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Wang X, Xiao Y, Sun Z, Xiong W. Effect of post-vitrification cryopreservation duration on singleton birth-weight in frozen-thawed blastocysts transfer cycles. Front Endocrinol (Lausanne) 2024; 15:1366360. [PMID: 38745950 PMCID: PMC11091412 DOI: 10.3389/fendo.2024.1366360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction This study aimed to explore the effect of cryopreservation duration after blastocyst vitrification on the singleton birth-weight of newborns to assess the safety of long-term preservation of frozen-thawed blastocyst transfer (FBT) cycles. Methods This was a retrospective observational study conducted at the Gynecological Endocrinology and Assisted Reproduction Center of the Peking Union Medical College Hospital. Patients who gave birth to singletons between January 2006 and December 2021 after undergoing FBT cycles were included. Five groups were formed according to the duration of cryopreservation of embryos at FBT: Group I included 274 patients with a storage time < 3 months. Group II included 607 patients with a storage time of 3-6 months. Group III included 322 patients with a storage time of 6-12 months. Group IV included 190 patients with a storage time of 12-24 months. Group V included 118 patients with a storage time of > 24 months. Neonatal outcomes were compared among the groups. Multivariate linear regression analysis was performed to evaluate birth-weights and other birth-related outcomes. Results A total of 1,511 patients were included in the analysis. The longest cryopreservation period was 12 years. The birth-weights of neonates in the five groups were 3344.1 ± 529.3, 3326.1 ± 565.7, 3260.3 ± 584.1, 3349.9 ± 582.7, and 3296.7 ± 491.9 g, respectively (P > 0.05). The incidences of preterm birth, very preterm birth, low birth-weight, and very low birth-weight were similar in all groups (P > 0.05). The large-for-gestational-age and small-for-gestational-age rates did not differ significantly among the groups (P > 0.05). After adjusting for confounding factors that may affect neonatal outcomes, a trend for an increased risk of low birth-weight with prolonged cryopreservation was observed. However, cryopreservation duration and neonatal birth-weight were not significantly correlated (P > 0.05). Conclusion The duration of cryopreservation after blastocyst vitrification with an open device for more than 2 years had no significant effect on the birth-weight of FBT singletons; however, attention should be paid to a possible increase in the risk of low birth-weight.
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Affiliation(s)
| | | | - Zhengyi Sun
- Department of Gynecology Endocrine and Reproductive Center, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Cobo A, Coello A, De Los Santos MJ, Remohi J, Bellver J. Embryo long-term storage does not affect assisted reproductive technologies outcome: analysis of 58,001 vitrified blastocysts over 11 years. Am J Obstet Gynecol 2024:S0002-9378(24)00469-1. [PMID: 38527601 DOI: 10.1016/j.ajog.2024.03.033] [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: 11/08/2023] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Recently, the potential detrimental effect that the duration of storage time may have on vitrified samples has raised some concerns, especially when some studies found an association between cryostorage length and decreased clinical results. OBJECTIVE This study aimed to evaluate the effects of the storage time length of day-5 vitrified blastocysts in 2 study groups: freeze-all cycles and nonelective frozen embryo transfers. STUDY DESIGN This was a retrospective study that included 58,001 vitrified/warmed day-5 blastocysts from 2 different populations, according to the reason for frozen embryo transfer. Elective frozen embryo transfer comprised freeze-all cycles (N=16,615 blastocysts and 16,615 patients) in which only single embryo transfers and only the first frozen embryo transfer were included. The nonelective frozen embryo transfer group included 41,386 embryos from 25,571 patients where frozen embryo transfer took place using supernumerary embryos after fresh embryo transfer. All the possible frozen embryo transfers were included. Both single embryo transfer and double embryo transfers were included. Donor and autologous oocytes were used. The period covered by this study was 11 years. The blastocyst sample was clustered into deciles, which provided specific storage duration categories. The main outcome was the live birth rate, and secondary outcomes were embryo survival, miscarriage, and clinical and ongoing pregnancy rates according to storage duration. The impact of storage time was assessed by univariable analyses in both groups. The comparison was made between each decile and the last one. A multivariable logistic regression analysis was conducted, including the variables with significant association found in the univariate analysis. Student t test and chi-square tests, or an analysis of variance, were used wherever appropriate. P<.05 was considered statistically significant. RESULTS There were statistical differences in baseline characteristics of patients included in the study groups. Storage durations ranged from ≤0.67 to ≥4.34 and from ≤1.8 to ≥34.81 months in freeze-all and nonelective frozen embryo transfer, respectively. Embryo survival did not show statistical differences across the categories of storage time in freeze-all and nonelective frozen embryo transfer groups. Statistical differences were found for the live birth rate across some, but not all, the subgroups of storage duration. The multivariable analysis showed no association between storage time and the live birth rate in both groups (nonsignificant). Blastocyst quality, body mass index, number of retrieved oocytes, endometrial preparation, male factor, and uterine factor were related to the drop in the live birth rate in the freeze-all group (P<.05). In the nonelective frozen embryo transfer group, the variables that showed significant association with the live birth rate were age at retrieval and frozen embryo transfer, type of frozen embryo transfer (single embryo transfer or double embryo transfers), number of retrieved oocytes, body mass index, endometrial preparation, origin of sperm sample, and female factor. CONCLUSION This large study demonstrated no association between storage time and clinical outcome. Other variables, such as the patient's age, embryo quality, body mass index, and etiology, are somewhat responsible for impacting the outcome. This provides evidence for the safety of embryo vitrification, even after long storage periods. This is reassuring for both in vitro fertilization practitioners and patients undergoing frozen embryo transfer of either elective or nonelective embryos.
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Affiliation(s)
- Ana Cobo
- IVIRMA Global Research Alliance, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain.
| | - Aila Coello
- IVIRMA Global Research Alliance, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
| | - María J De Los Santos
- IVIRMA Global Research Alliance, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
| | - Jose Remohi
- IVIRMA Global Research Alliance, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
| | - Jose Bellver
- IVIRMA Global Research Alliance, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
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Ma Y, Sun M, Wen T, Ding C, Liu LW, Meng T, Song J, Hou X, Mai Q, Xu Y. Storage time does not influence pregnancy and neonatal outcomes for first single vitrified high-quality blastocyst transfer cycle. Reprod Biomed Online 2023; 47:103254. [PMID: 37524030 DOI: 10.1016/j.rbmo.2023.06.009] [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: 03/07/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 08/02/2023]
Abstract
RESEARCH QUESTION Does blastocyst storage time have an impact on pregnancy and neonatal outcomes following the first single vitrified/warmed high-quality blastocyst transfer cycle for young women? DESIGN Retrospective cohort study in a university-affiliated reproductive medical centre. RESULTS A total of 2938 patients undergoing their first frozen embryo transfer (FET) cycle with a single high-quality blastocyst (Day 5: 3BB and above; Day 6: 4BB and above) transferred were divided into five groups: Group A with storage time ≤3 months (n = 1621), Group B with storage time of 4-6 months (n = 657), Group C with storage time of 7-12 months (n = 225), Group D with storage time of 13-24 months (n = 104), and Group E with storage time of 25-98 months (n = 331). After adjusting for confounding factors by multivariate logistic regression, there were no significant differences in live birth rate [Group A as reference; Group B: adjusted odds ratio (aOR) 0.954 (95% CI 0.791- 1.151); Group C: aOR 0.905 (95% CI 0.674-1.214); Group D: aOR 0.727 (95% CI 0.474-1.114); Group E: aOR 1.185 (955 CI 0.873-1.608)], β-human-chorionic-gonadotropin-positive rate, clinical pregnancy rate and miscarriage rate between Group A and the other groups. Among all singletons born after FET, there were no significant differences with regards to gestational age, preterm birth, birthweight, low birthweight, high birthweight and macrosomia. CONCLUSION Long-term cryostorage of human vitrified high-quality blastocysts does not affect pregnancy or neonatal outcomes.
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Affiliation(s)
- Yuanlin Ma
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Mingna Sun
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Tianrui Wen
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Chenhui Ding
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Lok-Wan Liu
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Tian Meng
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Junli Song
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Xuerong Hou
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Qingyun Mai
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China
| | - Yanwen Xu
- Reproductive Medicine Centre, The First Affiliated Hospital of Sun Yat-sun University, Guangzhou, People's Republic of China; Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China; Clinical Research Centre for Obstetrical and Gynaecological Diseases of Guangdong Province, Guangzhou, People's Republic of China.
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Torra-Massana M, Miguel-Escalada I, Vassena R, Rodríguez A. Long-term storage of vitrified oocytes does not affect pregnancy and live birth rates: analysis of 5362 oocyte donation cycles. Reprod Biomed Online 2023; 47:103228. [PMID: 37308341 DOI: 10.1016/j.rbmo.2023.04.019] [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: 11/30/2022] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 06/14/2023]
Abstract
RESEARCH QUESTION Does long-term storage of vitrified oocytes affect laboratory and reproductive outcomes after intracytoplasmic sperm injection? DESIGN Retrospective cohort study including 41,783 vitrified-warmed oocytes from 5362 oocyte donation cycles between 2013 and 2021. Five categories of storage time were established to analyse its effect on clinical and reproductive outcomes (≤1 year [reference group], 1-2 years, 2-3 years, 3-4 years and >4 years). RESULTS The mean number of warmed oocytes was 8.0 ± 2.5 oocytes. Oocyte storage time ranged from 3 days to 8.2 years (mean: 0.7 ± 0.9). Mean oocyte survival (90.2% ± 14.7% overall) did not significantly decrease with longer storage time after adjusting for confounders (88.9% for time >4 years, P = 0.963). A linear regression model did not show a significant effect of oocyte storage time on fertilization rate (about 70% in all time categories) (P > 0.05). Reproductive outcomes after the first embryo transfer were statistically comparable across storage times (P > 0.05 for all categories). Longer term oocyte storage (>4 years) did not affect the chances of clinical pregnancy (OR 0.700, 95% CI 0.423 to 1.158, P = 0.2214) or live birth (OR 0.716, 95% CI 0.425 to 1.208, P = 0.2670). CONCLUSIONS Oocyte survival, fertilization rate, pregnancy and live birth rates are not affected by the time spent by vitrified oocytes in vapour-phase nitrogen tanks.
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Zhang H, Ye D, Wu Y, Li Y, Huang X. Effect of exposed-to-air frequency of cryopreserved embryo on clinical outcomes of vitrified-warmed embryo transfer cycles: a retrospective analysis of 9,200 vitrified-warmed transfer cycles. BMC Pregnancy Childbirth 2023; 23:590. [PMID: 37592241 PMCID: PMC10433674 DOI: 10.1186/s12884-023-05879-w] [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: 08/31/2022] [Accepted: 07/26/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Cryopreservation of embryos plays a major role in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. However, the storage condition of the cryopreserved embryo can change temporarily due to repeated retrieval of the embryo from the liquid nitrogen (LN2) tank during the practical application during cryopreservation. Whether the implantation potential of a cryopreserved embryo will be damaged when the cane containing it is temporarily exposed to air due to the transfer between the LN2 tank and LN2 container is yet to be elucidated. Also, whether the exposed-to-air frequency (EAF) of cryopreserved embryos influences the clinical outcomes is unclear. OBJECTIVE To investigate whether the EAF of cryopreserved embryo affects the clinical outcomes of vitrified-warmed embryo transfer. METHODS A total of 9200 vitrified-warmed embryo transfer cycles were included in this study. All cycles were divided into five groups according to different EAFs (2, 4, 6, 8, or ≥ 10). Post-warming survival rates and clinical outcomes, including implantation, clinical pregnancy and live birth rates were investigated. Kruskal-Wallis test and Pearson's chi-squared tests were used to compare the patient characteristics and clinical outcomes among the five groups. Furthermore, multivariate logistic regression analyses were conducted to investigate the association between EAF and clinical outcomes. RESULTS No significant differences were observed in the positive HCG rate, implantation rate and live birth rate (P > 0.05) among five EAF groups with respect to D3 embryo, D5 blastocyst and D6 blastocyst. Post-warmed survival rate of D3 embryos (P = 0.015) differed significantly among the five EAF groups, but it was not EAF-dependent. Although clinical pregnancy was different among the five groups with respect to D5 blastocyst (P = 0.042), multivariate logistic regression analysis adjusted for confounding variables suggested that EAF did not adversely affect clinical pregnancy or live birth. CONCLUSION These findings indicated that human vitrified embryos in the open system could be repeatedly retrieved from the LN2 tank without affecting the implantation potential of the embryo.
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Affiliation(s)
- Huan Zhang
- Department of Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Fuxuexiang 96#, Wenzhou, 325000, Zhejiang, China
| | - Danna Ye
- Department of Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Fuxuexiang 96#, Wenzhou, 325000, Zhejiang, China
| | - Yonggen Wu
- Department of Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Fuxuexiang 96#, Wenzhou, 325000, Zhejiang, China
| | - Yan Li
- Department of Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Fuxuexiang 96#, Wenzhou, 325000, Zhejiang, China.
| | - Xuefeng Huang
- Department of Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Fuxuexiang 96#, Wenzhou, 325000, Zhejiang, China.
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Li X, Guo P, Blockeel C, Li X, Deng L, Yang J, Li C, Lin M, Wu H, Cai G, Hu Y, Chen X. Storage duration of vitrified embryos does not affect pregnancy and neonatal outcomes after frozen-thawed embryo transfer. Front Endocrinol (Lausanne) 2023; 14:1148411. [PMID: 36998477 PMCID: PMC10043480 DOI: 10.3389/fendo.2023.1148411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND With the refinement of cryopreservation technology, the number of frozen-warmed embryo transfer (FET) cycles and cryopreserved embryos has increased rapidly. However, studies investigating the effect of storage duration on pregnancy outcomes after vitrification are limited and their results are controversial. Furthermore, the available studies did not take patients' demographic nor clinical treatment characteristics into account and the cryo-storage duration was short. So this study aimed to explore the effect of storage duration of vitrified warmed embryos on pregnancy and neonatal outcomes in patients with good prognosis and long storage duration of vitrified embryos. METHODS This study was a bi-centre, retrospective study including 1037 women undergoing their first FET cycles following a fresh cycle from January 2012 until December 2021. Patients were divided into four storage groups in accordance with the storage duration of transferred embryos (612 patients in group I, with storage duration between 1 and 6 months; 202 patients in group II, with storage duration between 7 and 12 months; 141 patients in group III, with storage duration between 13 and 36 months; and 76 patients in group IV, with storage duration between 37 and 84 months). The pregnancy and neonatal outcomes were compared amongst different storage duration groups. RESULTS Amongst the different groups, no significant differences were observed in the pregnancy outcomes, including biochemical pregnancy rate, implantation rate, clinical pregnancy rate, ongoing pregnancy rate and live birth rate. In addition, no evidence of differences amongst different storage duration groups was observed in terms of preterm birth, birth length and low birthweight. CONCLUSIONS The pregnancy and neonatal outcomes of embryos after vitrification were not impaired by storage duration up to 7 years.
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Affiliation(s)
- Xuelan Li
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Pingping Guo
- Reproductive Medicine Center, Zhuhai Maternal and Childcare Service Center, Zhuhai, Guangdong, China
| | - Christophe Blockeel
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Xinning Li
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Ling Deng
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Jie Yang
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Chujun Li
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Min Lin
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Haocun Wu
- Department of Clinical Laboratory, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
| | - Guifeng Cai
- Reproductive Medicine Center, Zhuhai Maternal and Childcare Service Center, Zhuhai, Guangdong, China
- *Correspondence: Xin Chen, ; Yunzhao Hu, ; Guifeng Cai,
| | - Yunzhao Hu
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
- *Correspondence: Xin Chen, ; Yunzhao Hu, ; Guifeng Cai,
| | - Xin Chen
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People’s Hospital of Shunde), Foshan, Guangdong, China
- *Correspondence: Xin Chen, ; Yunzhao Hu, ; Guifeng Cai,
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Pregnancy and neonatal outcomes after long-term vitrification of blastocysts among 6,900 patients after their last live birth. Fertil Steril 2023; 119:36-44. [PMID: 36456212 DOI: 10.1016/j.fertnstert.2022.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate whether prolonged storage of vitrified blastocysts negatively impacts pregnancy and neonatal outcomes. DESIGN A retrospective cohort study. SETTING University hospital. PATIENT(S) A total of 6,900 patients who desired to transfer vitrified blastocysts from the same oocyte retrieval cycle as their last live birth met the inclusion criteria and were grouped according to the storage duration (1,890 patients in group 1 with storage duration < 3 years, 2,693 patients in group 2 with storage duration between 3 and 4 years, 1,344 patients in group 3 with storage duration between 4 and 5 years, 578 patients in group 4 with storage duration between 5 and 6 years and 395 patients in group 5 with storage duration ≥ 6 years but ≤ 10.5 years). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Rates of blastocyst survival, biochemical pregnancy, clinical pregnancy, miscarriage, ectopic pregnancy, and live birth and neonatal outcomes. RESULT(S) The survival rates of the vitrified blastocysts significantly decreased with prolonged storage from group 1 to the subsequent groups 2, 3, 4, and 5. After adjusting for potential confounding factors, the rates of biochemical pregnancy, clinical pregnancy, and live birth were significantly decreased when the vitrified blastocysts were stored for more than 6 years (group 5) compared with these for less than 3 years (group 1) but no distinct differences were found in these above-mentioned indicators among group 1, 2, 3, and group 4 (group 1 as reference). However, no significant differences were noted in the rates of miscarriage and ectopic pregnancy and neonatal outcomes on prolonged storage of vitrified blastocysts. CONCLUSION(S) Long-term blastocyst vitrification for more than 6 years can negatively affect the rates of biochemical pregnancy, clinical pregnancy, and live birth but does not impact neonatal outcomes.
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Mao Y, Tang N, Luo Y, Yin P, Li L. Effects of vitrified cryopreservation duration on IVF and neonatal outcomes. J Ovarian Res 2022; 15:101. [PMID: 36076245 PMCID: PMC9454210 DOI: 10.1186/s13048-022-01035-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background In this study, we aimed to evaluate the impact of the duration of cryopreservation storage on embryo viability, implantation competence, pregnancy outcome and neonatal outcomes. Methods We retrospectively evaluated the outcomes of patients who underwent IVF with vitrified cryopreserved embryos between January 2004 and August 2019 by following the first frozen embryo transfer cycles within the study period. A total of 31,143 patients met the inclusion criteria and were grouped according to the embryo storage time as follows: Group 1 (n = 20,926),1–90 days; Group 2 (n = 6,472), 91–180 days; Group 3 (n = 2,237), 181–365 days; Group 4 (n = 746), 366–730 days; and Group 5 (n = 762), > 731 days. Results The embryo survival rate decreased significantly with longer durations of cryopreservation. The highest and lowest survival rate was recorded in Group 1 and Group 5, respectively (34853/35338; 98.63% vs. 1281/1801; 71.13%; P < 0.01). The human chorionic gonadotropin (HCG) detection and clinical pregnancy rate was highest in Group 1 (57.85% and 55. 26%, respectively; P < 0.01). Short-term cryopreservation (≤ 3 months) is associated with higher rates of clinical pregnancy. There were no significant differences in neonatal birth weight, neonatal height and congenital anomalies among the groups (P > 0. 05). Conclusion The prolonged storage time of vitrified embryos negatively affected survival rate and clinical pregnancy rate. It did not have a significant influence on neonatal health. This study provides new findings about the relationship between prolonged storage time of vitrified embryos and clinical outcomes and offers evidence for the safety of using long-stored embryos after vitrification.
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Affiliation(s)
- Yuling Mao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ni Tang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanfen Luo
- Department of Medicine Laboratory, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Medicine Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Ping Yin
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Lei Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. .,Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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Li J, Zhu L, Huang J, Liu W, Han W, Huang G. Long-Term Storage Does Not Affect the Expression Profiles of mRNA and Long Non-Coding RNA in Vitrified-Warmed Human Embryos. Front Genet 2022; 12:751467. [PMID: 35178066 PMCID: PMC8844023 DOI: 10.3389/fgene.2021.751467] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Although vitrification has been widely applied in assisted reproductive technology, it is unknown whether storage time has any impact on the mRNA and lncRNA expression profiles in human embryos. Eleven women (aged 23-35 years) who had undergone in vitro fertilization treatment were recruited for this study. The transcriptomes of 3 fresh eight-cell embryos and 8 surviving vitrified-warmed eight-cell embryos (4 embryos were cryostored for 3 years, and the others were cryostored for 8 years) were analyzed through single-cell RNA-Seq. No differentially expressed mRNAs or lncRNAs were identified between the 3-years group and 8-years group. A total of 128 mRNAs and 365 lncRNAs were differentially expressed in the 8 vitrified-warmed embryos compared with the fresh embryos. The vitrification-warming impact was moderate, and it was mainly related to the pathways of metabolism, stress response, apoptosis, cell cycle, cell adhesion, and signaling for TFG-β and Hippo. The analysis of target mRNAs suggested that lncRNAs might contribute to the regulation of mRNAs after vitrification-warming. Our findings indicated that long-term storage after vitrification does not affect the mRNA and lncRNA expression profiles in human embryos, however, the procedure of vitrification-warming would lead to minor alteration of transcriptome.
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Affiliation(s)
- Jingyu Li
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Ling Zhu
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jin Huang
- Information Department, Chongqing Health Center for Women and Children, Chongqing, China
| | - Weiwei Liu
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Wei Han
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Guoning Huang
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
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10
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Canosa S, Cimadomo D, Conforti A, Maggiulli R, Giancani A, Tallarita A, Golia F, Fabozzi G, Vaiarelli A, Gennarelli G, Revelli A, Bongioanni F, Alviggi C, Ubaldi FM, Rienzi L. The effect of extended cryo-storage following vitrification on embryo competence: a systematic review and meta-analysis. J Assist Reprod Genet 2022; 39:873-882. [PMID: 35119549 PMCID: PMC9050987 DOI: 10.1007/s10815-022-02405-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/15/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Few studies explored whether prolonged cryo-storage after vitrification affects embryo competence and perinatal outcomes. This systematic review and meta-analysis aims at highlighting any putative impact of cryo-storage duration on cryo-survival, miscarriage, live birth and major malformations. METHODS A systematic review was performed using MEDLINE (PubMed), ISI Web of Knowledge, Scopus and Embase databases up to June 2021. Data were combined to obtain a pooled OR, and meta-analysis was conducted using a random effects model. Out of 1,389 screened abstracts, 22 papers were assessed for eligibility, and 5 studies were included (N = 18,047 embryos). Prolonged cryo-storage was defined as > 12 months (N = 3389 embryos). Subgroup analysis was performed for untested vitrified cleavage stage embryos (N = 1739 embryos) and for untested and euploid vitrified blastocysts (N = 13,596 and 2712 embryos, respectively). RESULTS Survival rate, miscarriage, live birth and major malformation rates were all similar in the two groups. CONCLUSION These data further support the safety of long-term cryo-storage of human embryos beyond 12 months. This is reassuring for good prognosis patients with surplus embryos, couples seeking a second child from supernumerary embryos and women postponing the transfer for clinical or personal reasons.
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Affiliation(s)
- S Canosa
- Livet, GeneraLife IVF, Turin, Italy
| | - D Cimadomo
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - A Conforti
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II University, Naples, Italy
| | - R Maggiulli
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy.
| | - A Giancani
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - A Tallarita
- Genera Veneto, GeneraLife IVF, Marostica, Italy
| | - F Golia
- Clinica Ruesch, GeneraLife IVF, Naples, Italy
| | - G Fabozzi
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - A Vaiarelli
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | | | | | | | - C Alviggi
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II University, Naples, Italy
| | - F M Ubaldi
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - L Rienzi
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
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11
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Kunjummen A, Reddy N, Parimala C, Karuppusami R, Mangalraj A. Effect of long-term embryo cryopreservation on subsequent frozen embryo transfer outcomes: A retrospective cohort study. J Hum Reprod Sci 2022; 15:293-299. [PMID: 36341019 PMCID: PMC9635375 DOI: 10.4103/jhrs.jhrs_83_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/30/2022] [Accepted: 08/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background: The duration of cryopreservation of embryos and its effect on the subsequent pregnancy outcomes, when they have been frozen for a longer duration remains a matter of concern. There is a continuous debate among studies comparing different durations of embryo cryopreservation as the results are contradictory. Aims: This study aims to find out if long-term cryopreservation of embryos has any effect on pregnancy and perinatal outcomes. Settings and Design :Retrospective cohort study was conducted in the department of reproductive medicine and surgery in a university-level teaching hospital. Materials and Methods: The study included women who underwent frozen embryo transfer (FET) from autologous in vitro fertilisation between January 2012 and December 2020 with the duration of cryopreservation of more than 5 years as one group and 3–5 years as another group. Pregnancy and perinatal outcomes were analysed. Statistical Analysis Used: Regression analysis was performed using logistic regression by entering clinically important variables associated with pregnancy outcome, and the results were expressed as odds ratio with a 95% confidence interval (CI). All statistical analysis was performed with SPSS (version 21.0, IBM, USA). Results: A total of 1680 FET cycles were carried out during the study period. Among these, 75 cycles with a duration of 3–5 years and 20 cycles with a duration of more than 5 years were included. Live birth rate (LBR) was 40.8% in the 3–5 years group and 35% in the more than 5 years group. After adjusting for important confounders, the LBR has no significant association in the more than 5 years group (adjusted odds ratio 1.07; 95% CI 0.34–3.32; P = 0.913) compared to the 3–5 years group. Conclusion: The duration of cryopreservation of embryos has no statistically significant effect on the pregnancy and perinatal outcomes.
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12
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Ma Y, Liu X, Shi G, Liu Y, Zhou S, Hou W, Xu Y. Storage Time of Cryopreserved Embryos and Pregnancy Outcomes: A Dose-Response Meta-Analysis. Geburtshilfe Frauenheilkd 2021; 81:311-320. [PMID: 33692592 PMCID: PMC7938942 DOI: 10.1055/a-1326-1830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/29/2020] [Indexed: 01/11/2023] Open
Abstract
Purpose Cryopreservation techniques have become an essential part of assisted reproduction technology. Embryos may be cryopreserved for several years before transfer, and the safety of long-term cryopreservation needs to be considered. This dose-response meta-analysis was conducted to evaluate whether there were dose-response relationships between the storage time of cryopreserved embryos and pregnancy outcomes such as survival rate, implantation rate, miscarriage rate, clinical pregnancy rate, and congenital malformation rate. Methods After searching the databases PubMed, Embase, MEDLINE, CCRT and related reviews up until June 4, 2020, seven studies were included for analysis. Two reviewers extracted the relevant information and independently assessed the study quality using the Newcastle-Ottawa scale. Potential linear or non-linear dose-response relationships were assessed with a random-effect dose-response meta-analysis. Results No dose-response association was found between duration of embryo cryostorage and survival rate, implantation rate, miscarriage rate, clinical pregnancy rate or congenital malformation rate. Conclusion The interval between the start of embryo cryopreservation and frozen/thawed embryo transfer does not influence pregnancy outcomes.
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Affiliation(s)
- Yuanlin Ma
- Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Xiaochen Liu
- Sun Yat-sen University Zhongshan School of Medicine, Guangzhou, China
| | - Gaohui Shi
- Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Yongxiang Liu
- Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Shurui Zhou
- Sun Yat-sen University Zhongshan School of Medicine, Guangzhou, China
| | - Wenhui Hou
- Zhengzhou University First Affiliated Hospital, Zhengzhou, China
| | - Yanwen Xu
- Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
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13
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Zhang X, Wu S, Hao G, Wu X, Ren H, Zhang Y, Yang A, Bi X, Bai L, Zhang Y, Tan J. Prolonged Cryopreservation Negatively Affects Embryo Transfer Outcomes Following the Elective Freeze-All Strategy: A Multicenter Retrospective Study. Front Endocrinol (Lausanne) 2021; 12:709648. [PMID: 34630326 PMCID: PMC8493094 DOI: 10.3389/fendo.2021.709648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/16/2021] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND With the development of embryo freezing and warming technology, frozen-thawed embryo transfer (FET) has been widely utilized. However, studies investigating the association between cryopreservation duration and FET outcomes are limited and controversial, and previous studies did not conduct stratification analyses based on demographic or clinical characteristics. METHODS This multicenter retrospective study included 17,826 women who underwent their first FET following the freeze-all strategy during the period from January 2014 to December 2018. Duration of cryopreservation was categorized into five groups: 3-8 weeks, 8-12 weeks, 12-26 weeks, 26-52 weeks, and >52 weeks. Modified Poisson regression and multivariate logistic regression were used to assess the association between cryostorage time of vitrified embryos and transfer outcomes. Moreover, further stratification analyses were performed according to variables with p <0.05 in multivariate models. RESULTS In this large multicenter study, we observed that storage duration was inversely associated with the possibility of pregnancy and live birth (p <0.001), but not with the risk of ectopic pregnancy and miscarriage. Stratification analyses based on maternal age, the number of oocytes retrieved, and condition of embryo transferred indicated that the inverse correlation was significant in the subpopulation with characteristics: (1) less than 40 years old, (2) more than 3 oocytes retrieved, and (3) only high-quality blastocysts transferred. CONCLUSION The results of this large, multicenter, retrospective study suggested that prolonged cryopreservation was inversely associated with the probability of pregnancy and live birth. Therefore, for patients who adopt a freeze-all strategy, early FET might achieve a better outcome.
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Affiliation(s)
- Xudong Zhang
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Disease and Fertility Remodeling of Liaoning Province, Shenyang, China
| | - Shanshan Wu
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Disease and Fertility Remodeling of Liaoning Province, Shenyang, China
| | - Guimin Hao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xueqing Wu
- Center of Reproductive Medicine, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, China
| | - Haiqin Ren
- Center of Reproductive Medicine, Jinghua Hospital, Shenyang, China
| | - Yinfeng Zhang
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
| | - Aimin Yang
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xingyu Bi
- Center of Reproductive Medicine, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, China
| | - Lina Bai
- Center of Reproductive Medicine, Jinghua Hospital, Shenyang, China
| | - Yunshan Zhang
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China
- *Correspondence: Yunshan Zhang, ; Jichun Tan,
| | - Jichun Tan
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Disease and Fertility Remodeling of Liaoning Province, Shenyang, China
- *Correspondence: Yunshan Zhang, ; Jichun Tan,
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14
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Lee HN, Park JK, Paek SK, Byun JH, Song H, Lee HJ, Chang EM, Kim JW, Lee WS, Lyu SW. Does duration of cryostorage affect survival rate, pregnancy, and neonatal outcomes? Large-scale single-center study of slush nitrogen (SN 2 ) vitrified-warmed blastocysts. Int J Gynaecol Obstet 2020; 152:351-357. [PMID: 32961588 DOI: 10.1002/ijgo.13381] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/25/2020] [Accepted: 09/16/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the effects of the duration of cryostorage on clinical outcomes after embryo transfer of vitrified blastocysts stored in an open-device slush-nitrogen (SN2 ) system. METHODS A retrospective cohort study was carried out on 1632 autologous vitrified-warmed blastocyst transfer cycles between January 2013 and June 2014. Duration of cryostorage was divided into four groups: Group I: 0-6 months (n=937); Group II: 7-12 months (n=299); Group III: 13-24 months (n=165); and Group IV: ≥25 months (n=231). The effects of the duration of cryostorage on the survival rate (SR), clinical pregnancy rate (CPR), live birth rate (LBR), and neonatal outcomes of vitrified blastocysts stored in an open-device SN2 system were evaluated. RESULTS There were no significant differences between groups in SR, CPR, LBR, and neonatal outcomes after autologous vitrified-warmed blastocyst transfer. Multivariate logistic regression analysis showed no effect on LBR from duration of cryostorage. CONCLUSION Vitrification using SN2 and long-term cryostorage in an open-device system are safe and effective and do not significantly affect clinical outcomes after embryo transfer.
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Affiliation(s)
- Hye Nam Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
| | - Jae Kyun Park
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea.,Department of Biomedical Science, CHA University, Seongnam, Korea
| | - Soo Kyung Paek
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
| | - Ji Hyun Byun
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
| | - Haengseok Song
- Department of Biomedical Science, CHA University, Seongnam, Korea
| | - Hee Jun Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
| | - Eun Mi Chang
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
| | - Ji Won Kim
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
| | - Woo Sik Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
| | - Sang Woo Lyu
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Seongnam, Korea
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15
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Sekhon L, Lee JA, Flisser E, Copperman AB, Stein D. Blastocyst vitrification, cryostorage and warming does not affect live birth rate, infant birth weight or timing of delivery. Reprod Biomed Online 2018; 37:33-42. [DOI: 10.1016/j.rbmo.2018.03.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 01/28/2023]
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