1
|
Sun LJ, Liang SS, Liu MH, Pan JP, Huang MY, Teng XM, Wu HX. Early cumulus cell removal increases cumulative live birth rate while having no negative effect on the malformation rate in in vitro fertilization: a propensity score-matched cohort study. Arch Gynecol Obstet 2024; 309:287-293. [PMID: 37755532 DOI: 10.1007/s00404-023-07212-4] [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: 05/31/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE The aim of this study was to investigate the efficacy and safety of early cumulus cell removal (ECCR) during human in vitro fertilization (IVF). METHODS A retrospective analysis was performed between January 2011 and December 2019. The study enrolled 1131 couples who underwent IVF treatment with ECCR. After propensity score matching at a 1:1 ratio, 1131 couples who underwent overnight coincubation of gametes were selected. The main outcome measure was the cumulative live birth rate. Secondary outcome measures included the cumulative pregnancy rate, polyspermy rate, available embryo rate, miscarriage rate, malformation rate, time to live birth, and oocyte-to-baby rate. RESULTS There were no significant differences found between the two groups in the polyspermy rate, available embryo rate, miscarriage rate, time to live birth, oocyte-to-baby rate, and neonatal congenital anomalies rate. The results of the study showed that ECCR was associated with a significantly higher cumulative live birth rate and cumulative pregnancy rate, along with a significantly lower fertilization rate. CONCLUSIONS ECCR tended to confer increased cumulative live birth rate and had no negative effect on the neonatal malformation rate.
Collapse
Affiliation(s)
- Li Juan Sun
- Department of Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shan Shan Liang
- Department of Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Min Hao Liu
- Department of Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia Ping Pan
- Department of Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mei Yuan Huang
- Department of Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao Ming Teng
- Department of Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hai Xia Wu
- Department of Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
- Department of Reproductive Medicine, Longhua Women and Children's Health Hospital, 68 Huawang Road, Shenzhen, China.
| |
Collapse
|
2
|
Liu L, Jiang X, Liu Z, Chen J, Yang C, Chen K, Yang X, Cai J, Ren J. Oocyte degeneration in a cohort adversely affects clinical outcomes in conventional IVF cycles: a propensity score matching study. Front Endocrinol (Lausanne) 2023; 14:1164371. [PMID: 37274329 PMCID: PMC10235780 DOI: 10.3389/fendo.2023.1164371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Background Oocyte degeneration was mostly described in intracytoplasmic sperm injection (ICSI) cycles; there is no report showing the relationship between oocyte degeneration and clinical outcomes in conventional in vitro fertilization (IVF) cycles. This retrospective study using the propensity score (PS) matching method aimed to explore whether the presence of oocyte degeneration in conventional IVF cycles would affect the sibling embryo development potential and clinical outcomes. Methods Patients with at least one oocyte degenerated after short-term insemination and stripping were defined as the degeneration (DEG) group, while patients with no oocyte degenerated were defined as the non-degeneration (NONDEG) group. The PS matching method was used to control for potential confounding factors, and a multivariate logistic regression analysis was made to evaluate whether the presence of oocyte degeneration would affect the cumulative live birth rate (CLBR). Results After PS matching, basic characteristics were similar between the two groups, oocyte yield was significantly higher in the DEG group than the NON-DEG group (P < 0.05), mature oocyte number, 2 pronuclear (2PN) embryo number, 2PN embryo clearage rate, "slow" embryo number, "accelerated" embryo number, rate of cycles with total day 3 embryo extended culture, number of frozen embryo transfer (FET) cycles, transferred embryo stage, transferred embryo number, and live birth rate in fresh embryo transfer cycles were all similar between the two groups (P > 0.05), but the 2PN fertilization rate, available embryo number, high-quality embryo number, "normal" embryo number, frozen embryo number, blastocyst formation rate, and no available embryo cycle rate were all significantly lower in the DEG group than the NON-DEG group (P < 0.05). The cumulative live birth rate was also significantly lower in the DEG group than in the NON-DEG group (70.2% vs. 74.0%, P = 0.0019). Multivariate logistic regression analysis further demonstrated that the presence of oocyte degeneration in conventional IVF cycles adversely affects the CLBR both before (OR = 0.83, 95% CI: 0.75-0.92) and after (OR = 0.82, 95% CI: 0.72-0.93) PS matching. Conclusion Our findings together revealed that the presence of oocyte degeneration in a cohort of oocytes may adversely affect subsequent embryo development potential and clinical outcomes in conventional IVF cycles.
Collapse
Affiliation(s)
- Lanlan Liu
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
- Medical College, Xiamen University, Xiamen, China
| | - Xiaoming Jiang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Zhenfang Liu
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Jinghua Chen
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Chao Yang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Kaijie Chen
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Xiaolian Yang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| | - Jiali Cai
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
- Medical College, Xiamen University, Xiamen, China
| | - Jianzhi Ren
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, China
| |
Collapse
|
3
|
Fan Y, Wu Z, Peng F, Peng H, Liang X, Zhu S. Brief and long co-incubation of sperm and oocytes for in vitro fertilization: a meta-analysis of randomized controlled trials. BMC Pregnancy Childbirth 2023; 23:200. [PMID: 36959550 PMCID: PMC10035113 DOI: 10.1186/s12884-023-05490-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/02/2023] [Indexed: 03/25/2023] Open
Abstract
Background There is still no consensus on the optimal time of oocyte–sperm co-incubation during in vitro fertilization and embryo transfer (IVF-ET). The aim of this meta-analysis was to compare the effects of brief (1-6 h) and long (16-24 h) gametes co-incubation time on IVF outcomes. Methods The study protocol was registered online through PROSPERO (CRD42022337503) and PRISMA guidelines were followed in the present study. The following databases were searched from inception to May 2022 for randomized controlled trials (RCTs): PubMed, Embase, Cochrane library, Web of Science, using search terms related to IVF, gametes, time of co-incubation and reproductive outcome measure. Studies comparing outcomes of brief co-incubation to that of long co-incubation during IVF, and reporting primary outcome (live birth rate), secondary outcomes (clinical pregnancy rate; ongoing pregnancy rate; miscarriage rate; normal fertilization rate; polyspermy rate; top-quality embryo rate; implantation rate) were searched. A total of 11 studies were included in the meta-analysis. Combined odds ratio (OR) and 95% confidence interval (CI) were calculated for the data. Statistical heterogeneity analysis between studies was assessed by Cochran Q and I2 statistic with a significant threshold of P < 0.05. Methodologic quality assessment of RCTs was made for potential risk of bias with Cochrane Risk of Bias Tool. Results Compared to long-term co-incubation, brief co-incubation had an advantage in increasing implantation rate (OR: 1.97, 95% CI: 1.52–2.57), ongoing pregnancy rate (OR: 2.18, 95% CI: 1.44–3.29) and top-quality embryo rate (OR: 1.17, 95% CI: 1.02–1.35). However, brief co-incubation of gametes had no advantages in the live-birth rate (OR: 1.09, 95% CI: 0.72–1.65), miscarriage rate (OR: 1.32, 95% CI: 0.55–3.18), clinical pregnancy rate (OR: 1.36, 95% CI: 0.99–1.87) and polyspermy rate (OR: 0.80, 95% CI: 0.48–1.33) than long-term co-incubation. Additionally, the brief co-incubation was associated with lower normal fertilization rate (OR: 0.89, 95% CI: 0.80–0.99), compared with long co-incubation. Conclusions Brief co-incubation of gametes had the advantages in increasing implantation rate, ongoing pregnancy rate and top-quality embryo rate than long-term co-incubation. However, the live-birth rate displayed no difference between the two in vitro fertilization methods. Gametes co-incubation time should be individualized according to each patient’s IVF history, infertility causes and the semen parameters.
Collapse
Affiliation(s)
- Yiyue Fan
- grid.411304.30000 0001 0376 205XSchool of Medical and Life Sciences/Reproductive &Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu City, 611137 Sichuan Province China
| | - Zeyu Wu
- grid.449525.b0000 0004 1798 4472The Affiliated Nanchong Central Hospital of North Sichuan Medical University, Nanchong City, Sichuan Province China
| | - Fang Peng
- grid.411304.30000 0001 0376 205XSchool of Medical and Life Sciences/Reproductive &Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu City, 611137 Sichuan Province China
| | - Hongyao Peng
- grid.411304.30000 0001 0376 205XSchool of Medical and Life Sciences/Reproductive &Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu City, 611137 Sichuan Province China
| | - Xin Liang
- grid.411304.30000 0001 0376 205XSchool of Medical and Life Sciences/Reproductive &Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu City, 611137 Sichuan Province China
| | - Shaomi Zhu
- grid.411304.30000 0001 0376 205XSchool of Medical and Life Sciences/Reproductive &Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu City, 611137 Sichuan Province China
| |
Collapse
|
4
|
Balli M, Cecchele A, Pisaturo V, Makieva S, Carullo G, Somigliana E, Paffoni A, Vigano’ P. Opportunities and Limits of Conventional IVF versus ICSI: It Is Time to Come off the Fence. J Clin Med 2022; 11:jcm11195722. [PMID: 36233589 PMCID: PMC9572455 DOI: 10.3390/jcm11195722] [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: 08/26/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 12/04/2022] Open
Abstract
Conventional IVF (c-IVF) is one of the most practiced assisted reproductive technology (ART) approaches used worldwide. However, in the last years, the number of c-IVF procedures has dropped dramatically in favor of intracytoplasmic sperm injection (ICSI) in cases of non-male-related infertility. In this review, we have outlined advantages and disadvantages associated with c-IVF, highlighting the essential steps governing its success, its limitations, the methodology differences among laboratories and the technical progress. In addition, we have debated recent insights into fundamental questions, including indications regarding maternal age, decreased ovarian reserve, endometriosis, autoimmunity, single oocyte retrieval-cases as well as preimplantation genetic testing cycles. The “overuse” of ICSI procedures in several clinical situations of ART has been critically discussed. These insights will provide a framework for a better understanding of opportunities associated with human c-IVF and for best practice guidelines applicability in the reproductive medicine field.
Collapse
Affiliation(s)
- Martina Balli
- Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Anna Cecchele
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy
| | - Valerio Pisaturo
- Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Sofia Makieva
- Kinderwunschzentrum, Klinik für Reproduktions-Endokrinologie, Universitätsspital Zürich, 8091 Zurich, Switzerland
| | - Giorgia Carullo
- Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy
| | | | - Paola Vigano’
- Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
- Correspondence:
| |
Collapse
|
5
|
Jiang L, Qian Y, Chen X, Ji X, Ou S, Li R, Yang D, Li Y. Effect of early rescue ICSI and split IVF-ICSI in preventing low fertilization rate during the first ART cycle: A real-world retrospective cohort study. Reprod Med Biol 2021; 21:e12420. [PMID: 34934401 PMCID: PMC8656193 DOI: 10.1002/rmb2.12420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To determine the utility of short gamete coincubation in in vitro fertilization (IVF‐S) combined with early rescue intracytoplasmic sperm injection (R‐ICSI) and split IVF‐ICSI in preventing low fertilization based on a retrospective cohort study. Methods Couples with a high risk of low IVF fertilization during the first ART cycle underwent IVF‐S with R‐ICSI or split IVF‐ICSI. Fertilization rate, embryo quality, and clinical outcomes were measured. Results After propensity score matching, we included 188 couples in the IVF‐S with R‐ICSI group as Group 1 and 720 in the split IVF‐ICSI group as Group 2. Normal fertilization rates were similar; however, Group 1 had a higher multiple pronuclei rate (10.42% vs. 4.50%, p < 0.001) but a higher embryo utilization rate (59.84% vs. 53.60%, p < 0.001). The groups were similar in the rates of high‐quality embryos, embryo implantation, clinical pregnancy, and live birth. Low IVF fertilization rate was 4.79% and 9.03% in Group 1 and Group 2, respectively, with similar fertilization rate and embryo development. Conclusion IVF‐S with early R‐ICSI and split IVF‐ICSI were effective strategies in preventing low fertilization rate. IVF‐S with early R‐ICSI could become the preferred approach because of its advantages—higher embryo utilization rate, fewer ICSI procedures, similar clinical pregnancy rate, and live birth rate.
Collapse
Affiliation(s)
- Linlin Jiang
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| | - Yifan Qian
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| | - Xiaoli Chen
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| | - Xiaohui Ji
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| | - Songbang Ou
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| | - Ruiqi Li
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| | - Dongzi Yang
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| | - Yu Li
- Department of Obstetrics and Gynecology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou China
| |
Collapse
|
6
|
Maddirevula S, Coskun S, Al-Qahtani M, Aboyousef O, Alhassan S, Aldeery M, Alkuraya FS. ASTL is mutated in female infertility. Hum Genet 2021; 141:49-54. [PMID: 34704130 DOI: 10.1007/s00439-021-02388-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022]
Abstract
Female infertility is a relatively common phenotype with a growing number of single gene causes although these account for only a minority of cases. Here, we report a consanguineous family in which adult females who are homozygous for a truncating variant in ASTL display markedly reduced fertility in a pattern strikingly similar to Astl-/- female mice. ASTL encodes ovastacin, which is known to trigger zona pellucida hardening (ZPH) as part of the cortical reaction upon fertilization. ZPH is required for normal early embryonic development and its absence can be caused by pathogenic variants in other zona pellucida proteins that result in a similar infertility phenotype in humans and mouse. This is the first report of ASTL-related infertility in humans and suggests that the inclusion of ASTL in female infertility gene panels is warranted.
Collapse
Affiliation(s)
- Sateesh Maddirevula
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Saudi Arabia
| | - Serdar Coskun
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center and College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mashael Al-Qahtani
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Saudi Arabia
| | - Omar Aboyousef
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Saudi Arabia
| | - Saad Alhassan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Meshael Aldeery
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Saudi Arabia.
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, 11533, Saudi Arabia.
| |
Collapse
|
7
|
Ebner T, Sesli Ö, Kresic S, Enengl S, Stoiber B, Reiter E, Oppelt P, Mayer RB, Shebl O. Time-lapse imaging of cytoplasmic strings at the blastocyst stage suggests their association with spontaneous blastocoel collapse. Reprod Biomed Online 2019; 40:191-199. [PMID: 31983545 DOI: 10.1016/j.rbmo.2019.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/30/2019] [Accepted: 11/14/2019] [Indexed: 01/01/2023]
Abstract
RESEARCH QUESTION To study the origin and temporal behaviour of cytoplasmic strings spanning the blastocoel (main objective) and their influence on treatment outcome (secondary objective). DESIGN This retrospective analysis of prospectively collected data was set up in a university medical centre. Patients who either underwent fresh (n = 95) or vitrified-warmed (n = 55) single blastocyst transfer were included. Time-lapse sequences of in-vitro developed blastocysts were screened for the presence of cytoplasmic strings. Pregnancies in string-positive and string-negative transfers were followed up to live birth. RESULTS A total of 387 blastocysts were obtained in the fresh cycles of 100 patients, corresponding to a blastocyst formation rate of 62.4%. Cytoplasmic strings were first detected around full stage (108.5 ± 6.4 h) in 170 blastocysts (43.9%). The number of strings varied (range: 1-7) and the duration of visibility was 5.2 ± 3.5 h. The occurrence of cytoplasmic strings was significantly associated with the presence of blastocoelic collapses (P < 0.001) but not with any of the annotated morphokinetic parameters. Live birth and neonatal outcome were the same for both string-positive and string-negative pregnancies. Moreover, collapses did not affect treatment outcome. CONCLUSION Time-lapse analysis of cytoplasmic strings at the blastocyst stage revealed that this morphological feature was not a negative predictor as previously reported. Although physiologically normal, at least some of the cytoplasmic strings are an artefact, possibly associated with blastocoelic collapses.
Collapse
Affiliation(s)
- Thomas Ebner
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria.
| | - Özcan Sesli
- University for Life, Beethovenstrasse 9, Graz Styria, Austria
| | - Sanja Kresic
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria
| | - Sabine Enengl
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria
| | - Barbara Stoiber
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria
| | - Elisabeth Reiter
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria
| | - Peter Oppelt
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria
| | - Richard Bernhard Mayer
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria
| | - Omar Shebl
- Kepler University, Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Krankenhausstrasse 26-30, Linz Upper Austria, Austria
| |
Collapse
|