment cycles was calculated. The surplus blastocysts resulted in clinical pregnancy, spontaneous abortion and delivery rates of 24.6%, 27.3% and 17.2% respectively. The use of surplus blastocysts raised cumulative delivery rate from 43% to 47% and 53 repeated new cycles were avoided. This study shows that the cumulative delivery rate can be increased, and repeated IVF-ICSI treatments avoided by using blastocysts developing from poor-quality cleavage stage embryos, which otherwise would have been discarded.
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Affiliation(s)
- Noora Kaartinen
- Tampere University Hospital, Department of Obstetrics and Gynaecology, Tampere University, Teiskontie 35, Tampere 33521, Finland.
| | - Pia Das
- Tampere University Hospital, Department of Obstetrics and Gynaecology, Tampere University, Teiskontie 35, Tampere 33521, Finland
| | - Kirsi Kananen
- Infertility Clinic Ovumia Ltd Biokatu 12, 33520 Tampere
| | - Heini Huhtala
- School of Health Sciences, Tampere University Medisiinarinkatu 3, 33520 Tampere
| | - Helena Tinkanen
- Tampere University Hospital, Department of Obstetrics and Gynaecology, Tampere University, Teiskontie 35, Tampere 33521, Finland
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Stecher A, Vanderzwalmen P, Zintz M, Wirleitner B, Schuff M, Spitzer D, Zech NH. Transfer of blastocysts with deviant morphological and morphokinetic parameters at early stages of in-vitro development: a case series. Reprod Biomed Online 2014; 28:424-35. [DOI: 10.1016/j.rbmo.2013.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 12/16/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
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Laser-assisted hatching improves clinical outcomes of vitrified-warmed blastocysts developed from low-grade cleavage-stage embryos: a prospective randomized study. Reprod Biomed Online 2014; 28:582-9. [PMID: 24631166 DOI: 10.1016/j.rbmo.2014.01.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate the effects of quarter zona-pellucida (ZP) opening by laser-assisted hatching (QLAH) on the clinical outcomes following transfer of vitrified-warmed blastocysts developed from low-grade cleavage-stage embryos in patients with all high-grade and fair-grade cleavage-stage embryos transferred without achieving pregnancy. Patients were randomized into two groups: QLAH (n=101) and control (n=102). The implantation and clinical pregnancy rates were significantly higher in the QLAH group compared with the control group (P=0.021 and P=0.034, respectively). The live birth rate of the QLAH group was also higher, although not significantly. When the clinical outcomes according to the day of blastocyst vitrification were compared between the groups, the implantation, clinical pregnancy and live birth rates of the QLAH group were significantly higher (P<0.05) than those of the control group for day 6 blastocysts, but not for day 5 or day 5/day 6 blastocysts. These results suggest that QLAH improves the clinical outcomes of vitrified-warmed blastocysts, especially of day 6 vitrified blastocysts, developed from low-grade cleavage-stage embryos.
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Is it acceptable to destroy or include human embryos before day 5 in research programmes? Reprod Biomed Online 2014; 28:522-9. [PMID: 24581988 DOI: 10.1016/j.rbmo.2013.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 12/13/2013] [Accepted: 12/17/2013] [Indexed: 11/21/2022]
Abstract
Day-3 poor-quality embryos (PQE) from IVF-embryo transfer cycles are usually destroyed or are included in research programmes. Knowing that these embryos have the ability to evolve to the blastocyst stage and yield embryonic stem cell lines, this study postulated that they could also give rise to live births. This is a prospective study including 186 IVF-embryo transfer candidates who had obtained at least one supernumerary PQE on day 3. PQE were kept for extended culture and high-quality blastocysts were frozen. A total of 620 PQE were eligible for the study, 217 (35.0%) reached the blastocyst stage and 73 (33.6%) were frozen. Blastulation rates were 7-fold higher (OR 7.29, 95% CI 5.01-10.61) in embryos compacted on day 4. Of the frozen blastocysts, 40 were thawed during 33 thawed blastocyst transfer cycles, which led to 10 clinical pregnancies. These pregnancies resulted in five miscarriages and five healthy live births at full term. PQE may achieve their development to the blastocyst stage, be frozen-thawed and harbour reasonable implantation potential. These results, thereby, raise an ethical issue regarding the fate reserved to PQE.
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