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Zalesky T, Bradshaw AJ, Bair ZJ, Meyer KW, Stamets P. Fungal cryopreservation across 61 genera: Practical application and method evaluation. Mycologia 2024; 116:865-876. [PMID: 38949868 DOI: 10.1080/00275514.2024.2363135] [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: 06/02/2023] [Accepted: 05/30/2024] [Indexed: 07/03/2024]
Abstract
Fungi occupy important environmental, cultural, and socioeconomic roles. However, biological research of this diverse kingdom has lagged behind that of other phylogenetic groups. This is partially the result of the notorious difficulty in culturing a diverse array of filamentous fungal species due to their (i) often unpredictable growth, (ii) unknown preferences for culturing conditions, and (iii) long incubation times compared with other microorganisms such as bacteria and yeasts. Given the complexity associated with concurrently culturing diverse fungal species, developing practical methods for preserving as many species as possible for future research is vital. The widely accepted best practice for preserving fungal tissue is the use of cryogenic biobanking at -165 C, allowing for the preservation and documentation of stable genetic lineages, thus enabling long-term diversity-centered research. Despite the extensive literature on fungal cryopreservation, substantial barriers remain for implementation of cryogenic biobanks in smaller mycological laboratories. In this work, we present practical considerations for the establishment of a fungal culture biobank, as well as provide evidence for the viability of 61 fungal genera in cryogenic storage. By providing a pragmatic methodology for cryogenically preserving and managing many filamentous fungi, we show that creating a biobank can be economical for independently owned and operated mycology laboratories, which can serve as a long-term resource for biodiversity, conservation, and strain maintenance.
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Affiliation(s)
- Travis Zalesky
- School of Geography, Development and Environment, University of Arizona, 1200 E University Boulevard, Tucson, Arizona 85721
| | - Alexander J Bradshaw
- School of Biological Sciences, University of Utah, 201 Presidents Circle, Salt Lake City, Utah 84112
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2
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Bedwal RG, Nair N, Pareek C, More A, Kalbande A. Enhancing the Fertility Potential: A Case Report on the Management of Oligoasthenozoospermia Using a Microfluidic Device. Cureus 2024; 16:e61737. [PMID: 38975441 PMCID: PMC11226179 DOI: 10.7759/cureus.61737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 07/09/2024] Open
Abstract
Low sperm count and motility in oligoasthenozoospermia present significant challenges to conception. This case report involves a couple, a 28-year-old female and a 35-year-old male, experiencing secondary infertility for four years. The male partner's habits of alcohol consumption and smoking were potential infertility factors. Semen analysis revealed a total sperm count of 10 million/mL, with total motility at 30% and progressive motility at 5%. The couple underwent intracytoplasmic sperm injection (ICSI), using advanced sperm separation techniques to isolate motile and morphologically normal sperm. Despite the suboptimal sperm parameters, this approach resulted in successful fertilization and pregnancy. The female partner's preparation involved a short antagonist treatment, leading to the retrieval of eight oocytes, seven of which were mature. A positive urine pregnancy test and ultrasound confirmed the pregnancy, with β-hCG at 798 mIU/mL. This case highlights the potential of individualized treatments in managing oligoasthenozoospermia, emphasizing their promise in improving assisted reproductive outcomes despite mixed research results.
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Affiliation(s)
- Rohit G Bedwal
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nancy Nair
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Charu Pareek
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aakash More
- Anatomy, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Avanti Kalbande
- Obstetrics and Gynaecology, Shalinitai Meghe Hospital and Research Centre, Nagpur, IND
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3
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Olmedo C, Veiga E, Sánchez L, Ferrer E, Ortiz N, Mauri A, Fernández M, Martínez L, López-Regalado ML, Iglesias M. ASEBIR Quality Special Interest Group guidance for quality in assisted reproduction technology. Reprod Biomed Online 2024; 48:103730. [PMID: 38368763 DOI: 10.1016/j.rbmo.2023.103730] [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: 06/14/2023] [Revised: 11/03/2023] [Accepted: 11/12/2023] [Indexed: 02/20/2024]
Abstract
Assisted human reproduction has undergone rapid advances since its inception 45 years ago. To keep pace with these advances, assisted reproduction laboratories should adhere to a quality management system that addresses staffing and training, physical space and air quality, equipment maintenance and other operational matters, and ensures gamete and embryo handling in accordance with the latest quality and safety standards. Accordingly, this review aims to provide a reference document that highlights the critical aspects to consider when establishing and operating an ART laboratory. The review collates and expands upon published national and international guidelines and consensus documents, providing easier access to this large body of important information.
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Affiliation(s)
- Carla Olmedo
- Unidad de Medicina Reproductiva, Hospital General Universitario de Valencia, Valencia, Spain.
| | - Ernesto Veiga
- Laboratorio Central/Unidad de Reproducción Humana Asistida, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela A Coruña, Spain
| | - Lourdes Sánchez
- Unidad de Reproducción Asistida, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Empar Ferrer
- Laboratorio de Embriología, Centro Médico de Reproducción Asistida (CREA), Valencia, Spain
| | - Nereida Ortiz
- Unidad de Reproducción, Hospital Universitario Torrejón de Ardóz, Madrid, Spain
| | - Alba Mauri
- Laboratorio de Embriología, Procrear, Reus, Tarragona, Spain
| | - María Fernández
- Laboratorio de Embriología, Clínica Ergo, Gijón, Asturias, Spain
| | - Luis Martínez
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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4
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Palmer GA, Tomkin G, Martín-Alcalá HE, Mendizabal-Ruiz G, Cohen J. The Internet of Things in assisted reproduction. Reprod Biomed Online 2023; 47:103338. [PMID: 37757612 DOI: 10.1016/j.rbmo.2023.103338] [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: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/29/2023]
Abstract
The Internet of Things (IoT) is a network connecting physical objects with sensors, software and internet connectivity for data exchange. Integrating the IoT with medical devices shows promise in healthcare, particularly in IVF laboratories. By leveraging telecommunications, cybersecurity, data management and intelligent systems, the IoT can enable a data-driven laboratory with automation, improved conditions, personalized treatment and efficient workflows. The integration of 5G technology ensures fast and reliable connectivity for real-time data transmission, while blockchain technology secures patient data. Fog computing reduces latency and enables real-time analytics. Microelectromechanical systems enable wearable IoT and miniaturized monitoring devices for tracking IVF processes. However, challenges such as security risks and network issues must be addressed through cybersecurity measures and networking advancements. Clinical embryologists should maintain their expertise and knowledge for safety and oversight, even with IoT in the IVF laboratory.
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Affiliation(s)
- Giles A Palmer
- IVF2.0 Ltd, London, UK; International IVF Initiative, New York, New York, USA
| | | | | | - Gerardo Mendizabal-Ruiz
- Conceivable Life Sciences, New York, New York, USA; Departamento de Bioingeniería Traslacional, Universidad de Guadalajara, Guadalajara, Mexico
| | - Jacques Cohen
- IVF2.0 Ltd, London, UK; International IVF Initiative, New York, New York, USA; Althea Science Inc, New York, New York, USA; Conceivable Life Sciences, New York, New York, USA.
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5
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Canosa S, Maggiulli R, Cimadomo D, Innocenti F, Fabozzi G, Gennarelli G, Revelli A, Bongioanni F, Vaiarelli A, Ubaldi FM, Rienzi L, Palmer GA, Nijs M. Cryostorage management of reproductive cells and tissues in ART: status, needs, opportunities and potential new challenges. Reprod Biomed Online 2023; 47:103252. [PMID: 37451970 DOI: 10.1016/j.rbmo.2023.06.007] [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: 08/09/2022] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023]
Abstract
Among the wide range of procedures performed by clinical embryologists, the cryopreservation of reproductive cells and tissues represents a fundamental task in the daily routine. Indeed, cryopreservation procedures can be considered a subspecialty of medically assisted reproductive technology (ART), having the same relevance as sperm injection or embryo biopsy for preimplantation genetic testing. However, although a great deal of care has been devoted to optimizing cryopreservation protocols, the same energy has only recently been spent on developing and implementing strategies for the safe and reliable storage and transport of reproductive specimens. Herein, we have summarized the content of the available guidelines, the risks, the needs and the future perspectives regarding the management of cryopreservation biorepositories used in ART.
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Affiliation(s)
| | | | - Danilo Cimadomo
- IVIRMA Global Research Alliance, Clinica Valle Giulia, Rome, Italy
| | | | - Gemma Fabozzi
- IVIRMA Global Research Alliance, Clinica Valle Giulia, Rome, Italy
| | | | | | | | | | - Flippo M Ubaldi
- IVIRMA Global Research Alliance, Clinica Valle Giulia, Rome, Italy
| | - Laura Rienzi
- IVIRMA Global Research Alliance, Clinica Valle Giulia, Rome, Italy; Department of Biomolecular Sciences, University of Urbino 'Carlo Bo', Urbino, Italy
| | - Giles A Palmer
- International IVF Initiative Inc, New York, NY, USA; Institute of Life, IASO Hospital, Athens, Greece; IVF 2.0 Ltd, London, UK
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6
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Applebaum J, Humphries LA, Nepps ME, Berger DS, O'Neill K. Malpractice litigation surrounding in vitro fertilization in the United States: a legal literature review. Fertil Steril 2023; 119:572-580. [PMID: 36581015 DOI: 10.1016/j.fertnstert.2022.12.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/21/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Analysis of malpractice lawsuits that involve in vitro fertilization (IVF) can provide insight into the breadth of legal challenges faced by IVF clinics and the patient harms and financial consequences that can result from alleged errors in practice. OBJECTIVE We aimed to review malpractice litigations involving IVF and identify common themes in plaintiff allegations and defense arguments. EVIDENCE REVIEW We queried Nexis Uni, Westlaw, and CourtListener legal databases to collect records from malpractice litigations involving IVF. The nature of the cases, allegations, and outcomes were abstracted from court documents. FINDINGS Of the 447 cases identified in the query, 53 involved both malpractice and IVF, occurring between 1993 and 2022. Defendants included a reproductive endocrinologist in 19 (35.8%) cases, an academic institution in 17 (32.1%) cases, embryology personnel in 9 (17.0%) cases, and nursing staff in 2 (3.8%) cases. Twenty-four (45.3%) cases involved embryology errors (e.g., lost specimens and incorrect sperm donor), 11 (20.8%) preimplantation genetic testing errors (e.g., child born with genetic illness despite testing), 6 (11.3%) medical or surgical complications (e.g., ovarian hyperstimulation syndrome), 4 (7.5%) misdiagnoses (e.g., malignancy before cycle start), 3 (5.6%) misrepresentations of IVF outcomes, 2 (3.8%) medical eligibility screening issues (e.g., medical comorbidities in a gestational carrier), 2 (3.8%) confidentiality breaches, and 1 (1.9%) case of discrimination. The most common secondary claims were negligence (23 cases, 16.4% of all claims), breach of contract (13, 9.3%), lack of informed consent (11, 7.9%), and negligent infliction of emotional distress (11, 7.9%). Twenty-nine (54.7%) cases were decided in favor of the defending IVF clinic or provider, 13 (24.5%) cases were decided in favor of the plaintiff, and 11 (20.8%) involved ongoing proceedings. Financial awards ranged from $4171 to $14,975,000, with the largest monetary award resulting from a cryostorage accident class action lawsuit. CONCLUSION In vitro fertilization malpractice claims are varied, with the most common issues involving embryology laboratory processes and genetic testing errors. Some errors may be avoidable with increased vigilance and implementation of stringent laboratory and clinical guidelines. Understanding jurisdiction-specific legislation and court processes may also assist IVF providers in navigating the malpractice litigation process. RELEVANCE This comprehensive review of IVF litigation may have the potential to promote practices that protect both providers and patients.
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Affiliation(s)
- Jeremy Applebaum
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Leigh Ann Humphries
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary Ellen Nepps
- Office of General Counsel, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Dara S Berger
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kathleen O'Neill
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Meeting the challenge of unclaimed cryopreserved embryos. Fertil Steril 2023; 119:15-20. [PMID: 36476953 DOI: 10.1016/j.fertnstert.2022.09.323] [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: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 12/08/2022]
Abstract
With the rise of efficient and highly effective embryo cryopreservation techniques, the modern in vitro fertilization laboratory has unintentionally become a long-term storage facility for embryos and gametes. One challenge posed by long-term storage is the issue of unclaimed, effectively abandoned, cryopreserved embryos whose owners cannot be identified or are unable to provide a dispositional decision. Given the nuanced nature of dealing with human tissue, no straightforward solutions for managing this novel scenario have prevailed. In this article, we discuss the problem faced by physicians, clinics, and patients alike when faced with unclaimed cryopreserved embryos. We also review strategies for proactive prevention and resolution of conflicts that may arise when making dispositional decisions.
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Maezawa T, Takae S, Takeuchi H, Takenaka M, Ota K, Horie A, Suzuki T, Takai Y, Kimura F, Furui T, Ikeda T, Suzuki N. A Nationwide Survey Aimed at Establishing an Appropriate Long-Term Storage and Management System for Fertility Preserving Specimens in Japan. J Adolesc Young Adult Oncol 2022. [DOI: 10.1089/jayao.2021.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Tadashi Maezawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroki Takeuchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Motoki Takenaka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Kuniaki Ota
- Department of Obstetrics and Gynecology, Tokyo Rosai Hospital, Ohta-ku, Japan
| | - Akihito Horie
- Department of Gynecology and Obstetrics, Graduate School of Medical Science, Kyoto University, Sakyo-ku, Japan
| | - Tatsuya Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Kawagoe, Japan
| | - Fuminori Kimura
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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Wood L, Proudlove N. Doing today’s work today: real-time data recording and rolling audit in an IVF clinic. BMJ Open Qual 2022; 11:bmjoq-2022-001943. [PMID: 36171005 PMCID: PMC9528667 DOI: 10.1136/bmjoq-2022-001943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
Abstract
The assisted conception unit at Sheffield Teaching Hospital NHS Foundation Trust provides in vitro fertilisation treatment. A team of seven embryologists provides a routine clinical laboratory service, involving culture and storage of embryos. This requires a series of management and statutory data administration and communication tasks. We were aware that these were often done many days after clinical tasks, resulting in delays sending patient correspondence and unavailability of clinical notes for multidisciplinary team (MDT) cycle-review meetings. Embryologists also complained that transcribing data were time-consuming and duplicated across our IDEAS software, spreadsheets and paper. We process-mapped our processes and gathered staff views on problems and potential solutions. The baseline average total cycle time (TCT) for completion of all administrative steps was around 17 days; data administration time (DAT, data ‘touch time’) was around 30 min per patient. We embarked on this Quality Improvemen (QI) project to reduce waste in TCT and DAT, and to have data available for patient communication and MDT deadlines. Exploration of IDEAS’ capabilities led to progressive realisation of how much could be transferred to this single data system, removing a lot of off-putting redundancy. Through this we developed a ‘to-be’ vision of all data entry being real time, as part of the clinical ‘jobs’. We conducted five Plan–Do–Study–Act cycles plus two more to test performance and sustainability as changes bedded-in and an external constraint disappeared. We have cut TCT to 0 or 1 days and DAT to around 18 min. All project metrics are reliably within our targets, and data are now always available for timely patient letters and the MDT. Other benefits include easy access for all staff to patient records and removal of paper and spreadsheets. A further, unanticipated, benefit was a switch from a tedious 2 yearly storage tank audit to a more-agreeable and safer rolling audit.
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Affiliation(s)
- Lucy Wood
- Assisted Conception Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Nathan Proudlove
- Alliance Manchester Business School, The University of Manchester, Manchester, UK
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10
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Pomeroy KO, Comizzoli P, Rushing JS, Lersten IL, Nel-Themaat L. The ART of cryopreservation and its changing landscape. Fertil Steril 2022; 117:469-476. [DOI: 10.1016/j.fertnstert.2022.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
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Capelli C, Frigerio S, Lisini D, Nava S, Gaipa G, Belotti D, Cabiati B, Budelli S, Lazzari L, Bagnarino J, Tanzi M, Comoli P, Perico N, Introna M, Golay J. A comprehensive report of long-term stability data for a range ATMPs: A need to develop guidelines for safe and harmonized stability studies. Cytotherapy 2022; 24:544-556. [PMID: 35177338 DOI: 10.1016/j.jcyt.2021.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND AIMS Advanced therapy medicinal products (ATMPs) are novel drugs based on genes, cells or tissues developed to treat many different diseases. Stability studies of each new ATMP need to be performed to define its shelf life and guarantee efficacy and safety upon infusion, and these are presently based on guidelines originally drafted for standard pharmaceutical drugs, which have properties and are stored in conditions quite different from cell products. The aim of this report is to provide evidence-based information for stability studies on ATMPs that will facilitate the interlaboratory harmonization of practices in this area. METHODS We have collected and analyzed the results of stability studies on 19 different cell-based experimental ATMPs, produced by five authorized cell factories forming the Lombardy "Plagencell network" for use in 36 approved phase I/II clinical trials; most were cryopreserved and stored in liquid nitrogen vapors for 1 to 13 years. RESULTS The cell attributes collected in stability studies included cell viability, immunophenotype and potency assays, in particular immunosuppression, cytotoxicity, cytokine release and proliferation/differentiation capacity. Microbiological attributes including sterility, endotoxin levels and mycoplasma contamination were also analyzed. All drug products (DPs), cryopreserved in various excipients containing 10% DMSO and in different primary containers, were very stable long term at <-150°C and did not show any tendency for diminished viability or efficacy for up to 13.5 years. CONCLUSIONS Our data indicate that new guidelines for stability studies, specific for ATMPs and based on risk analyses, should be drafted to harmonize practices, significantly reduce the costs of stability studies without diminishing safety. Some specific suggestions are presented in the discussion.
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Affiliation(s)
- Chiara Capelli
- Center of Cellular Therapy "G. Lanzani", ASST Papa Giovanni XXIII, Bergamo, Italy; Fondazione per la Ricerca Ospedale di Bergamo, Bergamo, Italy
| | - Simona Frigerio
- Cell Therapy Production Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Daniela Lisini
- Cell Therapy Production Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Nava
- Cell Therapy Production Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Gaipa
- Laboratory of Cell and Gene Therapy Stefano Verri, ASST Monza Ospedale San Gerardo, Monza, Italy
| | - Daniela Belotti
- Laboratory of Cell and Gene Therapy Stefano Verri, ASST Monza Ospedale San Gerardo, Monza, Italy
| | - Benedetta Cabiati
- Laboratory of Cell and Gene Therapy Stefano Verri, ASST Monza Ospedale San Gerardo, Monza, Italy
| | - Silvia Budelli
- Laboratory of Regenerative Medicine - Cell Factory, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Lorenza Lazzari
- Laboratory of Regenerative Medicine - Cell Factory, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Jessica Bagnarino
- UOSD Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Matteo Tanzi
- UOSD Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Comoli
- UOSD Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Norberto Perico
- Aldo & Cele Daccò Clinical Research Center for Rare Diseases, Istituto Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Martino Introna
- Center of Cellular Therapy "G. Lanzani", ASST Papa Giovanni XXIII, Bergamo, Italy.
| | - Josée Golay
- Center of Cellular Therapy "G. Lanzani", ASST Papa Giovanni XXIII, Bergamo, Italy; Fondazione per la Ricerca Ospedale di Bergamo, Bergamo, Italy
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12
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Anagnostopoulou C, Rosas IM, Gugnani N, Desai D, Manoharan M, Singh N, Leonardi Diaz SI, Singh K, Wirka KA, Gupta S, Darbandi S, Chockalingam A, Darbandi M, Boitrelle F, Finelli R, Sallam HN, Agarwal A. An expert commentary on essential equipment, supplies and culture media in the ART laboratory. Panminerva Med 2022; 64:140-155. [PMID: 35146990 DOI: 10.23736/s0031-0808.22.04671-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ART laboratory is a complex system designed to sustain the fertilization, survival, and culture of the preimplantation embryo to the blastocyst stage. ART outcomes depend on numerous factors, among which are the equipment, supplies and culture media used. The number and type of incubators also may affect ART results. While large incubators may be more suitable for media equilibration, bench-top incubators may provide better embryo culture conditions in separate or smaller chambers and may be coupled with time-lapse systems that allow continuous embryo monitoring. Microscopes are essential for observation, assessment, and micromanipulation. Workstations provide a controlled environment for gamete and embryo handling and their quantity should be adjusted according to the number of ART cycles treated in order to provide a steady and efficient workflow. Continuous maintenance, quality control and monitoring of equipment is essential and quality control devices such as the thermometer, and pH-meter are necessary to maintain optimal culture conditions. Tracking, appropriate delivery and storage conditions, and quality control of all consumables is recommended so that the adequate quantity and quality is available for use. Embryo culture media have evolved: preimplantation embryos are cultured either by sequential media or single-step media that can be used for interrupted or uninterrupted culture. There is currently no sufficient evidence that any individual commercially-available culture system is better than others in terms of embryo viability. In this review, we aim to analyse the various parameters that should be taken into account when choosing the essential equipment, consumables and culture media systems that will create optimal culture conditions and provide the most effective patient treatment.
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Affiliation(s)
| | - Israel M Rosas
- Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico
| | - Nivita Gugnani
- BabySoon Fertility and IVF Center, New Delhi, India India Institute of Medical Sciences, Delhi, India
| | - Dimple Desai
- DPU IVF & ENDOSCOPY CENTER, Dr. D. Y. Patil Hospital & Research Centre, Pune, India
| | | | | | | | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados
| | - Kelly A Wirka
- Fertility & Endocrinology, Medical Affairs, EMD Serono, USA
| | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland, Ohio, USA
| | - Sara Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran.,Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | | | - Mahsa Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran.,Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.,Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland, Ohio, USA
| | - Hassan N Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland, Ohio, USA -
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13
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In re: the disposition of frozen embryos: 2022. Fertil Steril 2022; 117:477-480. [DOI: 10.1016/j.fertnstert.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 11/19/2022]
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Gore M, Narvekar A, Bhagwat A, Jain R, Dandekar P. Macromolecular cryoprotectants for the preservation of mammalian cell culture: lessons from crowding, overview and perspectives. J Mater Chem B 2021; 10:143-169. [PMID: 34913462 DOI: 10.1039/d1tb01449h] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Cryopreservation is a process used for the storage of mammalian cells at a very low temperature, in a state of 'suspended animation.' Highly effective and safe macromolecular cryoprotectants (CPAs) have gained significant attention as they obviate the toxicity of conventional CPAs like dimethyl sulfoxide (DMSO) and reduce the risks involved in the storage of cultures at liquid nitrogen temperatures. These agents provide cryoprotection through multiple mechanisms, involving extracellular and intracellular macromolecular crowding, thereby impacting the biophysical and biochemical dynamics of the freezing medium and the cryopreserved cells. These CPAs vary in their structures and physicochemical properties, which influence their cryoprotective activities. Moreover, the introduction of polymeric crowders in the cryopreservation media enables serum-free storage at low-DMSO concentrations and high-temperature vitrification of frozen cultures (-80 °C). This review highlights the need for macromolecular CPAs and describes their mechanisms of cryopreservation, by elucidating the role of crowding effects. It also classifies the macromolecules based on their chemistry and their structure-activity relationships. Furthermore, this article provides perspectives on the factors that may influence the outcomes of the cell freezing process or may help in designing and evaluating prospective macromolecules. This manuscript also includes case studies about cellular investigations that have been conducted to demonstrate the cryoprotective potential of macromolecular CPAs. Ultimately, this review provides essential directives that will further improve the cell cryopreservation process and may encourage the use of macromolecular CPAs to fortify basic, applied, and translational research.
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Affiliation(s)
- Manish Gore
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai, 400 019, India.
| | - Aditya Narvekar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai, 400 019, India.
| | - Advait Bhagwat
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai, 400 019, India.
| | - Ratnesh Jain
- Department of Chemical Engineering, Institute of Chemical Technology, Mumbai, 400 019, India.
| | - Prajakta Dandekar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai, 400 019, India.
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15
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Storage, transport, and disposition of gametes and embryos: legal issues and practical considerations. Fertil Steril 2021; 115:274-281. [PMID: 33579521 DOI: 10.1016/j.fertnstert.2020.11.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 11/21/2022]
Abstract
Cryopreservation of reproductive material has dramatically improved clinical outcomes for patients all over the world. At the same time the practice has produced significant legal, ethical, and practical challenges to physicians and practices who use this technique. Failing to meet the expectations of patients, for example by losing material because of a freezer failure, has significant implications for the reproductive facility. Similarly, improperly transporting or receiving gametes or embryos can result in substantial risk to a practice. Perhaps the most widely publicized conundrum is how best to manage embryos that are abandoned. This paper will describe the legal principles and best practices that should be incorporated into the management of a fertility cryopreservation program.
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Adiga SK, Tholeti P, Uppangala S, Kalthur G, Gualtieri R, Talevi R. Fertility preservation during the COVID-19 pandemic: mitigating the viral contamination risk to reproductive cells in cryostorage. Reprod Biomed Online 2020; 41:991-997. [PMID: 33032909 PMCID: PMC7490241 DOI: 10.1016/j.rbmo.2020.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 12/12/2022]
Abstract
Reopening fertility care services across the world in the midst of a pandemic brings with it numerous concerns that need immediate addressing, such as the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the male and female reproductive cells and the plausible risk of cross-contamination and transmission. Due to the novelty of the disease the literature contains few reports confirming an association of SARS-CoV-2 with reproductive tissues, gametes and embryos. Cryobanking, an essential service in fertility preservation, carries the risk of cross-contamination through cryogenic medium and thus calls for risk-mitigation strategies. This review aims to address the available literature on the presence of SARS-CoV-2 on tissues, gametes and embryos, with special reference to the possible sources of cross-contamination through liquid nitrogen. Strategies for risk mitigation have been extrapolated from reports dealing with other viruses to the current global crisis, for safety in fertility treatment services in general, and specifically for oncofertility.
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Affiliation(s)
- Satish K Adiga
- Centre for Fertility Preservation, Department of Clinical Embryology, Kasturba Medical College, and Manipal Academy of Higher Education, Manipal, India.
| | - Prathima Tholeti
- Centre for Fertility Preservation, Department of Clinical Embryology, Kasturba Medical College, and Manipal Academy of Higher Education, Manipal, India
| | - Shubhashree Uppangala
- Centre for Fertility Preservation, Department of Clinical Embryology, Kasturba Medical College, and Manipal Academy of Higher Education, Manipal, India
| | - Guruprasad Kalthur
- Centre for Fertility Preservation, Department of Clinical Embryology, Kasturba Medical College, and Manipal Academy of Higher Education, Manipal, India
| | - Roberto Gualtieri
- Department of Biology, University of Naples "Federico II", Complesso Universitario di Monte S. Angelo, Naples, Italy
| | - Riccardo Talevi
- Department of Biology, University of Naples "Federico II", Complesso Universitario di Monte S. Angelo, Naples, Italy.
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Mouttham L, Garrison SJ, Archer DL, Castelhano MG. A Biobank's Journey: Implementation of a Quality Management System and Accreditation to ISO 20387. Biopreserv Biobank 2020; 19:163-170. [PMID: 33147079 DOI: 10.1089/bio.2020.0068] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Biobanks play an integral role in research and precision medicine by acquiring, processing, storing, and distributing high-quality, clinically annotated biological material. Compliance with biobanking standards and the implementation of quality management systems (QMS) can improve the quality of the biological material and associated data (BMaD). By undergoing third-party assessments, biobanks can demonstrate compliance to these standards and instill confidence in their users. In the 8 months following the publication of the International Organization for Standardization (ISO) 20387:2018 General Requirements for Biobanking standard, the Cornell Veterinary Biobank (CVB) became compliant with the standard requirements, including developing and implementing a QMS. This was achieved through the documentation of all biobanking processes, demonstration of personnel competence, the stringent control of documents and records, and ongoing evaluation of processes and the QMS. Procedures describing the control of documents and records were implemented first to provide a foundation on which to build the QMS, followed by procedures for documenting the identification of risks and opportunities, improvements, and corrective actions following nonconforming outputs. Internal audit and management review programs were developed to verify QMS performance and to monitor quality objectives. Procedures for the governance and management of the biobank were developed, including the following: organizational structure; confidentiality and impartiality policies; facility and equipment maintenance, calibration, and monitoring; personnel training and competency; and evaluation of external providers. All processes on scope were described, along with the validation and verification of methods, to ensure the fitness-for-purpose of the BMaD and the reproducibility of biobanking processes. Training sessions were held during implementation of the QMS to ensure all personnel would conform to the procedures. In April 2019, the CVB underwent third-party assessment by the American Association of Laboratory Accreditation (A2LA) and became the first biobank in the world to receive accreditation to ISO 20387:2018.
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Affiliation(s)
- Lara Mouttham
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Susan J Garrison
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Denise L Archer
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.,Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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18
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Choucair F, Younis N, Hourani A. IVF laboratory COVID-19 pandemic response plan: a roadmap. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020; 25:31. [PMID: 33046958 PMCID: PMC7542571 DOI: 10.1186/s43043-020-00043-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/22/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The potential of COVID-19 severe pandemic necessitates the development of an organized and well-reasoned plan for the management of embryology/andrology laboratories while safeguarding the wellbeing of patients and IVF staff. MAIN BODY A COVID-19 pandemic response plan was proposed for embryology and andrology laboratories for pre-pandemic preparedness and pandemic management in anticipation of a possible second coronavirus wave. Preparation involves many plans and logistics before a pandemic risk rises. Many operational changes can be considered during the pandemic. This plan includes logistical arrangements, reducing labor needs, conserving supplies, and protective measures for embryologists and gametes/embryos. CONCLUSION The unpredictable emergence of the COVID-19 pandemic dictates the need for a preparedness plan for embryology/andrology laboratories, which includes an action-oriented plan to secure the safety of all stakeholders.
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Affiliation(s)
- Fadi Choucair
- Middle East Fertility Society Embryology Specialty Interest Group, Beirut, Lebanon
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Nagham Younis
- Middle East Fertility Society Embryology Specialty Interest Group, Beirut, Lebanon
- University of Jordan, Amman, Jordan
| | - Alia Hourani
- Middle East Fertility Society Embryology Specialty Interest Group, Beirut, Lebanon
- Quttainah Medical Center, Kuwait City, Kuwait
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19
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Cryostorage of reproductive tissues in the in vitro fertilization laboratory: a committee opinion. Fertil Steril 2020; 114:486-491. [DOI: 10.1016/j.fertnstert.2020.06.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 10/23/2022]
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Tao Y, Sanger E, Saewu A, Leveille MC. Human sperm vitrification: the state of the art. Reprod Biol Endocrinol 2020; 18:17. [PMID: 32145746 PMCID: PMC7060631 DOI: 10.1186/s12958-020-00580-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/28/2020] [Indexed: 12/18/2022] Open
Abstract
Sperm cryopreservation has been widely used in assisted reproductive technology (ART) and has resulted in millions of live births. Two principal approaches have been adopted: conventional (slow) freezing and vitrification. As a traditional technique, slow freezing has been successfully employed and widely used at ART clinics whereas the latter, a process to solidify liquid into an amorphous or glassy state, may become a faster alternative method of sperm cryopreservation with significant benefits in regard to simple equipment and applicability to fertility centers. Sperm vitrification has its own limitations. Firstly, small volume of load is usually plunged to liquid nitrogen to achieve high cooling rate, which makes large volume sample cryopreservation less feasible. Secondly, direct contact with liquid nitrogen increases the potential risk of contamination. Recently, new carriers have been developed to facilitate improved control over the volume and speed, and new strategies have been implemented to minimize the contamination risk. In summary, although sperm vitrification has not yet been applied in routine sperm cryopreservation, its potential as a standard procedure is growing.
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Affiliation(s)
- Yong Tao
- Ottawa Fertility Center, 100-955 Green Valley Crescent, Ottawa, ON K2C 3V4 Canada
| | - Erika Sanger
- Ottawa Fertility Center, 100-955 Green Valley Crescent, Ottawa, ON K2C 3V4 Canada
| | - Arpornrad Saewu
- Ottawa Fertility Center, 100-955 Green Valley Crescent, Ottawa, ON K2C 3V4 Canada
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21
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Pomeroy KO, Reed ML, LoManto B, Harris SG, Hazelrigg WB, Kelk DA. Cryostorage tank failures: temperature and volume loss over time after induced failure by removal of insulative vacuum. J Assist Reprod Genet 2019; 36:2271-2278. [PMID: 31650453 DOI: 10.1007/s10815-019-01597-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/25/2019] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine liquid nitrogen evaporation rates of intact liquid nitrogen storage tanks and tanks with their vacuum removed. METHODS Donated storage tank performance (LN2 evaporation) was evaluated before and after induced vacuum failure. Vacuum of each tank was removed by drilling through the vacuum port. Temperature probes were placed 2 in. below the bottom of the styrofoam cap/plug, and tanks were weighed every 3 h. Evaporation rate and time from failure to the critical temperature was determined. RESULT Storage tanks with failed vacuum have a much higher evaporation rate than those with intact vacuum; evaporation rates increased dramatically within 3 to 6 h in the smaller tanks, and time to complete depletion varied according to starting LN2 volume. Tanks with storage racks/specimens may have altered evaporation profiles compared to tanks without. Locating temperature probes 2 in. below the styrofoam cap/plug suggests that for most applications, alarms would sound approximately 1 h prior to reaching the critical warming temperature, approximately - 130 °C. External signs of vacuum loss were dramatic: vapor, frost, and audible movement of air. CONCLUSION For the first time, we have data on how liquid nitrogen storage tanks behave when their vacuum is removed. These findings are conservative; each lab must consider starting volume, tank size/capacity, function (storage or shipping), age, and pre-existing evaporation behavior in order to develop an emergency response to critical tank failure. Times to complete failure/evaporation and critical warming temperature after vacuum loss are different; these data should be considered when evaluating tank alarm systems.
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Affiliation(s)
- Kimball O Pomeroy
- The World Egg Bank, 7227 North 16th Street, Suite 160, Phoenix, AZ, 85020, USA.
| | - Michael L Reed
- Fertility Center of New Mexico, 201 Cedar Street SE, Suite S1-20, Albuquerque, NM, 87106, USA
| | - Brian LoManto
- The World Egg Bank, 7227 North 16th Street, Suite 160, Phoenix, AZ, 85020, USA
| | - Stanley G Harris
- Kaiser Permanente Center for Reproductive Health, 39141 Civic Center Drive, Suite 350, Fremont, CA, 94538, USA
| | - W Brent Hazelrigg
- Repro Tech, Ltd., 18 South Ninth Street, Suite 201, Columbia, MO, 65201, USA
| | - Dawn A Kelk
- Yale Fertility Center, 150 Sargent Drive, New Haven, CT, 06511, USA
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22
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Cryostorage failures: a medicolegal review. J Assist Reprod Genet 2019; 36:1041-1048. [PMID: 31127476 DOI: 10.1007/s10815-019-01478-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To heighten awareness of the potential legal and financial burdens faced by those providing cryopreservation storage services of embryos and gametes in light of recent lawsuits involving inadvertent thawing of specimens. METHODS Case law review of US legal databases and courthouse dockets with a focus on lawsuits against reproductive endocrinologists and cryostorage facilities offering cryopreservation. Emphasis was placed on court decisions, awarded damages, and legal and media coverage related to cryostorage failure events. RESULTS Lawsuits pertaining to two notable ongoing cases of cryostorage failure that occurred at fertility clinics in the US in 2018 were reviewed. Media coverage of these events and plaintiff and defense attorney strategies were evaluated. Legal documents from previous, similar cryostorage failures were also reviewed. Common claims in cryostorage system failures include breach of contract and negligent handling of property. Facilities offering cryostorage services are vulnerable to significant burden, legally and financially, if they are to experience a storage system failure. CONCLUSION Providing cryostorage services is not without significant financial risk. Inadvertent thawing of specimens can lead to high damage awards against cryostorage facilities and those individuals linked to a cryostorage failure event. Because monetary damages can surpass insurance policy limits, those providing cryostorage services should be aware of plaintiff attorney strategies, common legal defenses, and basic asset protection principles to safeguard themselves if ever faced with these situations. Facilities should also carry out regular maintenance and safety checks on equipment and alarm structures to deter such events.
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Early detection of cryostorage tank failure using a weight-based monitoring system. J Assist Reprod Genet 2019; 36:655-660. [PMID: 30834464 DOI: 10.1007/s10815-019-01402-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To study the relationship between liquid nitrogen loss and temperature in cryostorage dewars and develop an early-warning alarm for impending tank failure. METHODS Cryostorage dewars were placed on custom-engineered scales, and weight and temperature data were continuously monitored in the setting of slow, medium, and fast rate-loss of LN2 to simulate three scenarios of tank failure. RESULTS LN2 Tank weights and temperatures were continuously monitored and recorded, with a calculated alarm trigger set at 10% weight loss and temperature of - 185 °C. With an intact tank, a 10% loss in LN2 occurred in 4.2-4.9 days. Warming to - 185 °C occurred in 37.8-43.7 days, over 30 days after the weight-based alarm was triggered. Full evaporation of LN2 required ~ 36.8 days. For the medium rate-loss simulation, a 10% loss in LN2 occurred in 0.8 h. Warming to - 185 °C occurred in 3.7-4.8 h, approximately 3 h after the weight-based alarm was triggered. For the fast rate-loss simulation, a 10% weight loss occurred within 15 s, and tanks were depleted in under 3 min. Tank temperatures began to rise immediately and at a relatively constant rate of 43.9 °C/h and 51.6 °C/h. Temperature alarms would have sounded within 0.37 and 0.06 h after the breech. CONCLUSIONS This study demonstrates that a weight-based alarm system can detect tank failures prior to a temperature-based system. Weight-based monitoring could serve as a redundant safety mechanism for added protection of cryopreserved reproductive tissues.
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