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Izadi M, Khalili MA, Rezvani ME, Anbari F, Maleki B, Woodward B, Aflatoonian B. Sperm Selection Using Zona Pellucida-Binding Enhanced Embryo Morphokinetic and Clinical Outcomes in ICSI: A Sibling Oocytes Study. Am J Mens Health 2024; 18:15579883241228236. [PMID: 38279800 PMCID: PMC10822090 DOI: 10.1177/15579883241228236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/29/2024] Open
Abstract
The objective was to investigate the embryo morphokinitics using a time-lapse monitoring (TLM) system and assessment of clinical outcomes following intracytoplasmic sperm injection (ICSI) with zona pellucida (ZP)-bound sperm selection and conventional methods. A total of 371 metaphase II (MII) oocytes from 50 ICSI cycles were studied. Sibling oocytes were randomly divided into control (n = 199) and ZP-bound group (n = 172). All resulting zygotes were cultured and monitored in the TLM system up to Day 3 after ICSI. Fertilization rate, early embryo development, and clinical outcomes were evaluated. No significant differences were found in fertilization rate, time-lapse qualitative and quantitative measures, pronuclear fading time (PNF) t2, t3, t4, t5, t6, and t7 (times of cleavage to 2, 3, 4, 5, 6, and 7 cells), respectively. However, the t8 (time of cleavage to eight cells) and cc3 (duration of third cell cycle) revealed a significant difference between control and ZP-bound groups (p < .05). A significant difference between the two groups (p < .05) in the rates of Grade A embryos (according to Basile algorithm), chemical pregnancy, clinical pregnancy, and implantation was observed. Sperm selection using biological materials, such as ZP, improved both embryo quality and pregnancy outcomes, despite not affecting the early embryo development and morphokinetic parameters up to t8. This prospective randomized sibling oocyte trial was registered in October 2020 to January 2022 (IRCT20200705048021N1).
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Affiliation(s)
- Mahin Izadi
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ali Khalili
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ebrahim Rezvani
- Department of Physiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Anbari
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Behnam Maleki
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Infertility Center, Department of Obstetrics and Gynecology, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Behrouz Aflatoonian
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Advanced Medical Sciences and Technologies, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Saberivand A, Mehrabi R, Peighambarzadeh SZ, Saberivand M, Shirafkan M, Haghgouei T, Sarvarzadeh F, Safaei P, Saki M, Javdaneh Siahpoush K, Alizadeh T. The cryoprotective effect of Guar gum co-supplemented with ethylene glycol and glycerol in Simmental bull semen. Anim Reprod Sci 2023; 259:107362. [PMID: 37956627 DOI: 10.1016/j.anireprosci.2023.107362] [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: 03/27/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
Sperm cryopreservation often reduces sperm quality by forming of intra- and extracellular ice crystals. Various compounds widely used to counteract this effect. The guar gum was considered as an extracellular cryoprotective substance. The present study evaluated the impact of the co-supplementation of guar gum with ethylene glycol or glycerol in the cryopreservation of bull sperm. Four ejaculates from 4 bulls were pooled and divided into ten groups consisting of 4 controls (glycerol 6%, ethylene glycol 6%, glycerol 3.5%, and ethylene glycol 3.5%, and six treatment groups including guar gum in 0.001% and 0.002% alone and or co-supplemented either with 3.5% glycerol or 3.5% ethylene glycol and frozen in liquid nitrogen. The sperm motility, viability, plasma membrane and DNA integrity, apoptotic-like changes, antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities evaluated. The groups contained 3.5% glycerol + 0.001% guar gum, 3.5% ethylene glycol + 0.001% guar gum, and 0.001% guar gum alone showed higher values for live sperm, antioxidant enzymes, membrane integrity, mitochondrial membrane potential (MMP), fertilization, cleavage, and blastocyst rates; and lower values for apoptotic-like changes, H2O2 level, and DNA damage than the control groups. In conclusion, adding guar gum to the bull sperm diluent either alone or combined with glycerol or ethylene glycol ameliorated sperm viability and kinematic parameters and antioxidant capacity while reducing DNA damage and apoptotic-like changes. Guar gum also has improved embryo development. Due to its cost-effectiveness and physicochemical properties, guar gum is a promising supplement for bull sperm cryopreservation.
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Affiliation(s)
- Adel Saberivand
- Theriogenology section, Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.
| | - Raheleh Mehrabi
- Faculty of Agriculture, Department of Veterinary Medicine, Shoushtar Branch, Islamic Azad University, Shoushtar, Iran
| | | | - Maryam Saberivand
- Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Mahdiye Shirafkan
- Theriogenology section, Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Tannaz Haghgouei
- Theriogenology section, Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Fatemeh Sarvarzadeh
- Faculty of Agriculture, Department of Veterinary Medicine, Shoushtar Branch, Islamic Azad University, Shoushtar, Iran
| | - Peghah Safaei
- Faculty of Agriculture, Department of Veterinary Medicine, Shoushtar Branch, Islamic Azad University, Shoushtar, Iran
| | - Marzieh Saki
- Faculty of Agriculture, Department of Veterinary Medicine, Shoushtar Branch, Islamic Azad University, Shoushtar, Iran
| | | | - Toran Alizadeh
- Department of Animal Science, Faculty of Agriculture, The University of Kordestan, Sanandaj, Iran
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What Does Intracytoplasmic Sperm Injection Change in Embryonic Development? The Spermatozoon Contribution. J Clin Med 2023; 12:jcm12020671. [PMID: 36675600 PMCID: PMC9867417 DOI: 10.3390/jcm12020671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/30/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
The intracytoplasmic sperm injection (ICSI) technique was invented to solve severe male infertility due to altered sperm parameters. Nowadays, it is applied worldwide for the treatment of couple infertility. ICSI is performed with any available spermatozoon from surgery or ejaculated samples, whatever are the sperm motility, morphology or quantity. The aim of the present review was to study if embryo development and kinetics would be modified by (1) ICSI under the technical aspects, (2) the micro-injected spermatozoa in connection with male infertility. From published data, it can be seen that ICSI anticipates the zygote kinetics Furthermore, because fertilization rate is higher in ICSI compared to conventional in vitro fertilization (IVF), more blastocysts are obtained for clinical use in ICSI. Sperm and spermatozoa characteristics, such as sperm parameters, morphology and vitality, DNA content (levels of sperm DNA fragmentation, microdeletions, and chromosomal abnormalities), RNA content, epigenetics, and sperm recovery site (testicular, epididymis, and ejaculated), have an impact on fertilization and blastocyst rates and embryo kinetics in different ways. Even though ICSI is the most common solution to solve couples' infertility, the causes of male infertility are crucial in building a competent spermatozoa that will contribute to normal embryonic development and healthy offspring.
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Jumeau F, Rives N, Lechevallier P, Boniou C, Letailleur M, Réal-Lhommet A, Feraille A. Sperm Chromatin Condensation Defect Accelerates the Kinetics of Early Embryonic Development but Does Not Modify ICSI Outcome. Int J Mol Sci 2022; 24:ijms24010393. [PMID: 36613835 PMCID: PMC9820555 DOI: 10.3390/ijms24010393] [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: 11/11/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
The origin and quality of gametes are likely to influence the kinetics of embryonic development. The purpose of the study was to assess the impact of sperm nuclear quality, and in particular sperm chromatin condensation, on the kinetics of early embryo development after intracytoplasmic sperm injection (ICSI). Our study included 157 couples who benefitted from ICSI for male factor infertility. Chromatin condensation and DNA fragmentation were assessed in spermatozoa prior to ICSI. Above the 20% threshold of sperm condensation defect, patients were included in the abnormal sperm chromatin condensation (ASCC) group; below the 20% threshold, patients were included in the normal sperm chromatin condensation (NSCC) group. After ICSI, the oocytes were placed in the time-lapse incubator. The kinetics of the cohort's embryonic development have been modeled. The fading times of pronuclei and the time to two blastomeres (t2, first cleavage) and four blastomeres (t4, third cleavage) differed significantly between the NSCC and ASCC groups, with earlier events occurring in the ASCC group. On the other hand, the state of sperm chromatin condensation did not seem to have an impact on live birth rates or the occurrence of miscarriages. The kinetics of early embryonic development was accelerated in males with a sperm chromatin condensation defect without compromising the chances of pregnancy or promoting miscarriage. However, our study highlights the paternal contribution to early embryonic events and potentially to the future health of the conceptus.
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Affiliation(s)
- Fanny Jumeau
- Team Adrenal and Gonadal Pathophysiology, Reproductive Biology Laboratory—CECOS, Rouen University Hospital, University Rouen Normandie, Inserm, U1239 NorDIC, F-76000 Rouen, France
| | - Nathalie Rives
- Team Adrenal and Gonadal Pathophysiology, Reproductive Biology Laboratory—CECOS, Rouen University Hospital, University Rouen Normandie, Inserm, U1239 NorDIC, F-76000 Rouen, France
- Correspondence: ; Tel.: +33-02-32-88-82-25
| | - Pauline Lechevallier
- Team Adrenal and Gonadal Pathophysiology, Reproductive Biology Laboratory—CECOS, Rouen University Hospital, University Rouen Normandie, Inserm, U1239 NorDIC, F-76000 Rouen, France
| | - Coline Boniou
- Team Adrenal and Gonadal Pathophysiology, Reproductive Biology Laboratory—CECOS, Rouen University Hospital, University Rouen Normandie, Inserm, U1239 NorDIC, F-76000 Rouen, France
| | - Maria Letailleur
- Assisted Reproductive Center, Department of Gynaecology and Obstetrics, Rouen Normandy University Hospital, F-76000 Rouen, France
| | - Audrey Réal-Lhommet
- Assisted Reproductive Center, Department of Gynaecology and Obstetrics, Rouen Normandy University Hospital, F-76000 Rouen, France
| | - Aurélie Feraille
- Team Adrenal and Gonadal Pathophysiology, Reproductive Biology Laboratory—CECOS, Rouen University Hospital, University Rouen Normandie, Inserm, U1239 NorDIC, F-76000 Rouen, France
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BUDAK Ö, BOSTANCI MS, KÖSE O, AKDEMİR N, GÖKÇE A, CEVRİOĞLU S. Evaluation Of The Clinical Results Of Using Microfluidic Channel System For Sperm Selection In IVF Cycles In Patients With Low Sperm Concentration. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.1171576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Microfluidic channel system (MAC), a new generation method, gives the chance to select better quality spermatozoa with lower DNA fragmentation indices. This study evaluated the treatment results in patients who underwent ICSI-ET due to the MAC technique's male factors.
Methods: Sakarya University ART Center carried out this retrospective study. Patients with 35 male factor indications were included in our study. In these patients, swim-up (SU) was used in the first of two consecutive IVF cycles, and the MAC sperm preparation technique was used in the second. Our study compared fertilization, quality embryo counts, implantation after fresh embryo transfer, pregnancy rates, fifth-day embryo, and frozen embryo numbers.
Results: Fertilization rate was higher in the MAC group than in the SU group (P=0.009). The number of 3rd and 5th Day Grade 1 embryo in the MAC group was statistically higher than in the SU group (p=0.000 for both parameters). The number of quality embryos frozen on day 5 was higher in the MAC group than in the SU group (P=0.000).
Conclusions: It is thought that MAC application does not make a statistically significant contribution on implantation and pregnancy in IVF cycles performed due to the malefactor. However, it may positively affect fertilization rate and embryo quality. In addition, we think that it increases the number of embryos frozen at the end of the cycle, and for this reason, the MAC technique may provide positive benefits to IVF treatments.
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Affiliation(s)
| | - Mehmet Sühha BOSTANCI
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
| | - Osman KÖSE
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI
| | - Nermin AKDEMİR
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
| | - Ahmet GÖKÇE
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
| | - Serhan CEVRİOĞLU
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
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Méndez M, Guimerà M, Corral J, Cívico S. Sperm origin impact on early human embryo kinetics. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2022.100750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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7
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The effect of Caulerpa sertularioides extract on bull sperm freezablity and subsequent embryo development. Theriogenology 2022; 189:167-176. [PMID: 35760028 DOI: 10.1016/j.theriogenology.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/05/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022]
Abstract
Artificial insemination is a valuable and essential tool in genetic improvement programs, and its success requires proper semen collection, freezing, and thawing procedures. Nowadays, despite applying of advanced protocols for semen cryopreservation, post-thawing sperm quantitative and qualitative parameters are not satisfactorily comparable to fresh sperm. The present study was designed to evaluate the effects of the supplementation of an alcoholic extract of Caulerpa sertolarioides alga into the tris-egg yolk-based Simmental bull sperm freezing media. The pooled semen samples were divided into five groups, of which four were supplemented with 500, 1000, 1500, and 2000 ppm alga extract and one allocated as a control. Total motility, progressive motility, plasma membrane integrity, DNA integrity, apoptosis, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, and total antioxidant capacity (TAC) of sperm were measured. The frozen sperm from each group were used for IVF on the slaughterhouse-derived oocytes. Fertilization, cleavage, and blastocyst rates were assessed for all groups. Total motility, progressive motility, and velocity curvilinear (VCL) parameters were higher (p ≤ 0.05) in group 1000 ppm than the control group. Velocity in a straight path (VSL) was higher (p ≤ 0.05) in all treatment groups except in 500 ppm compared to the control group. Average path velocity (VAP) was higher (p ≤ 0.05) in 1000 and 1500 ppm groups than in the control group. Straightness (STR) showed a higher value (p ≤ 0.05) in 1000 and 2000 ppm than the control group. Groups 500 and 1000 ppm showed more viable sperm than the control group (p ≤ 0.05). DNA damage was lower (p ≤ 0.05) in group 1000 ppm than in the control group. HOST was higher (p ≤ 0.05) in all groups than in the control group. SOD, GPx, and TAC were higher (p ≤ 0.05) in 1000 ppm than the control and all other groups. Apoptosis was not significantly different among the treatment and control groups. In conclusion, supplementation of alcoholic extract of Caulerpa sertularioides into the Simmental bull freezing extender ameliorated the sperm parameters after the freeze-thawing process. Moreover, the results of this study indicated that the best dose to achieve the antioxidant properties of the alga extract in Simmental bull sperm freezing media was 1000 ppm. It was also evident that 1000 ppm alga extract supplementation into the bull sperm improved fertilization, cleavage, and blastocyst rates.
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Peer A, Atzmon Y, Aslih N, Bilgory A, Estrada D, Raya YSA, Shalom-Paz E. Male genome influences embryonic development as early as pronuclear stage. Andrology 2021; 10:525-533. [PMID: 34842361 DOI: 10.1111/andr.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/20/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Impaired paternal genome expression may cause poor embryonic development after in vitro fertilization (IVF). OBJECTIVE To evaluate the expression of male infertility on embryo morphokinetics using a time-lapse incubator and its impact on IVF cycles. MATERIALS AND METHODS This retrospective cohort study followed patients from January 2017 to August 2019. Patients were divided according to the cause of infertility to male factor (study group) and unexplained infertility (control group) and further subdivided according to the severity of male infertility. RESULTS A cohort of 462 patients who underwent IVF cycles, with a total of 3,252 embryos was evaluated. Intracytoplasmic sperm injection (ICSI) was conducted more often in the study group compared to the control group (94% vs. 47%, p < 0.0001) and more embryos were discarded (47% vs. 43%, p = 0.016). Treatment outcomes were comparable in both groups regardless of the severity of male infertility. T3-T5 had a significant impact on embryo quality and more transfer and freeze compared to discard. Maternal age, number of aspirated oocytes, BMI, protocol used, and faster time to T3, T6 were significant in increasing chances of achieving pregnancy. CONCLUSION The paternal genome may have an earlier impact on embryo development than previously surmised and may also account for faster morphokinetics. Faster embryo cleavage in male infertility IVF-ICSI cycles may contribute to outcomes comparable to other causes of infertility, in terms of embryo quality and clinical pregnancy rate, despite lower sperm quality, even in cases of severe Oligo-terato-Astheno spermia (OTA).
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Affiliation(s)
- Aviv Peer
- Department of Obstetrics & Gynecology, IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, The Technion-Institute of Technology, Haifa, Israel
| | - Yuval Atzmon
- Department of Obstetrics & Gynecology, IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Nardin Aslih
- Department of Obstetrics & Gynecology, IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Asaf Bilgory
- Department of Obstetrics & Gynecology, IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Daniela Estrada
- Department of Obstetrics & Gynecology, IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yasmin Shibli Abu Raya
- Department of Obstetrics & Gynecology, IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel
| | - Einat Shalom-Paz
- Department of Obstetrics & Gynecology, IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, The Technion-Institute of Technology, Haifa, Israel
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9
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Setti AS, Braga DPDAF, Vingris L, Iaconelli A, Borges E. Early and late paternal contribution to cell division of embryos in a time-lapse imaging incubation system. Andrologia 2021; 53:e14211. [PMID: 34437729 DOI: 10.1111/and.14211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022] Open
Abstract
The objective of this study was to investigate the impact of male age, semen quality and days of ejaculatory abstinence on embryo morphokinetics. A total of 1,220 zygotes obtained from 139 couples in a private in vitro fertilisation centre were analysed. The timing of specific events from the point of insemination, such as timings to pronuclei appearance and fading, to two, three, four, five, six, seven and eight cells and to blastulation were recorded. Multivariate linear regression analysis was used to evaluate the influence of paternal factors on embryo morphokinetic events. Paternal age was positively correlated with delayed cell cleavage and blastulation, and negatively associated with implantation rate, and clinical pregnancy and live-birth chances. The ejaculatory abstinence was inversely correlated with the implantation rate. Inverse relationships were observed between semen parameters (sperm count, progressive sperm motility, total motile sperm count and morphology) and the timing of specific events during embryo development. Sperm morphology was also positively associated with implantation rate and pregnancy and live-birth chances. Increased paternal age and ejaculatory abstinence, and poor semen quality correlate with delayed cell cleavage and blastulation and negatively impact intracytoplasmic sperm injection outcomes.
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Affiliation(s)
- Amanda Souza Setti
- Scientific Research Department, Fertility Medical Group, São Paulo, Brazil.,Scientific Research Department, Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | - Daniela Paes de Almeida Ferreira Braga
- Scientific Research Department, Fertility Medical Group, São Paulo, Brazil.,Scientific Research Department, Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | | | - Assumpto Iaconelli
- Scientific Research Department, Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.,Clinical Department, Fertility Medical Group, São Paulo, Brazil
| | - Edson Borges
- Scientific Research Department, Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.,Clinical Department, Fertility Medical Group, São Paulo, Brazil
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10
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Boediono A, Handayani N, Sari HN, Yusup N, Indrasari W, Polim AA, Sini I. Morphokinetics of embryos after IMSI versus ICSI in couples with sub-optimal sperm quality: A time-lapse study. Andrologia 2021; 53:e14002. [PMID: 33606295 DOI: 10.1111/and.14002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/06/2021] [Accepted: 01/17/2021] [Indexed: 11/30/2022] Open
Abstract
An investigation was conducted to determine the influence of two sperm selection modalities, IMSI and ICSI, on the morphokinetics, dynamic development and ploidy status of embryos derived from males with sub-optimal sperm profiles during IVF program. A total of 209 PGTA-tested top-quality blastocysts (IMSI = 129, ICSI = 80) from 84 couples (IMSI = 51, ICSI = 33) were assessed retrospectively. This study found that both IMSI and ICSI yielded comparable embryo morphokinetics, except for the T7, TEB and CC3 parameters (p < 0.05). A significant lower incidence of multinucleation was observed in the IMSI group when compared to the ICSI group (48.8% vs. 71.3%, p = 0.002), while other parameters of embryo development such as direct cleavage, distorted cytoplasmic movement, reverse cleavage and vacuole(s) appearance did not differ (p > 0.05). No differences were noticed in the proportion of generating chromosomally euploid embryos (44.2% vs. 51.3%, p = 0.394, respectively, for IMSI and ICSI). The implementation of IMSI or ICSI in couples with sub-optimal sperm profiles resulted in embryos with comparatively similar morphokinetics. Furthermore, the incidence of multinucleation at the two- to four-cell stage was lower following the practice of IMSI, although the method did not improve the proportion of gaining euploid embryos.
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Affiliation(s)
- Arief Boediono
- Morula IVF Jakarta Clinic, Jakarta, Indonesia.,IRSI Research and Training Centre, Jakarta, Indonesia.,Department of Anatomy, Physiology and Pharmacology, IPB University, Bogor, Indonesia
| | - Nining Handayani
- Morula IVF Jakarta Clinic, Jakarta, Indonesia.,IRSI Research and Training Centre, Jakarta, Indonesia
| | | | - Nuraeni Yusup
- IRSI Research and Training Centre, Jakarta, Indonesia
| | | | - Arie A Polim
- Morula IVF Jakarta Clinic, Jakarta, Indonesia.,IRSI Research and Training Centre, Jakarta, Indonesia.,Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, Atmajaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Ivan Sini
- Morula IVF Jakarta Clinic, Jakarta, Indonesia.,IRSI Research and Training Centre, Jakarta, Indonesia
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Karavani G, Kan-Tor Y, Schachter-Safrai N, Levitas E, Or Y, Ben-Meir A, Buxboim A, Har-Vardi I. Does sperm origin-Ejaculated or testicular-Affect embryo morphokinetic parameters? Andrology 2020; 9:632-639. [PMID: 33251758 DOI: 10.1111/andr.12952] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 11/04/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND It is unclear whether sperm origin, either ejaculated or testicular, in couples diagnosed with male factor infertility, affects the timing of the embryo's developmental events evaluated by time-lapse monitoring and implantation rates. OBJECTIVE To examine the effect of sperm origin on embryo morphokinetics in couples diagnosed with male factor infertility. MATERIALS AND METHODS This study included a retrospective analysis of morphokinetic parameters performed by time-lapse monitoring between 2013 and 2017. The developmental processes and morphokinetic parameters of 419 embryos obtained from couples with male factor infertility attributed to oligo-astheno-teratozoospermia, 158 embryos derived from surgically extracted testicular spermatozoa from couples diagnosed with non-obstructive azoospermia, and 190 embryos from couples with normal ejaculated spermatozoa and female mechanical factor-related infertility, were evaluated. A comparison of morphokinetic parameters, implantation, and clinical pregnancy rates was performed between the groups with additional analysis in accordance with implantation status. RESULTS Embryos from the normal ejaculated spermatozoa and oligo-astheno-teratozoospermia patients reached the later morphokinetic milestones-synchronous division (S3) and time to morula (tM)-faster than embryos obtained from testicular spermatozoa. Implantation rate was similar in the normal ejaculated spermatozoa and oligo-astheno-teratozoospermia groups (41.9% vs. 45.8%, NS), with higher implantation rate in the oligo-astheno-teratozoospermia group compared to the testicular spermatozoa group (45.8% vs. 33.6%, p = 0.02). Comparison of Known Implantation Data (KID) positive (KIDp) and KID negative (KIDn) embryos in each group revealed more rapid development in KIDp embryos in the normal ejaculated spermatozoa and the oligo-astheno-teratozoospermia groups, while in the testicular spermatozoa group implanted embryos reached the late morphokinetic milestones (time to 8 cell stage-t8, ECC3, S3, and tM) significantly faster than embryos that failed to implant. In a multivariate logistic regression analysis of the male factor infertility population, (oligo-astheno-teratospermia) (OR = 2.54, p = 0.003) and t8 (OR = 0.95, p = 0.027) were predictive of successful implantation. Male factor infertility embryos that reached the t8 milestone within 48-56 h had favorable implantation rates (p < 0.001). DISCUSSION The study results may highlight another pathophysiology by means of which sperm origin affects embryo developmental kinetics. Selecting embryos demonstrating a faster developmental rate at t8 and specifically the 48- to 56 h interval following time of pronuclei fading (tPNf) may improve implantation rates in cases of male factor infertility. CONCLUSION This study showed that ejaculated spermatozoa is associated with faster late cell divisions, more rapid compaction, and higher implantation rates compared to testicular spermatozoa. Additionally, t8 is an important predictor for implantation in the male factor infertility population.
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Affiliation(s)
- Gilad Karavani
- Department of Obstetrics and Gynecology, Hadassah Medical Center-Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yoav Kan-Tor
- Alexander Grass Center for Bioengineering, The Hebrew University of Jerusalem, Jerusalem, Israel.,School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Natali Schachter-Safrai
- Department of Obstetrics and Gynecology, Hadassah Medical Center-Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eliahu Levitas
- Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yuval Or
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Kaplan Hospital, Rehovot, Israel
| | - Assaf Ben-Meir
- Department of Obstetrics and Gynecology, Hadassah Medical Center-Hebrew University of Jerusalem, Jerusalem, Israel.,Infertility and IVF Unit, Hadassah Medical Center-Hebrew University of Jerusalem, Jerusalem, Israel
| | - Amnon Buxboim
- Alexander Grass Center for Bioengineering, The Hebrew University of Jerusalem, Jerusalem, Israel.,School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Cell and Developmental Biology, Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Iris Har-Vardi
- Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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12
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Minasi MG, Greco P, Varricchio MT, Barillari P, Greco E. The clinical use of time-lapse in human-assisted reproduction. Ther Adv Reprod Health 2020; 14:2633494120976921. [PMID: 33336190 PMCID: PMC7724395 DOI: 10.1177/2633494120976921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/04/2020] [Indexed: 11/18/2022] Open
Abstract
A major challenge in the assisted reproduction laboratory is to set up
reproducible and efficient criteria to identify the embryo with the
highest developmental potential. Over the years, several methods have
been used worldwide with this purpose. Initially, standard morphology
assessment was the only available strategy. It is now universally
recognized that besides being a very subjective embryo selection
strategy, morphology evaluation alone has a very poor prognostic
value. More recently, the availability of time-lapse incubators
allowed a continuous monitoring of human embryo development. This
technology has spread quickly and many fertility clinics over the
world produced a remarkable amount of data. To date, however, a
general consensus on which variables, or combination of variables,
should play a central role in embryo selection is still lacking. Many
confounding factors, concerning both patient features and clinical and
biological procedures, have been observed to influence embryo
development. In addition, several studies have reported unexpected
positive outcomes, even in the presence of abnormal developmental
criteria. While it does not seem that time-lapse technology is ready
to entirely replace the more invasive preimplantation genetic testing
in identifying the embryo with the highest implantation potential, it
is certainly true that its application is rapidly growing, becoming
progressively more accurate. Studies involving artificial intelligence
and deep-learning models as well as combining morphokinetic with other
non-invasive markers of embryo development, are currently ongoing,
raising hopes for its successful applicability for clinical purpose in
the near future. The present review mainly focuses on data published
starting from the first decade of 2000, when time-lapse technology was
introduced as a routine clinical practice in the infertility
centers.
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Affiliation(s)
| | | | | | - Paolo Barillari
- Center for Reproductive Medicine,
Villa Mafalda, Rome, Italy
| | - Ermanno Greco
- Center for Reproductive Medicine,
Villa Mafalda, Rome, Italy
- Saint Camillus International
University of Health and Medical Sciences (UniCamillus), Rome,
Italy
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13
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Influence of Different Quality Sperm on Early Embryo Morphokinetic Parameters and Cleavage Patterns: A Retrospective Time-lapse Study. Curr Med Sci 2020; 40:960-967. [PMID: 33123909 DOI: 10.1007/s11596-020-2272-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 05/28/2020] [Indexed: 10/23/2022]
Abstract
To investigate whether sperm with low concentration and motility can impact preimplantation embryos and to analyze how the effects present under a time-lapse incubation system, 2905 oocytes were collected from 219 couples between January 2014 and December 2015. Patients were divided into three groups according to sperm quality. Morphokinetic parameters and six cleavage patterns in the initial three cleavages were evaluated using the Primo Vision system. Embryo quality and clinic outcomes such as implantation rate, pregnancy rate and live birth rate were measured. The results showed that the concentration and motility of sperm correlated strongly with the rate of 2PN embryos, good-quality embryos on D3, blastocysts on D5/6 and good-quality embryos on D5/6. The time-lapse system recordings showed that compromised sperm quality could result in a significant delay in cc1 and a decrease in cc2, and impact embryo developmental potential mainly through large fragments or/and blastomere fragmentation in the initial three cleavages. In conclusion, sperm with low concentration and motility can have paternal effects on preimplantation embryos. These paternal effects present both as changes in morphokinetic parameters and cleavage patterns, which occur as early as fertilization and may cause severe damage to the preimplantation embryos.
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14
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Apter S, Ebner T, Freour T, Guns Y, Kovacic B, Le Clef N, Marques M, Meseguer M, Montjean D, Sfontouris I, Sturmey R, Coticchio G. Good practice recommendations for the use of time-lapse technology †. Hum Reprod Open 2020; 2020:hoaa008. [PMID: 32206731 PMCID: PMC7081060 DOI: 10.1093/hropen/hoaa008] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/05/2019] [Accepted: 01/29/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
| | | | - Thomas Ebner
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler Universitätsklinikum, Linz, Austria
| | - Thomas Freour
- Médecine de la Reproduction, CHU de Nantes, Nantes, France
| | - Yves Guns
- Center for Reproductive Medicine, UZ Brussel, Brussels, Belgium
| | - Borut Kovacic
- Department of Reproductive Medicine and Gynecologic Endocrinology, Univerzitetni klinicni center Maribor, Maribor, Slovenia
| | - Nathalie Le Clef
- European Society of Human Reproduction and Embryology, Grimbergen, Belgium
| | | | - Marcos Meseguer
- IVF Laboratory, Instituto Valenciano de Infertilidad, Valencia, Spain
| | - Debbie Montjean
- Médecine et Biologie de la Reproduction, Hopital Saint Joseph, Marseille, France
| | | | - Roger Sturmey
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
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15
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Kuroda S, Takeshima T, Takeshima K, Usui K, Yasuda K, Sanjo H, Kawahara T, Uemura H, Murase M, Yumura Y. Early and late paternal effects of reactive oxygen species in semen on embryo development after intracytoplasmic sperm injection. Syst Biol Reprod Med 2020; 66:122-128. [PMID: 32063036 DOI: 10.1080/19396368.2020.1720865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although reactive oxygen species in semen are associated with unfavorable results with respect to assisted reproductive technology, their effects based on the detailed stages of embryo development are unclear. We investigated the relationship between reactive oxygen species in semen and the oocyte fertilization rate, cleavage rate, and blastulation rate of intracytoplasmic sperm injections. This retrospective study enrolled 77 couples who underwent intracytoplasmic sperm injection and analyzed 887 eggs from 141 cycles of intracytoplasmic sperm injection. The reactive oxygen species level in semen was compared between the fertilized and nonfertilized groups, between the good-cleavage-embryo and non-developed-embryo groups, and between the good-quality-blastocyst and poor-quality-blastocyst groups. The cut-off level of reactive oxygen species was calculated to predict good-cleavage-embryo and good-quality-blastocyst development. The fertilization rate was 65.4%, and the mean reactive oxygen species levels were not significantly different between the fertilized and nonfertilized groups. The reactive oxygen species level was significantly higher in the non-developed-embryo group than in the good-cleavage-embryo group (P = 0.0026) and was significantly lower in the good-quality-blastocyst group than in the poor-quality-embryo group (P = 0.015). Cleavage embryos and blastocysts were divided into high- and low-reactive-oxygen-species groups using a cut-off value of 6601 and 4926 relative light units, as calculated from the receiver operating characteristic curve. The rates of good-cleavage embryos and good-quality blastocysts were lower in the high-reactive-oxygen-species group than in the low-reactive-oxygen-species group, which were both statistically significant. To conclude, reactive oxygen species in semen is considered to have an adverse effect on both the early and late stages of embryo development in intracytoplasmic sperm injection.Abbreviations: GnRH, gonadotropin-releasing hormone; ICSI, intracytoplasmic sperm injection; IVF, in vitro fertilization; LPO, lipid peroxidation; NADPH, nicotinamide adenine dinucleotide phosphate; RLU, relative light units; ROC, receiver operating characteristic; ROS, reactive oxygen species.
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Affiliation(s)
- Shinnosuke Kuroda
- Department of Urology, Reproduction Centre, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Teppei Takeshima
- Department of Urology, Reproduction Centre, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Kazumi Takeshima
- Department of Gynaecology, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Kimitsugu Usui
- Department of Urology, Reproduction Centre, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Kengo Yasuda
- Department of Urology, Reproduction Centre, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Hiroyuki Sanjo
- Department of Urology, Reproduction Centre, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Takashi Kawahara
- Department of Urology and Renal Transplantation, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Mariko Murase
- Department of Gynaecology, Yokohama City University Medical Centre, Kanagawa, Japan
| | - Yasushi Yumura
- Department of Urology, Reproduction Centre, Yokohama City University Medical Centre, Kanagawa, Japan
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16
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Sacha CR, Dimitriadis I, Christou G, James K, Brock ML, Rice ST, Bhowmick P, Bormann CL, Souter I. The impact of male factor infertility on early and late morphokinetic parameters: a retrospective analysis of 4126 time-lapse monitored embryos. Hum Reprod 2020; 35:24-31. [DOI: 10.1093/humrep/dez251] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/19/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
STUDY QUESTION
Is there an effect of male factor infertility (MFI) on either early or late morphokinetic parameters obtained during embryonic culture to blastocyst stage in a time-lapse imaging (TLI) incubator?
SUMMARY ANSWER
Neither mild nor severe MFI had an impact on overall time to blastocyst or duration of individual cleavage stages in the total embryo population.
WHAT IS KNOWN ALREADY
Prior studies have suggested that paternal DNA and sperm quality affect embryo morphokinetic parameters, but the impact of MFI is not fully understood.
STUDY DESIGN, SIZE, DURATION
This retrospective cohort study, at a major academic fertility centre, included 536 couples (women, ≤44 years of age) undergoing IVF between September 2013 and September 2016.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Data from 4126 embryos cultured to the blastocyst stage in a TLI-monitored incubator were retrospectively reviewed. Embryos derived from the sperm of men with MFI were compared with those derived from patients with other infertility diagnoses. Generalized fixed and random effects models, t-test and χ2 were used as appropriate.
MAIN RESULTS AND THE ROLE OF CHANCE
Couples with MFI had a higher rate of ICSI utilization and fewer usable embryos on average, and the men were older compared with couples with other diagnoses. Additionally, the women in MFI couples were younger and had higher antral follicle counts (AFCs) and higher anti-Müllerian hormone (AMH) levels compared with the other women undergoing IVF. When controlling for maternal and paternal ages, AMH and fertilization method (conventional IVF versus ICSI), neither mild nor severe MFI affected duration of individual cleavage stages or overall time to the blastocyst stage, when all or only usable embryos were examined (coefficient 0.44 hours in all embryos, P = 0.57; coefficient 0.39 hours in usable embryos, P = 0.60). Whether the sperm was surgically extracted similarly had no significant effect on embryo morphokinetic parameters. When the fertilization method was assessed independently, ICSI lengthened the overall time to blastocyst stage by 1.66 hours (P = 0.03) on average, primarily due to an increase in duration of the time from 5-cell embryo stage to early blastulation (P5SB).
LIMITATIONS, REASONS FOR CAUTION
This large cohort study avoided embryo selection bias due to random assignment of embryos to the TLI incubators. However, our findings may not be generalizable to groups under-represented in our clinic population. Future studies should also evaluate the impact of male hormonal status and detailed sperm morphology, such as head versus flagellum defects, on embryo morphokinetic development.
WIDER IMPLICATIONS OF THE FINDINGS
Our findings suggest that the fertilization method rather than MFI per se impacts time to early blastulation. The clinical implications of this effect on embryo development warrant further investigation.
STUDY FUNDING/COMPETING INTEREST(S)
There were no sources of funding for this study. There are no competing interests.
TRIAL REGISTRATION NUMBER
N/A
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Affiliation(s)
- C R Sacha
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - I Dimitriadis
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - G Christou
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - K James
- Deborah Kelly Center for Outcomes Research, Department of OB/GYN, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - M L Brock
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - S T Rice
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - P Bhowmick
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - C L Bormann
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - I Souter
- Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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17
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Kahraman S, Sahin Y, Yelke H, Kumtepe Y, Tufekci MA, Yapan CC, Yesil M, Cetinkaya M. High rates of aneuploidy, mosaicism and abnormal morphokinetic development in cases with low sperm concentration. J Assist Reprod Genet 2020; 37:629-640. [PMID: 31901112 PMCID: PMC7125256 DOI: 10.1007/s10815-019-01673-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 12/22/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose The aim of our study was to evaluate the impact of severe male infertility (SMF) on the chromosomal status of embryos and any possible correlation between chromosomal status and embryo morphokinetics in younger women using data obtained from comprehensive preimplantation genetic tests. Methods The trial was conducted in an ART and Reproductive Genetics Centre between 2011 and 2018. A total of 326 cycles in cases with SMF where the female partner’s age was ≤ 35 years were evaluated. SMF is defined as sperm concentration below 5 mil/ml (million per milliliter) and divided into three subgroups according to sperm concentrations: 1–5 mil/ml, < 1mil/ml and testicular sperm. The control group of 190 cycles had normal sperm parameters. Results Significantly lower chromosomal euploidy rates were found in the testicular sperm group compared with the normal sperm controls when the female age was ≤ 35 years. In SMF, statistically significantly affected chromosomes were 2, 10, 11, 17, 21 and sex chromosomes. The mosaicism and abnormal morphokinetic development rates were higher in the SMF group than in control group, and this difference was significant when testicular sperm was used. Conclusion Lower euploidy rates, higher mosaicism rates and a higher incidence of abnormal morphokinetic development were observed in cases with testicular sperm with female partners ≤ 35 years compared with normal sperm controls. These findings suggest that PGT-A may be advisable in severe male infertility cases. Furthermore, the correlation between morphokinetics and chromosomal status was greatly reduced or absent in these most severe forms of male infertility, thus the need for new morphokinetic models. Electronic supplementary material The online version of this article (10.1007/s10815-019-01673-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Semra Kahraman
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey.
| | - Yucel Sahin
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Hakan Yelke
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Yesim Kumtepe
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Mehmet A Tufekci
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Cigdem C Yapan
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Mesut Yesil
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
| | - Murat Cetinkaya
- Assisted Reproductive Technologies and Reproductive Genetics Center, Istanbul Memorial Hospital, Piyalepasa Bulvari, Sisli, 34384, Istanbul, Turkey
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18
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Dietrich JE, Freis A, Beedgen F, von Horn K, Holschbach V, Liebscher J, Strowitzki T, Germeyer A. Intraindividual Embryo Morphokinetics Are Not Affected by a Switch of the Ovarian Stimulation Protocol Between GnRH Agonist vs. Antagonist Regimens in Consecutive Cycles. Front Endocrinol (Lausanne) 2020; 11:246. [PMID: 32411093 PMCID: PMC7198727 DOI: 10.3389/fendo.2020.00246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/03/2020] [Indexed: 11/26/2022] Open
Abstract
Background: The impact of controlled ovarian stimulation (COS) during medically assisted reproduction (MAR) on human embryogenesis is still unclear. Therefore, we investigated if early embryonic development is affected by the type of gonadotropin-releasing hormone (GnRH) analog used to prevent a premature LH surge. We compared embryo morphology and morphokinetics between GnRH agonist and antagonist cycles, both involving human chorionic gonadotropin (hCG)-trigger. To reduce possible confounding factors, we used intraindividual comparison of embryo morphokinetics in consecutive treatment cycles of the same patients that underwent a switch in the COS protocol. Methods: This retrospective cohort study analyzed morphokinetics of embryos from patients (n = 49) undergoing a switch in COS protocols between GnRH agonists followed by GnRH antagonists, or vice versa, after culture in a time-lapse incubator (EmbryoScope®, Vitrolife) in our clinic between 06/2011 and 11/2016 (n = 49 GnRH agonist cycles with n = 172 embryos; n = 49 GnRH antagonist cycles with n = 163 embryos). Among time-lapse cycles we included all embryos of the two consecutive cycles before and after a switch in the type of COS in the same patient. In-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) was performed and embryos were imaged up to day 5. Data were analyzed using Mann-Whitney U test or Fisher's exact test. The significance level was set to p = 0.05. Patients with preimplantation genetic screening cycles were excluded. Results: The mean age (years ± standard deviation) of patients at the time of treatment was 35.7 ± 4.3 (GnRH agonist) and 35.8 ± 4.0 (GnRH antagonist) (p = 0.94). There was no statistically significant difference in the number of oocytes collected or the fertilization rate. The numbers of top quality embryos (TQE), good-quality embryos (GQE), or poor-quality embryos (PQE) were also not different in GnRH agonist vs. antagonist cycles. We found no statistically significant difference between the analyzed morphokinetic parameters between the study groups. Conclusions: Our finding supports the flexible use of GnRH analogs to optimize patient treatment for COS without affecting embryo morphokinetics.
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Affiliation(s)
- Jens E. Dietrich
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
- *Correspondence: Jens E. Dietrich
| | - Alexander Freis
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Franziska Beedgen
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
- Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Kyra von Horn
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Verena Holschbach
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Julia Liebscher
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Thomas Strowitzki
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Ariane Germeyer
- Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
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19
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Yalcinkaya Kalyan E, Can Celik S, Okan O, Akdeniz G, Karabulut S, Caliskan E. Does a microfluidic chip for sperm sorting have a positive add-on effect on laboratory and clinical outcomes of intracytoplasmic sperm injection cycles? A sibling oocyte study. Andrologia 2019; 51:e13403. [PMID: 31434165 DOI: 10.1111/and.13403] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/01/2019] [Indexed: 12/19/2022] Open
Abstract
The most recent technologies for sperm sorting involve microfluidics. However, the most important question whether their use is of any advantage in terms of laboratory and clinical IVF/ICSI outcomes still remains controversy. In this study, we aimed to investigate whether a microfluidic sperm sorting device (Fertile Plus® ) has a positive add-on effect on laboratory and clinical outcomes. Sibling oocytes of 81 patients were assigned to two sperm sorting groups including swim up and Fertile Plus® . All embryos were cultured until day 5/6. Fertilisation, embryo quality and blastocyst development were assessed as primary outcomes among 81 patients; clinical pregnancy, implantation and live birth rates were analysed as secondary outcomes as a subgroup analysis due to transfer cancellations. No statistically significant differences were found between groups in terms of all outcomes analysed in laboratory and clinical terms (p > .05 for all). The results of this study suggest that sorting spermatozoa through Fertile chip does not improve laboratory outcomes significantly and does not seem to have a positive contribution to clinical outcomes.
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Affiliation(s)
| | - Seren Can Celik
- Okan University Hospital Assisted Reproduction Unit, Istanbul, Turkey
| | - Ozlem Okan
- Adatip Hospital Assisted Reproduction Unit, Sakarya, Turkey
| | - Gulden Akdeniz
- Adatip Hospital Assisted Reproduction Unit, Sakarya, Turkey
| | - Seda Karabulut
- International School of Medicine, Regenerative and Restorative Medicine Research Center (REMER), Medipol University, Istanbul, Turkey
| | - Eray Caliskan
- Okan University Hospital Assisted Reproduction Unit, Istanbul, Turkey
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20
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Mangoli E, Khalili MA, Talebi AR, Agha‐Rahimi A, Soleimani M, Faramarzi A, Pourentezari M. IMSI procedure improves clinical outcomes and embryo morphokinetics in patients with different aetiologies of male infertility. Andrologia 2019; 51:e13340. [DOI: 10.1111/and.13340] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/29/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Esmat Mangoli
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Mohammad Ali Khalili
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Ali Reza Talebi
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Azam Agha‐Rahimi
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Mehrdad Soleimani
- Department of Reproductive Biology, Research and Clinical Center for Infertility Shahid Sadoughi University of Medical Sciences Yazd Iran
| | - Azita Faramarzi
- Fertility and Infertility Research Center Health Technology Institute, Kermanshah University of Medical Sciences Kermanshah Iran
| | - Majid Pourentezari
- Departments of Biology and Anatomical Sciences Shahid Sadoughi University of Medical Sciences Yazd Iran
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21
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Buran A, Tulay P, Dayıoğlu N, Bakircioglu ME, Bahceci M, İrez T. Evaluation of the morphokinetic parameters and development of pre‐implantation embryos obtained by testicular, epididymal and ejaculate spermatozoa using time‐lapse imaging system. Andrologia 2018; 51:e13217. [DOI: 10.1111/and.13217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/03/2018] [Accepted: 11/11/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Ali Buran
- Department of Histology and Embryology, Faculty of Medicine Yeni Yuzyil University Istanbul Turkey
| | - Pinar Tulay
- Department of Medical Genetics, Faculty of Medicine Near East University Nicosia North Cyprus
| | - Nurten Dayıoğlu
- Department of Medical Statistics, Faculty of Medicine Yeni Yuzyil University Istanbul Turkey
| | | | | | - Tulay İrez
- Department of Histology and Embryology, Faculty of Medicine Biruni University Istanbul Turkey
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22
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Gaspard O, Vanderzwalmen P, Wirleitner B, Ravet S, Wenders F, Eichel V, Mocková A, Spitzer D, Jouan C, Gridelet V, Martens H, Henry L, Zech H, d'Hauterive SP, Nisolle M. Impact of high magnification sperm selection on neonatal outcomes: a retrospective study. J Assist Reprod Genet 2018; 35:1113-1121. [PMID: 29607458 DOI: 10.1007/s10815-018-1167-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/16/2018] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The aim of this study was to compare the effect of the deselection of spermatozoa presenting vacuole-like structures using IMSI (intracytoplasmic morphologically selected sperm injection) with ICSI (intracytoplasmic sperm injection) by means of neonatal outcomes. METHODS In a retrospective two-center analysis, a total of 848 successful IMSI or ICSI cycles ending with a live birth, induced abortion, or intrauterine fetal death (IUFD) were included. RESULTS The IMSI and ICSI groups included 332 and 655 babies or fetuses, respectively. The parents were older in the IMSI group than in the ICSI group (mothers were 35.1 vs 32.9 years, and fathers were 39.1 vs 36.2 years). The multiple pregnancy rate was higher in the IMSI group. The mean pregnancy duration and mean birth weight were almost identical in both groups. There was no significant difference in major congenital malformations between the two groups. However, this rate was decreased in the IMSI group compared to that in the ICSI group (1.8 vs 3.2%), the difference being mainly found in singletons (1.4 vs 3.3%). Boys were more often affected than girls in both groups. The percentages of chromosomal abnormalities did not differ between the IMSI and ICSI groups (0.6 and 0.8%). The reported congenital malformations mainly affected the heart, urogenital, and musculoskeletal systems. CONCLUSIONS In the present study, the malformation rates observed in the IMSI and ICSI groups were not significantly different, even if slightly lower after IMSI. However, the observed difference followed the same trends observed in previous reports, indicating the possible impact of IMSI on decreasing congenital malformation occurrences. This highlights the necessity to prospectively evaluate the impact of IMSI on neonatal outcome after IVF treatment.
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Affiliation(s)
- Olivier Gaspard
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium.
| | | | | | - Stéphanie Ravet
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Frédéric Wenders
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | | | - Alice Mocková
- Department of Neonatology, Faculty of Medicine in Pilsen and University Hospital, Charles University in Prague, Prague, Czech Republic
| | | | - Caroline Jouan
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Virginie Gridelet
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium.,GIGA I3, Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Henri Martens
- GIGA I3, Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Laurie Henry
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Herbert Zech
- IVF-Centers Prof. Zech, Bregenz, Austria.,IVF-Centers Prof. Zech, Salzburg, Austria
| | - Sophie Perrier d'Hauterive
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Michelle Nisolle
- Centre de Procréation Médicalement Assistée - ULiège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
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23
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Freis A, Dietrich JE, Binder M, Holschbach V, Strowitzki T, Germeyer A. Relative Morphokinetics Assessed by Time-Lapse Imaging Are Altered in Embryos From Patients With Endometriosis. Reprod Sci 2017; 25:1279-1285. [PMID: 29141509 DOI: 10.1177/1933719117741373] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Time-lapse technology allows almost continuous noninvasive assessment of embryonic development. It was shown previously that relative kinetics defining cleavage synchronicity are better predictors of blastocyst quality than absolute time points. This study aims to compare relative kinetics in embryos from patients with and without endometriosis. METHODS Time-lapse data were collected retrospectively from 596 patients undergoing infertility treatment for in vitro fertilization from January 2011 to July 2016. Four hundred twenty-eight patients with confounding comorbidities (ie, polycystic ovary syndrome, pathological spermiogram in the included cycle, numerical/structural genetic abnormalities, preimplantation genetic screening performed) or incomplete data sets were excluded. Of the 168 included patients, 72 (42.9%) had endometriosis. Indications for in vitro fertilization of controls were tubal factor, unexplained infertility, or prolonged infertility. Relative kinetics were calculated as defined previously: cleavage synchronicity (CS)2-8=((t3-t2) + (t5-t4))/(t8-t2), CS4-8=(t8-t5)/(t8-t4), CS2-4=(t4-t3)/(t4-t2), DNA replication time ratio (DR)=(t3-t2)/(t5-t3). In women with more than one embryo, the median time was analyzed. RESULTS Median age, body mass index, smoking status, and AMH levels were similar in both groups. Embryos from patients with endometriosis showed poorer relative kinetics. The relative time CS2-8 was decreased in embryos from patients with endometriosis (0.7 [0.0-0.93] vs 0.8 [0.0-0.94], P < .05) and CS4-8 was increased (0.4 [0.0-1.0] vs 0.3 [0.0-1.0], P < .05). The less powerful diagnostic relative kinetic parameters (CS2-4 and DR) were not significantly different. CONCLUSIONS Embryos from patients with endometriosis presented with altered relative kinetics suggesting poorer embryo quality. These findings support recently published data demonstrating reduced oocyte quality in patients with endometriosis which is one possible explanation for their poor response to fertility treatment.
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Affiliation(s)
- Alexander Freis
- 1 Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg University Hospital, Heidelberg, Germany
| | - Jens Erik Dietrich
- 1 Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg University Hospital, Heidelberg, Germany
| | - Moritz Binder
- 2 Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Verena Holschbach
- 1 Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Strowitzki
- 1 Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg University Hospital, Heidelberg, Germany
| | - Ariane Germeyer
- 1 Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg University Hospital, Heidelberg, Germany
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24
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Are blastocyst aneuploidy rates different between fertile and infertile populations? J Assist Reprod Genet 2017; 35:403-408. [PMID: 29063503 DOI: 10.1007/s10815-017-1060-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE This study aimed to determine if patients with infertility or recurrent pregnancy loss have higher rates of embryo aneuploidy than fertile controls. METHODS This was a retrospective review of all pre-implantation genetic screening (PGS) cases processed by a single reference lab prior to March 2014 after a blastocyst biopsy. Cases were excluded if no indication for PGS was designated or patients were translocation carriers. The fertile control group consisted of patients undergoing IVF with PGS for sex selection only. The comparison cohorts included those with recurrent pregnancy loss, male factor infertility, unexplained infertility, prior failed IVF, or previous aneuploid conceptions. A quasi-binomial regression model was used to assess the relationship between the dependent variable, aneuploidy rate and the independent variables, maternal age and reason for PGS. A quasi-Poisson regression model was used to evaluate the relationship between similar independent variables and the number of blastocyst biopsies per case. RESULTS The initial study population consisted of 3378 IVF-PGS cycles and 18,387 analyzed trophectoderm samples. Controlling for maternal age, we observed an increased rate of aneuploidy among patients with recurrent pregnancy loss (OR 1.330, p < 0.001), prior aneuploid pregnancy (OR 1.439, p < 0.001), or previous failed IVF cycles (OR 1.356, p = 0.0012) compared to fertile controls. Patients with unexplained and male factor infertility did not have a significantly different aneuploidy rate than controls (p > 0.05). The increase in aneuploidy in patients with RPL and prior IVF failure was driven by both an increase in meiotic (OR 1.488 and 1.508, p < 0.05) and mitotic errors (1.269 and 1.393, p < 0.05) relative to fertile controls, while patients with prior aneuploid pregnancies had only an increased risk of meiotic error aneuploidies (OR 1.650, p < 0.05). CONCLUSIONS Patients with recurrent pregnancy loss, previous IVF failures, and prior aneuploid pregnancies have a significantly higher, age-independent, aneuploidy rate compared to patients without infertility.
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