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Liperis G, Makieva S, Serdarogullari M, Uraji J, Ali ZE, Pisaturo V, Cuevas-Saiz I, Scarica C, Sharma K, Fraire-Zamora JJ. Agree to disagree: reaching consensus amongst embryologists on the clinical management of low-quality blastocysts. Hum Reprod 2024; 39:1353-1356. [PMID: 38670550 DOI: 10.1093/humrep/deae083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Affiliation(s)
- George Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia
- Embryorigin Fertility Centre, Larnaca, Cyprus
| | - Sofia Makieva
- Kinderwunschzentrum, Klinik für Reproduktions-Endokrinologie, Universitätsspital Zürich, Zurich, Switzerland
| | - Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Nicosia, Turkey
| | - Julia Uraji
- IVF Laboratory, TFP Düsseldorf GmbH, Düsseldorf, Germany
| | - Zoya Enakshi Ali
- Research & Development Department, Hertility Health Limited, London, UK
| | - Valerio Pisaturo
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | | | - Catello Scarica
- European Hospital, New Fertility Group Centre for Reproductive Medicine, Rome, Italy
| | - Kashish Sharma
- HealthPlus Fertility Center, HealthPlus Network of Specialty Centers, Abu Dhabi, United Arab Emirates
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Cao P, Derhaag J, Coonen E, Brunner H, Acharya G, Salumets A, Zamani Esteki M. Generative artificial intelligence to produce high-fidelity blastocyst-stage embryo images. Hum Reprod 2024; 39:1197-1207. [PMID: 38600621 PMCID: PMC11145014 DOI: 10.1093/humrep/deae064] [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: 12/19/2023] [Revised: 02/13/2024] [Indexed: 04/12/2024] Open
Abstract
STUDY QUESTION Can generative artificial intelligence (AI) models produce high-fidelity images of human blastocysts? SUMMARY ANSWER Generative AI models exhibit the capability to generate high-fidelity human blastocyst images, thereby providing substantial training datasets crucial for the development of robust AI models. WHAT IS KNOWN ALREADY The integration of AI into IVF procedures holds the potential to enhance objectivity and automate embryo selection for transfer. However, the effectiveness of AI is limited by data scarcity and ethical concerns related to patient data privacy. Generative adversarial networks (GAN) have emerged as a promising approach to alleviate data limitations by generating synthetic data that closely approximate real images. STUDY DESIGN, SIZE, DURATION Blastocyst images were included as training data from a public dataset of time-lapse microscopy (TLM) videos (n = 136). A style-based GAN was fine-tuned as the generative model. PARTICIPANTS/MATERIALS, SETTING, METHODS We curated a total of 972 blastocyst images as training data, where frames were captured within the time window of 110-120 h post-insemination at 1-h intervals from TLM videos. We configured the style-based GAN model with data augmentation (AUG) and pretrained weights (Pretrained-T: with translation equivariance; Pretrained-R: with translation and rotation equivariance) to compare their optimization on image synthesis. We then applied quantitative metrics including Fréchet Inception Distance (FID) and Kernel Inception Distance (KID) to assess the quality and fidelity of the generated images. Subsequently, we evaluated qualitative performance by measuring the intelligence behavior of the model through the visual Turing test. To this end, 60 individuals with diverse backgrounds and expertise in clinical embryology and IVF evaluated the quality of synthetic embryo images. MAIN RESULTS AND THE ROLE OF CHANCE During the training process, we observed consistent improvement of image quality that was measured by FID and KID scores. Pretrained and AUG + Pretrained initiated with remarkably lower FID and KID values compared to both Baseline and AUG + Baseline models. Following 5000 training iterations, the AUG + Pretrained-R model showed the highest performance of the evaluated five configurations with FID and KID scores of 15.2 and 0.004, respectively. Subsequently, we carried out the visual Turing test, such that IVF embryologists, IVF laboratory technicians, and non-experts evaluated the synthetic blastocyst-stage embryo images and obtained similar performance in specificity with marginal differences in accuracy and sensitivity. LIMITATIONS, REASONS FOR CAUTION In this study, we primarily focused the training data on blastocyst images as IVF embryos are primarily assessed in blastocyst stage. However, generation of an array of images in different preimplantation stages offers further insights into the development of preimplantation embryos and IVF success. In addition, we resized training images to a resolution of 256 × 256 pixels to moderate the computational costs of training the style-based GAN models. Further research is needed to involve a more extensive and diverse dataset from the formation of the zygote to the blastocyst stage, e.g. video generation, and the use of improved image resolution to facilitate the development of comprehensive AI algorithms and to produce higher-quality images. WIDER IMPLICATIONS OF THE FINDINGS Generative AI models hold promising potential in generating high-fidelity human blastocyst images, which allows the development of robust AI models as it can provide sufficient training datasets while safeguarding patient data privacy. Additionally, this may help to produce sufficient embryo imaging training data with different (rare) abnormal features, such as embryonic arrest, tripolar cell division to avoid class imbalances and reach to even datasets. Thus, generative models may offer a compelling opportunity to transform embryo selection procedures and substantially enhance IVF outcomes. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by a Horizon 2020 innovation grant (ERIN, grant no. EU952516) and a Horizon Europe grant (NESTOR, grant no. 101120075) of the European Commission to A.S. and M.Z.E., the Estonian Research Council (grant no. PRG1076) to A.S., and the EVA (Erfelijkheid Voortplanting & Aanleg) specialty program (grant no. KP111513) of Maastricht University Medical Centre (MUMC+) to M.Z.E. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Ping Cao
- Department of Clinical Genetics, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
- Department of Genetics and Cell Biology, GROW Research Institute for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Josien Derhaag
- Department of Reproductive Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Edith Coonen
- Department of Clinical Genetics, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
- Department of Reproductive Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Han Brunner
- Department of Clinical Genetics, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
- Department of Genetics and Cell Biology, GROW Research Institute for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ganesh Acharya
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Andres Salumets
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Masoud Zamani Esteki
- Department of Clinical Genetics, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
- Department of Genetics and Cell Biology, GROW Research Institute for Oncology and Reproduction, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
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Kim HM, Kang H, Lee C, Park JH, Chung MK, Kim M, Kim NY, Lee HJ. Evaluation of the Clinical Efficacy and Trust in AI-Assisted Embryo Ranking: Survey-Based Prospective Study. J Med Internet Res 2024; 26:e52637. [PMID: 38830209 DOI: 10.2196/52637] [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: 09/12/2023] [Revised: 10/23/2023] [Accepted: 05/06/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Current embryo assessment methods for in vitro fertilization depend on subjective morphological assessments. Recently, artificial intelligence (AI) has emerged as a promising tool for embryo assessment; however, its clinical efficacy and trustworthiness remain unproven. Simulation studies may provide additional evidence, provided that they are meticulously designed to mitigate bias and variance. OBJECTIVE The primary objective of this study was to evaluate the benefits of an AI model for predicting clinical pregnancy through well-designed simulations. The secondary objective was to identify the characteristics of and potential bias in the subgroups of embryologists with varying degrees of experience. METHODS This simulation study involved a questionnaire-based survey conducted on 61 embryologists with varying levels of experience from 12 in vitro fertilization clinics. The survey was conducted via Google Forms (Google Inc) in three phases: (1) phase 1, an initial assessment (December 23, 2022, to January 22, 2023); (2) phase 2, a validation assessment (March 6, 2023, to April 5, 2023); and (3) phase 3 an AI-guided assessment (March 6, 2023, to April 5, 2023). Inter- and intraobserver assessments and the accuracy of embryo selection from 360 day-5 embryos before and after AI guidance were analyzed for all embryologists and subgroups of senior and junior embryologists. RESULTS With AI guidance, the interobserver agreement increased from 0.355 to 0.527 and from 0.440 to 0.524 for junior and senior embryologists, respectively, thus reaching similar levels of agreement. In a test of accurate embryo selection with 90 questions, the numbers of correct responses by the embryologists only, embryologists with AI guidance, and AI only were 34 (38%), 45 (50%), and 59 (66%), respectively. Without AI, the average score (accuracy) of the junior group was 33.516 (37%), while that of the senior group was 35.967 (40%), with P<.001 in the t test. With AI guidance, the average score (accuracy) of the junior group increased to 46.581 (52%), reaching a level similar to that of the senior embryologists of 44.833 (50%), with P=.34. Junior embryologists had a higher level of trust in the AI score. CONCLUSIONS This study demonstrates the potential benefits of AI in selecting embryos with high chances of pregnancy, particularly for embryologists with 5 years or less of experience, possibly due to their trust in AI. Thus, using AI as an auxiliary tool in clinical practice has the potential to improve embryo assessment and increase the probability of a successful pregnancy.
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Affiliation(s)
| | - Hyoeun Kang
- AI Lab, Kai Health, Seoul, Republic of Korea
| | | | - Jong Hyuk Park
- IVF Clinic, Miraewaheemang Hospital, Seoul, Republic of Korea
| | - Mi Kyung Chung
- IVF Clinic, Seoul Rachel Fertility Center, Seoul, Republic of Korea
| | - Miran Kim
- Department of Obstetrics & Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Na Young Kim
- IVF Clinic, HI Fertility Center, Seoul, Republic of Korea
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Park JK, Jeon Y, Bang S, Kim JW, Kwak IP, Lee WS. Time-lapse imaging of morula compaction for selecting high-quality blastocysts: a retrospective cohort study. Arch Gynecol Obstet 2024; 309:2897-2906. [PMID: 38649499 DOI: 10.1007/s00404-024-07461-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/04/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Before blastocyst development, embryos undergo morphological and metabolic changes crucial for their subsequent growth. This study aimed to investigate the relationship between morula compaction and blastocyst formation and the subsequent chromosomal status of the embryos. METHODS This retrospective cohort study evaluated embryo development (n = 371) using time-lapse imaging; 94 blastocysts underwent preimplantation genetic testing for aneuploidy (PGT-A). RESULTS The embryos were classified as fully (Group 1, n = 194) or partially (Group 2, n = 177) compacted. Group 1 had significantly higher proportions of good- and average-quality blastocysts than Group 2 (21.6% vs. 3.4%, p = 0.001; 47.9% vs. 26.6%, p = 0.001, respectively). The time from the morula stage to the beginning and completion of compaction and blastocyst formation was significantly shorter in Group 1 than in Group 2 (78.6 vs. 82.4 h, p = 0.001; 87.0 vs. 92.2 h, p = 0.001; 100.2 vs. 103.7 h, p = 0.017, respectively). Group 1 embryos had larger surface areas than Group 2 embryos at various time points following blastocyst formation. Group 1 blastocysts had significantly higher average expansion rates than Group 2 blastocysts (653.6 vs. 499.2 μm2/h, p = 0.001). PGT-A revealed a higher proportion of euploid embryos in Group 1 than in Group 2 (47.2% vs. 36.6%, p = 0.303). CONCLUSION Time-lapse microscopy uncovered a positive relationship between compaction and blastocyst quality and its association with embryo ploidy. Hence, compaction evaluation should be prioritized before blastocyst selection for transfer or cryopreservation.
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Affiliation(s)
- Jae Kyun Park
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Korea
| | - Yunmi Jeon
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Korea
| | - Soyoung Bang
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Korea
| | - Ji Won Kim
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Korea.
| | - In Pyung Kwak
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Korea
| | - Woo Sik Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Korea.
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Basar M, Unsal E, Ergun Y. Embryology with precision: effective quality control in the in vitro fertilization laboratory. Curr Opin Obstet Gynecol 2024; 36:200-207. [PMID: 38572581 DOI: 10.1097/gco.0000000000000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
The purpose of this review is to address the critical need for standardization and clarity in the use of key performance indicators (KPIs) within the realm of in vitro fertilization (IVF), particularly emphasizing the integration of preimplantation genetic testing (PGT) processes. This review is timely and relevant given the persistently modest success rates of IVF treatments, which stand at approximately 30%, and the growing complexity of IVF procedures, including PGT practices. The review synthesizes recent findings across studies focusing on technical and clinical KPIs in embryology and genetic laboratories, identifying gaps in current research and practice, particularly the lack of standardized KPIs and terminology. Recent findings highlighted include the critical evaluation of technical KPIs such as Intracytoplasmic Sperm Injection (ICSI) fertilization rates, embryo development rates, and laboratory performance metrics, alongside clinical KPIs like the proportion of mature oocytes and clinical pregnancy rates. Notably, the review uncovers a significant gap in integrating and standardizing KPIs for PGT applications, which is essential for improving IVF outcomes and genetic diagnostic accuracy. The implications of these findings are profound for both clinical practice and research. For clinical practice, establishing a standardized set of KPIs, especially for PGT, could significantly enhance the success rates of IVF treatments by providing clearer benchmarks for quality and performance. For research, this review underscores the necessity for further studies to close the identified gaps, promoting a more integrated and standardized approach to KPIs in IVF and PGT processes. This comprehensive approach will not only aid in improving clinical outcomes but also in advancing the field of reproductive medicine.
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Affiliation(s)
- Murat Basar
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven
- Yale Fertility Center, Orange, Connecticut
| | - Evrim Unsal
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven
- Yale Fertility Center, Orange, Connecticut
| | - Yagmur Ergun
- IVIRMA Global Research Alliance, IVIRMA, New Jersey, Marlton, New Jersey, USA
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Zhou H, Ye L, Zhang H, Zheng Y, Jin W. Should we should consider day 3 blastomere number during single vitrified-warmed blastocyst transfer cycle? A retrospective study. Eur J Obstet Gynecol Reprod Biol 2024; 297:209-213. [PMID: 38688135 DOI: 10.1016/j.ejogrb.2024.04.021] [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: 01/02/2024] [Revised: 03/18/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
The present study investigated whether day 3 blastomere number has an effect on the clinical outcomes during single vitrified-warmed blastocyst transfer cycles. A total of 3294 vitrified-warmed single day 5 blastocyst transferred cycles were analyzed in this retrospective study from January 2018 to December 2021. The cycles were divided into ≥ 7 and < 7 blastomere groups depending on the day 3 embryo blastomere number. The clinical outcomes were compared between the two groups, moreover multivariate logistic regression analysis was conducted to investigate the correlation between the number of day 3 blastomeres and clinical outcomes. The chi-square test demonstrated that the rates of clinical pregnancy and live birth were significantly higher in the ≥ 7 blastomere group compared to the < 7 blastomere group with respect to single high-quality blastocyst transfer cycles. Conversely, these rates were similar in the two groups with respect to single low-quality blastocyst transfer cycles. These results were confirmed by multivariate logistic regression analysis. However, the miscarriage rate was higher in the < 7 blastomere group than in ≥ 7 group during low-quality blastocyst transfer cycles. These results suggested that day 3 blastomere number should be considered during single vitrified-warmed blastocyst transfer cycles. Thus, blastocsyts derived from ≥ 7 blastomere embryos are preferred when choosing the same quality blastocysts.
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Affiliation(s)
- Haisu Zhou
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Lianmin Ye
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Huan Zhang
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Yi Zheng
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Wumin Jin
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
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Youngster M, Maman O, Kedem A, Avraham S, Rabbi ML, Gat I, Yerushalmi G, Baum M, Hourvitz A, Maman E. The effect of COVID-19 vaccination during IVF stimulation on cycle outcomes- a retrospective cohort study. J Reprod Immunol 2024; 163:104246. [PMID: 38677139 DOI: 10.1016/j.jri.2024.104246] [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: 11/24/2023] [Revised: 02/15/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
The effect of the mRNA-BNT162b2 vaccine administered prior to fertility treatments has been addressed in several studies, presenting reassuring results. Cycle outcomes of patients receiving the vaccine during the stimulation itself have not been previously described. This retrospective cohort study included patients who received mRNA-BNT162b2-vaccine during the stimulation of fresh IVF cycles, between January-September 2021, age matched to pre-stimulation vaccinated patients and to non-vaccinated patients. Demographics, cycle characteristics and cycle outcomes were compared between groups. A total of 132 in-treatment vaccinated patients (study group), 132 pre-treatment vaccinated and 132 non-vaccinated patients that underwent fresh IVF cycles were included. Mean time from vaccination to retrieval in the study group was 6.68 days (SD 3.74; range 0-12). Oocyte yield was similar between groups (9.35 versus10.22 and 10.05 respectively; p=0.491). A linear regression model demonstrated no effect of vaccination before or during the stimulation, on oocyte yield (p>0.999). Clinical pregnancy rates (30 % versus 30 % versus 28 %) and ongoing pregnancy rates (25 % for all groups) did not differ between groups. In a logistic regression model for clinical pregnancy rates, vaccine administration and timing of vaccination were not a significant factor. This is the first study reporting the outcome of the mRNA BNT162b2 vaccine administration during the IVF stimulation itself. The vaccine administration had no impact on fresh IVF treatment outcomes compared to pre-treatment vaccinated or non-vaccinated patients. This adds to the growing evidence of COVID-19 vaccine safety in relation to fertility treatments and enables more flexibility regarding timing of vaccine administration.
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Affiliation(s)
- Michal Youngster
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; IVF Unit, Herzliya Medical Centre, Herzliya, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
| | - Omer Maman
- Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Alon Kedem
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; IVF Unit, Herzliya Medical Centre, Herzliya, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Sarit Avraham
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; IVF Unit, Herzliya Medical Centre, Herzliya, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Moran Landau Rabbi
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel
| | - Itai Gat
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Gil Yerushalmi
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Micha Baum
- IVF Unit, Herzliya Medical Centre, Herzliya, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel; IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Centre, Ramat-Gan, Israel
| | - Ariel Hourvitz
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Centre, Ramat-Gan, Israel
| | - Ettie Maman
- IVF Unit, Herzliya Medical Centre, Herzliya, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel; IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Centre, Ramat-Gan, Israel
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Basirat F, Esmaeilzadeh S, Basirat Z, Ghofrani F, Golsorkhtabaramiri M. Effect of nifedipine administration before embryo transfer on reproductive outcome in ICSI cycles, a double-blind control trial study. Arch Gynecol Obstet 2024; 309:2891-2896. [PMID: 38578543 DOI: 10.1007/s00404-023-07362-5] [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: 04/24/2022] [Accepted: 01/05/2023] [Indexed: 04/06/2024]
Abstract
PURPOSE Nifedipine is a calcium channel blocker with smooth muscle relaxing properties. This study set out to investigate the efficacy of nifedipine administered orally before embryo transfer (ET) on the improvement of the intracytoplasmic sperm injection (ICSI) outcome. This randomized, double-blind, comparator-controlled, was carried out between 2019 and 2020 in the infertility center of Babol, Iran. 200 women candidates for ICSI and recipients of frozen-thawed ET aged 18-40 years were randomly assigned in the ratio 1:1 to an intervention group that received nifedipine 20 mg tablets orally 30 min before ET (n = 100) or to a group of placebo (n = 100). A randomization center in Babol University of Medical Science used computer-generated numbers to allocate treatments. The allocation treatment was blind to the participants, the sonographer of endometer monitoring, the staff of the ICSI laboratory, and the outcome assessor. The primary analysis was based on the intention-to-treat principle done on 200 participants, (n = 100), comparing chemical pregnancy rates in the two comparing groups at 14 days' follow-up after ET. Implantation rate and clinical pregnancy were considered secondary outcomes. RESULT 200 participants were analyzed. There is no significant difference in the number of oocytes and the quality of embryos in the nifedipine and placebo groups. Despite a numerical increase in the rate of chemical pregnancy, there were no statistical differences in the study group versus the comparison group (24% vs 14%, P = 0.1, rate ratio 0.88, 95% CI 0.77 to 1.01), respectively. Also, no significant increase in clinical pregnancy was found compared with the placebo (17% vs 8%, P = 0.26, rate ratio 0.90, 0.81 to 1.00). CONCLUSION Nifedipine administered orally 30 min before embryo transfer did not improve the chemical pregnancy rate, and clinical pregnancy rate in infertile women undergoing ICSI. This trial has been registered on the Iranian Clinical Trials Registration Site (IRCT) with the number IRCT20180417039338N3.
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Affiliation(s)
- Fatemeh Basirat
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Science, Shahid Salehi Ave, 31, Babol, 47191-73599, Iran
| | - Sedighe Esmaeilzadeh
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Science, Shahid Salehi Ave, 31, Babol, 47191-73599, Iran
| | - Zahra Basirat
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Science, Shahid Salehi Ave, 31, Babol, 47191-73599, Iran.
| | - Faeze Ghofrani
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Science, Shahid Salehi Ave, 31, Babol, 47191-73599, Iran
| | - Masoumeh Golsorkhtabaramiri
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Science, Shahid Salehi Ave, 31, Babol, 47191-73599, Iran
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Xu X, Jiang Y, Du J, Sun H, Wang X, Zhang C. Development and validation of a prediction model for suboptimal ovarian response in polycystic ovary syndrome (PCOS) patients undergoing GnRH-antagonist protocol in IVF/ICSI cycles. J Ovarian Res 2024; 17:116. [PMID: 38807145 PMCID: PMC11134646 DOI: 10.1186/s13048-024-01437-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: 01/07/2024] [Accepted: 05/11/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND PCOS patients with unexpectedly low oocyte yield following conventional ovarian stimulation are referred to as suboptimal responders. However, identifying suboptimal responders presents a significant challenge within reproductive medicine and limited research exists on the occurrence of suboptimal response. This analysis aimed to develop a predictive model of suboptimal response during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatments in PCOS patients. METHODS This retrospective study involved a cohort of 313 PCOS patients undergoing their first IVF/ICSI cycle from 2019 to 2022. Univariate logistic regression analyses, least absolute shrinkage, selection operator regression analysis, and recursive feature elimination were employed to identify relevant characteristics and construct predictive models. Moreover, a nomogram was constructed based on the best model. Receiver operating characteristic curves, decision curve analysis (DCA), and calibration curves were used to evaluate the model. RESULTS The predictors included in the model were age, Anti-Mullerian hormone, antral follicle count, and basal follicle-stimulating hormone. The area under the receiver operating characteristic curve (AUC) was 0.7702 (95% confidence interval 0.7157-0.8191). The AUC, along with the DCA curve and calibration curve, demonstrated a satisfactory level of congruence and discrimination ability. CONCLUSION The nomogram effectively predicted the probability of suboptimal response in PCOS patients undergoing gonadotropin-releasing hormone antagonist protocol during IVF/ICSI treatment.
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Affiliation(s)
- Xiaohang Xu
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, China
- Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China
| | - Yilin Jiang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, China
- Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jinlin Du
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, China
- Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China
| | - Haoyue Sun
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, China
- Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xue Wang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, China
- Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China
| | - Cuilian Zhang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Zhengzhou, China.
- Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China.
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10
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Liss J, Kuczyńska M, Kunicki M, Zieliński K, Drzyzga D. Serum levels of stem cell factor for predicting embryo quality. Sci Rep 2024; 14:11689. [PMID: 38778076 PMCID: PMC11111753 DOI: 10.1038/s41598-024-61419-2] [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: 06/05/2023] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
We evaluated whether serum stem cell factor (s-SCF) levels just prior to ovulation induction could indicate the ability to develop a top-quality (TQ) blastocyst by day 5. We investigated patients with normal ovarian reserve (NOR), polycystic ovary syndrome (PCOS), diminished ovarian reserve (DOR), or mild endometriosis. Our pilot research suggests a correlation between s-SCF levels and the ability to form TQ blastocysts in patients with mild endometriosis. This significant statistical difference (p < 0.05) was noted between mild endometriosis patients for whom a TQ blastocyst was obtained and those for whom it was not possible, as measured on the 8th day of stimulation and the day of oocyte retrieval. The mean SCF levels in the serum of these women on the 8th day were at 28.07 (± 2.67) pg/ml for the TQ subgroup and 53.32 (± 16.02) pg/ml for the non-TQ subgroup (p < 0.05). On oocyte retrieval day it was 33.47 (± 3.93) pg/ml and 52.23 (± 9.72) pg/ml (p < 0.05), respectively.
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Affiliation(s)
- Joanna Liss
- Research and Development Center, INVICTA, Polna 64, 81-740, Sopot, Poland
- Department of Medical Biology and Genetics, University of Gdańsk, Gdańsk, Poland
| | - Martyna Kuczyńska
- Department of Medical Biology and Genetics, University of Gdańsk, Gdańsk, Poland
| | - Michał Kunicki
- Research and Development Center, INVICTA, Polna 64, 81-740, Sopot, Poland.
- Department of Gynecological Endocrinology, Medical University of Warsaw, Warsaw, Poland.
| | - Krystian Zieliński
- Research and Development Center, INVICTA, Polna 64, 81-740, Sopot, Poland
| | - Damian Drzyzga
- Research and Development Center, INVICTA, Polna 64, 81-740, Sopot, Poland
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11
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Chen H, Cai J, Sun X, Liu L, Liu Z, Gao P, Jiang X, Ren J. Atosiban interacts with growth hormones as adjuvants in frozen-thawed embryo transfer cycles. Front Endocrinol (Lausanne) 2024; 15:1380778. [PMID: 38841302 PMCID: PMC11150816 DOI: 10.3389/fendo.2024.1380778] [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: 02/02/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Objective To investigate the interaction between atosiban and growth hormone (GH) as adjuvants in frozen-thawed embryo transfer (FET) cycles. Method A total of 11627 patients who underwent FET at Xiamen University Affiliated Chenggong Hospital between January 2018 to December 2022 were retrospectively analyzed. Among them, 482 patients received atosiban and 275 patients received GH. The interactions were estimated by comparing the odds ratio (OR) for pregnancy comparing patients with or without atosiban adjuvant in cohorts stratified according to the presence of GH use in either the overall cohort or a propensity score (PS) matched cohort. An interaction term (atosiban × GH) was introduced to a multivariate model to calculate the ratio of OR (ORR) adjusted for confounders. Results For all patients receiving atosiban administration, no obvious effect on pregnancy was observed in comparison with either matched or unmatched controls. However, when the patients were stratified according to GH administration, atosiban showed a significant association with clinical pregnancy in comparison with either matched or unmatched controls among patients with GH treatment with rate ratios (RR) of 1.32 (95%CI: 1.05,1.67) and 1.35 (95%CI: 1,1.82), respectively. On the other hand, however, the association was absent among patients without GH treatment. The adjusted ORRs in both matched and unmatched cohorts were 2.44 (95%CI: 1.07,5.84) and 1.95 (95%CI: 1.05, 3.49) respectively. Conclusion The combination use of atosiban and GH in FET cycles is potentially beneficial to the pregnancy. However, indications for the use of atosiban and GH may need further assessment.
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Affiliation(s)
- Haixiao Chen
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
| | - Jiali Cai
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
- Medical College, Xiamen University, Xiamen, Fujian, China
| | - Xiaohua Sun
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
| | - Lanlan Liu
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
- Medical College, Xiamen University, Xiamen, Fujian, China
| | - Zhenfang Liu
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
| | - Peng Gao
- Medical College, Xiamen University, Xiamen, Fujian, China
- Quality Management Department, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
| | - Xiaoming Jiang
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
- Medical College, Xiamen University, Xiamen, Fujian, China
| | - Jianzhi Ren
- Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China
- Medical College, Xiamen University, Xiamen, Fujian, China
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12
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Omes C, Conti A, Benedetti L, Tomasoni V, De Marchi D, Nappi RE, Cusella De Angelis MG, Ceccarelli G. Expression of miRNA from spent pre-implantation embryos culture media. Reprod Biol 2024; 24:100847. [PMID: 38776743 DOI: 10.1016/j.repbio.2023.100847] [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: 04/29/2023] [Revised: 12/04/2023] [Accepted: 12/22/2023] [Indexed: 05/25/2024]
Abstract
This study examines the expression of three microRNAs (hsa-miR-661, hsa-miR-21-5p, hsa-miR-372-5p) in spent pre-implantation embryos culture media to identify possible new non-invasive biomarkers of embryo competence, predictive of development to the blastocyst stage. A preliminary analysis on 16 patients undergoing IVF cycles was performed by collecting and stored spent culture media on the fifth/sixth day of embryo culture. Expression of miRNAs was evaluated according to the embryos' fate: 1) NE/DG: non-evolved or degenerate embryos; 2) BLOK: embryos developed to the blastocyst stage. Preliminary results revealed a higher miRNAs expression in NE/DG spent media. To elucidate the roles of these miRNAs, we employed a robust bioinformatics pipeline involving: 1) in-silico miRNA Target Prediction using RNAHybrid, which identified the most-likely gene targets; 2) Construction of a Protein-Protein Interaction network via GeneMania, linking genes with significant biological correlations; 3) application of modularity-based clustering with the gLay app in Cytoscape, resulting in three size-adapted subnets for focused analysis; 4) Enrichment Analysis to discern the biological pathways influenced by the miRNAs. Our bioinformatics analysis revealed that hsa-miR-661 was closely associated with pathways regulating cell shape and morphogenesis of the epithelial sheet. These data suggest the potential use of certain miRNAs to identify embryos with a higher likelihood of developing to the blastocyst stage. Further analysis will be necessary to explore the reproducibility of these findings and to understand if miRNAs here investigated can be used as biomarkers for embryo selection before implantation into the uterus or if they may be reliable predictors of IVF outcome.
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Affiliation(s)
- Claudia Omes
- Center for Reproductive Medicine - Obstetrics and Gynecology Unit 2, Woman and Child Health Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Alice Conti
- Human Anatomy Unit, Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia, Italy
| | - Laura Benedetti
- Human Anatomy Unit, Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia, Italy
| | - Veronica Tomasoni
- Center for Reproductive Medicine - Obstetrics and Gynecology Unit 2, Woman and Child Health Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Davide De Marchi
- Centre for Health Technologies (CHT), University of Pavia, Pavia, Italy; Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Rossella E Nappi
- Center for Reproductive Medicine - Obstetrics and Gynecology Unit 2, Woman and Child Health Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - M Gabriella Cusella De Angelis
- Human Anatomy Unit, Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia, Italy; Centre for Health Technologies (CHT), University of Pavia, Pavia, Italy
| | - Gabriele Ceccarelli
- Human Anatomy Unit, Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia, Italy; Centre for Health Technologies (CHT), University of Pavia, Pavia, Italy
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13
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Yarkiner Z, Boynukalın FK, Coban Ö. Assessment of Repetitive Controlled Ovarian Stimulation (COS) Cycles on Oocyte Donors: Impact on Oocyte Quality and Viable Embryo Yield. Reprod Sci 2024:10.1007/s43032-024-01584-x. [PMID: 38767768 DOI: 10.1007/s43032-024-01584-x] [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: 10/31/2023] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
The utilization of donor eggs has broadened the options for Assisted Reproductive Technology (ART) among women facing challenges with egg quantity or quality. Given that donors are typically selected from young and fertile individuals, In Vitro Fertilization with egg donation (IVF-ED) tends to exhibit higher rates of implantation, pregnancy, and live births compared to IVF with the woman's own eggs, especially for females over 35 years old. This has led to a projected increase in the demand for IVF-ED, surpassing the number of available donors. Consequently, many centers opt to use oocyte donors for multiple cycles. However, the correlation between repeated Controlled Ovarian Stimulation (COS) cycles and the performance of donors in terms of viable blastocyst stage embryo (VEC) or blastocyst embryo rate is not definitively established and remains of interest. This study aims to explore the preimplantation characteristics of embryo development and oocyte maturation status based on the number of donor COS cycles, employing a Generalized Linear Mixed Model (GLMM) framework. The study encompasses 1965 embryo transfer (ET) cycles involving 399 donors who underwent a minimum of two and a maximum of nine controlled ovarian hyperstimulation (COS) cycles. The findings indicate that, with the patient undergoing six or more cycles of ovarian stimulation, despite a 3.9% increase in both maturation and fertilization rates, there is a corresponding decrease of 4.5% in VEC rate and 4.7% in blastulation rates. In essence, an escalating number of donor COS cycles appears to be associated with a disadvantageous reduction in embryo quality.
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Affiliation(s)
- Zalihe Yarkiner
- Department of Basic Sciences and Humanities, Faculty of Arts and Sciences, Cyprus International University, Nicosia, Cyprus.
| | - Fazilet Kübra Boynukalın
- Infertility Department, Turkey, Obstetrics and Gynaecology, Istanbul, Bahçeci Fulya IVF Center, Üsküdar University, Istanbul, Turkey
| | - Önder Coban
- British Cyprus IVF Hospital, Embryology, Nicosia, Cyprus
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14
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Dong J, Yin M, Wu L, Wang T, Li M, Zhang W, Ma M, Li B. Pregnancy and neonatal outcomes of ICSI using pentoxifylline to identify viable spermatozoa in patients with frozen-thawed testicular spermatozoa. Front Endocrinol (Lausanne) 2024; 15:1364285. [PMID: 38812814 PMCID: PMC11133548 DOI: 10.3389/fendo.2024.1364285] [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: 01/02/2024] [Accepted: 04/24/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Although the effectiveness of pentoxifylline (PF) as a selective inhibitor of phosphodiesterase to enhance sperm motility through increasing cyclic nucleotide in cases of absolute asthenozoospermia has been demonstrated for ICSI, data related to babies born from the PF-ICSI are still severely lacking. Concerns have been raised regarding the potential embryotoxicity of PF due to the controversial results obtained from the analysis of this compound on animal embryo development. This study aimed to determine whether the application of PF to trigger frozen-thawed TESA (testicular sperm aspiration) spermatozoa increases the risk of adverse obstetric and neonatal outcomes compared with non-PF frozen-thawed TESA ICSI and conventional ICSI using fresh ejaculation. Materials and methods A total of 5438 patients were analyzed in this study, including 240 patients underwent PF-TESA ICSI (ICSI using PF triggered frozen-thawed testicular spermatozoa), 101 patients underwent non-PF TESA ICSI (ICSI using frozen-thawed testicular spermatozoa) and 5097 patients underwent conventional ICSI using fresh ejaculation. Propensity score matching was executed to control the various characteristics of patients. Results No significant differences in pregnancy outcomes were observed among the three groups (PF-TESA ICSI, non-PF TESA ICSI and conventional ICSI), including biochemical pregnancy, clinical pregnancy, implantation, miscarriage, ectopic pregnancy, multiple pregnancy, and live birth, following propensity score matching. Additionally, neonatal outcomes were found to be similar among the three groups, with no statistical differences observed in the birth defect, birth weight, gestational age, preterm birth, and early-neonatal death. Discussion and conclusion PF-ICSI may be an alternative treatment in patients using frozen-thawed testicular spermatozoa, resulting in comparable pregnancy and neonatal outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | - Bin Li
- Department of Assisted Reproduction, the Ninth People’s Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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15
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Yazdani A, Halvaei I, Boniface C, Esfandiari N. Effect of cytoplasmic fragmentation on embryo development, quality, and pregnancy outcome: a systematic review of the literature. Reprod Biol Endocrinol 2024; 22:55. [PMID: 38745305 PMCID: PMC11092204 DOI: 10.1186/s12958-024-01217-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/01/2024] [Indexed: 05/16/2024] Open
Abstract
The role of cytoplasmic fragmentation in human embryo development and reproductive potential is widely recognized, albeit without standard definition nor agreed upon implication. While fragmentation is best understood to be a natural process across species, the origin of fragmentation remains incompletely understood and likely multifactorial. Several factors including embryo culture condition, gamete quality, aneuploidy, and abnormal cytokinesis seem to have important role in the etiology of cytoplasmic fragmentation. Fragmentation reduces the volume of cytoplasm and depletes embryo of essential organelles and regulatory proteins, compromising the developmental potential of the embryo. While it has been shown that degree of fragmentation and embryo implantation potential are inversely proportional, the degree, pattern, and distribution of fragmentation as it relates to pregnancy outcome is debated in the literature. This review highlights some of the challenges in analysis of fragmentation, while revealing trends in our evolving knowledge of how fragmentation may relate to functional development of the human embryos, implantation, and pregnancy outcome.
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Affiliation(s)
- Ariella Yazdani
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Medical Center, The Robert Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA
- Present address: Obstetrics and Gynecology Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA
| | - Iman Halvaei
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Catherine Boniface
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Medical Center, The Robert Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA
| | - Navid Esfandiari
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Medical Center, The Robert Larner College of Medicine at the University of Vermont, Burlington, VT, 05405, USA.
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology and Reproductive Sciences, University of Vermont, 111 Colchester Avenue, Burlington, Vermont, 05401, USA.
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16
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Shen L, Zeng H, Fu Y, Ma W, Guo X, Luo G, Hua R, Wang X, Shi X, Wu B, Luo C, Quan S. Specific plasma microRNA profiles could be potential non-invasive biomarkers for biochemical pregnancy loss following embryo transfer. BMC Pregnancy Childbirth 2024; 24:351. [PMID: 38720272 PMCID: PMC11080217 DOI: 10.1186/s12884-024-06488-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 04/07/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Plasma microRNAs act as biomarkers for predicting and diagnosing diseases. Reliable non-invasive biomarkers for biochemical pregnancy loss have not been established. We aim to analyze the dynamic microRNA profiles during the peri-implantation period and investigate if plasma microRNAs could be non-invasive biomarkers predicting BPL. METHODS In this study, we collected plasma samples from patients undergoing embryo transfer (ET) on ET day (ET0), 11 days after ET (ET11), and 14 days after ET (ET14). Patients were divided into the NP (negative pregnancy), BPL (biochemical pregnancy loss), and CP (clinical pregnancy) groups according to serum hCG levels at day11~14 and ultrasound at day28~35 following ET. MicroRNA profiles at different time-points were detected by miRNA-sequencing. We analyzed plasma microRNA signatures for BPL at the peri-implantation stage, we characterized the dynamic microRNA changes during the implantation period, constructed a microRNA co-expression network, and established predictive models for BPL. Finally, the sequencing results were confirmed by Taqman RT-qPCR. RESULTS BPL patients have distinct plasma microRNA profiles compared to CP patients at multiple time-points during the peri-implantation period. Machine learning models revealed that plasma microRNAs could predict BPL. RT-qPCR confirmed that miR-181a-2-3p, miR-9-5p, miR-150-3p, miR-150-5p, and miR-98-5p, miR-363-3p were significantly differentially expressed between patients with different reproductive outcomes. CONCLUSION Our study highlights the non-invasive value of plasma microRNAs in predicting BPL.
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Affiliation(s)
- Lang Shen
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Hong Zeng
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
- Department of Reproductive Medicine Center, Foshan Maternal and Child Health Care Hospital, Southern Medical University, Foshan, 528000, China
| | - Yu Fu
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Wenmin Ma
- Department of Reproductive Medicine Center, Foshan Maternal and Child Health Care Hospital, Southern Medical University, Foshan, 528000, China
| | - Xiaoling Guo
- Department of Reproductive Medicine Center, Foshan Maternal and Child Health Care Hospital, Southern Medical University, Foshan, 528000, China
| | - Guoqun Luo
- Department of Reproductive Medicine Center, Foshan Maternal and Child Health Care Hospital, Southern Medical University, Foshan, 528000, China
| | - Rui Hua
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xiaocong Wang
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xiao Shi
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Biao Wu
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Chen Luo
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Song Quan
- Reproductive Center of Gynecology and Obstetrics Department, NanFang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Lee T, Peirce K, Natalwala J, Chapple V, Mark PJ, Sanders K, Liu Y. Abnormal cleavage up to Day 3 does not compromise live birth and neonatal outcomes of embryos that have achieved full blastulation: a retrospective cohort study. Hum Reprod 2024; 39:955-962. [PMID: 38553025 PMCID: PMC11063553 DOI: 10.1093/humrep/deae062] [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: 12/20/2023] [Revised: 02/22/2024] [Indexed: 05/03/2024] Open
Abstract
STUDY QUESTION Do embryos displaying abnormal cleavage (ABNCL) up to Day 3 have compromised live birth rates and neonatal outcomes if full blastulation has been achieved prior to transfer? SUMMARY ANSWER ABNCL is associated with reduced full blastulation rates but does not impact live birth rates and neonatal outcomes once full blastulation has been achieved. WHAT IS KNOWN ALREADY? It is widely accepted that ABNCL is associated with reduced implantation rates of embryos when transferred at the cleavage stage. However, evidence is scarce in the literature reporting birth outcomes from blastocysts arising from ABNCL embryos, likely because they are ranked low priority for transfer. STUDY DESIGN, SIZE, DURATION This retrospective cohort study included 1562 consecutive autologous in vitro fertilization cycles (maternal age 35.1 ± 4.7 years) performed at Fertility North, Australia between January 2017 and June 2022. Fresh transfers were performed on Day 3 or 5, with remaining embryos cultured up to Day 6 before vitrification. A total of 6019 embryos were subject to blastocyst culture, and a subset of 664 resulting frozen blastocysts was included for live birth and neonatal outcome analyses following single transfers. PARTICIPANTS/MATERIALS, SETTING, METHODS ABNCL events were annotated from the first mitotic division up to Day 3, including direct cleavage (DC), reverse cleavage (RC) and <6 intercellular contact points at the 4-cell stage (<6ICCP). For DC and RC in combination, the ratios of affected blastomeres over the total number of all blastomeres up to Day 3 were also recorded. All pregnancies were followed up until birth with gestational age, birthweight, and sex of the baby being recorded. MAIN RESULTS AND THE ROLE OF CHANCE Full blastulation rates for embryos showing DC (19.5%), RC (41.7%), <6ICCP (58.8%), and mixed (≥2) ABNCL types (26.4%) were lower than the rates for those without ABNCL (67.2%, P < 0.01 respectively). Subgroup analysis showed declining full blastulation rates with increasing ratios of combined DC/RC affected blastomeres over all blastomeres up to the 8-cell stage (66.2% when 0 affected, 47.0% when 0.25 affected, 27.4% when 0.5 affected, 14.5% when 0.75 affected, and 7.7% when all affected, P < 0.01). However, once full blastulation had been achieved, no difference was detected between DC, RC, <6ICCP, and no ABNCL blastocysts following single frozen transfers in subsequent live birth rates (25.9%, 33.0%, 36.0% versus 30.8%, P > 0.05, respectively), gestational age (38.7 ± 1.6, 38.5 ± 1.2, 38.3 ± 3.5 versus 38.5 ± 1.8 weeks, P > 0.05, respectively) and birthweight (3343.0 ± 649.1, 3378.2 ± 538.4, 3352.6 ± 841.3 versus 3313.9 ± 509.6 g, P > 0.05, respectively). Multiple regression (logistic or linear as appropriate) confirmed no differences in all of the above measures after accounting for potential confounders. LIMITATIONS, REASONS FOR CAUTION Our study is limited by its retrospective nature, making it impossible to control every known or unknown confounder. Embryos in our dataset, being surplus after selection for fresh transfer, may not represent the general embryo population. WIDER IMPLICATIONS OF THE FINDINGS Our findings highlight the incremental impact of ABNCL, depending on the ratio of affected blastomeres up to Day 3, on subsequent full blastulation. The reassuring live birth and neonatal outcomes of ABNCL blastocysts imply a potential self-correction mechanism among those embryos reaching the blastocyst stage, which provides valuable guidance for clinical practice and patient counseling. STUDY FUNDING/COMPETTING INTEREST(S) This research is supported by an Australian Government Research Training Program (RTP) Scholarship. All authors report no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Tammy Lee
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
- Fertility North, Joondalup Private Hospital, Joondalup, WA, Australia
| | - Kelli Peirce
- Fertility North, Joondalup Private Hospital, Joondalup, WA, Australia
| | - Jay Natalwala
- Fertility North, Joondalup Private Hospital, Joondalup, WA, Australia
| | - Vincent Chapple
- Fertility North, Joondalup Private Hospital, Joondalup, WA, Australia
| | - Peter J Mark
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Katherine Sanders
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Yanhe Liu
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
- Fertility North, Joondalup Private Hospital, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
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Meyer D, Kort J, Chen CH, Zhao H, Yi X, Lai SY, Lu F, Yang WJ, Hsieh IC, Chiang CL, Chen WM, Huang JYJ, Camarillo D, Behr B. Development and evaluation of a usable blastocyst predictive model using the biomechanical properties of human oocytes. PLoS One 2024; 19:e0299602. [PMID: 38696439 PMCID: PMC11065297 DOI: 10.1371/journal.pone.0299602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/13/2024] [Indexed: 05/04/2024] Open
Abstract
PURPOSE The purposes of this study were to determine whether biomechanical properties of mature oocytes could predict usable blastocyst formation better than morphological information or maternal factors, and to demonstrate the safety of the aspiration measurement procedure used to determine the biomechanical properties of oocytes. METHODS A prospective split cohort study was conducted with patients from two IVF clinics who underwent in vitro fertilization. Each patient's oocytes were randomly divided into a measurement group and a control group. The aspiration depth into a micropipette was measured, and the biomechanical properties were derived. Oocyte fertilization, day 3 morphology, and blastocyst development were observed and compared between measured and unmeasured cohorts. A predictive classifier was trained to predict usable blastocyst formation and compared to the predictions of four experienced embryologists. RESULTS 68 patients and their corresponding 1252 oocytes were included in the study. In the safety analyses, there was no significant difference between the cohorts for fertilization, while the day 3 and 5 embryo development were not negatively affected. Four embryologists predicted usable blastocyst development based on oocyte morphology with an average accuracy of 44% while the predictive classifier achieved an accuracy of 71%. Retaining the variables necessary for normal fertilization, only data from successfully fertilized oocytes were used, resulting in a classifier an accuracy of 81%. CONCLUSIONS To date, there is no standard guideline or technique to aid in the selection of oocytes that have a higher likelihood of developing into usable blastocysts, which are chosen for transfer or vitrification. This study provides a comprehensive workflow of extracting biomechanical properties and building a predictive classifier using these properties to predict mature oocytes' developmental potential. The classifier has greater accuracy in predicting the formation of usable blastocysts than the predictions provided by morphological information or maternal factors. The measurement procedure did not negatively affect embryo culture outcomes. While further analysis is necessary, this study shows the potential of using biomechanical properties of oocytes to predict embryo developmental outcomes.
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Affiliation(s)
- Daniel Meyer
- Department of Bioengineering, Stanford University, Stanford, CA, United States of America
| | - Jonathan Kort
- Division of Reproductive Endocrinology and Infertility, Stanford University, Stanford, CA, United States of America
| | - Ching Hung Chen
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan
- Department of Obstetrics and Gynecology, Ton Yen General Hospital, Hsinchu, Taiwan
- Taiwan IVF Group Center for Reproductive Medicine & Infertility, Hsinchu, Taiwan
| | - Huan Zhao
- Department of Reproductive Medicine, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xiaoling Yi
- Department of Reproductive Medicine, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Shin-Yu Lai
- Taiwan IVF Group Center for Reproductive Medicine & Infertility, Hsinchu, Taiwan
| | - Farn Lu
- Department of Obstetrics and Gynecology, Ton Yen General Hospital, Hsinchu, Taiwan
- Taiwan IVF Group Center for Reproductive Medicine & Infertility, Hsinchu, Taiwan
| | - Wen Jui Yang
- Department of Obstetrics and Gynecology, Ton Yen General Hospital, Hsinchu, Taiwan
- Taiwan IVF Group Center for Reproductive Medicine & Infertility, Hsinchu, Taiwan
| | - I-Chiao Hsieh
- Department of Data Science, Inti Taiwan, Inc., Zhubei City, Hsinchu, Taiwan
| | - Chung-Li Chiang
- Department of Data Science, Inti Taiwan, Inc., Zhubei City, Hsinchu, Taiwan
| | - Wei-Ming Chen
- Department of Data Science, Inti Taiwan, Inc., Zhubei City, Hsinchu, Taiwan
| | - Jack Yu Jen Huang
- Division of Reproductive Endocrinology and Infertility, Stanford University, Stanford, CA, United States of America
- Department of Obstetrics and Gynecology, Ton Yen General Hospital, Hsinchu, Taiwan
- Taiwan IVF Group Center for Reproductive Medicine & Infertility, Hsinchu, Taiwan
| | - David Camarillo
- Department of Bioengineering, Stanford University, Stanford, CA, United States of America
| | - Barry Behr
- Division of Reproductive Endocrinology and Infertility, Stanford University, Stanford, CA, United States of America
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Zhang Q, Jin H, Long S, Tang X, Li J, Liu W, Han W, Liao H, Fu T, Huang G, Chen S, Lin T. Deletion of ACTRT1 is associated with male infertility as sperm acrosomal ultrastructural defects and fertilization failure in human. Hum Reprod 2024; 39:880-891. [PMID: 38414365 DOI: 10.1093/humrep/deae031] [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: 06/06/2023] [Revised: 01/10/2024] [Indexed: 02/29/2024] Open
Abstract
STUDY QUESTION Could actin-related protein T1 (ACTRT1) deficiency be a potential pathogenic factor of human male infertility? SUMMARY ANSWER A 110-kb microdeletion of the X chromosome, only including the ACTRT1 gene, was identified as responsible for infertility in two Chinese males with sperm showing acrosomal ultrastructural defects and fertilization failure. WHAT IS KNOWN ALREADY The actin-related proteins (e.g. ACTRT1, ACTRT2, ACTL7A, and ACTL9) interact with each other to form a multimeric complex in the subacrosomal region of spermatids, which is crucial for the acrosome-nucleus junction. Actrt1-knockout (KO) mice are severely subfertile owing to malformed sperm heads with detached acrosomes and partial fertilization failure. There are currently no reports on the association between ACTRT1 deletion and male infertility in humans. STUDY DESIGN, SIZE, DURATION We recruited a cohort of 120 infertile males with sperm head deformations at a large tertiary hospital from August 2019 to August 2023. Genomic DNA extracted from the affected individuals underwent whole exome sequencing (WES), and in silico analyses were performed to identify genetic variants. Morphological analysis, functional assays, and ART were performed in 2022 and 2023. PARTICIPANTS/MATERIALS, SETTING, METHODS The ACTRT1 deficiency was identified by WES and confirmed by whole genome sequencing, PCR, and quantitative PCR. Genomic DNA of all family members was collected to define the hereditary mode. Papanicolaou staining and electronic microscopy were performed to reveal sperm morphological changes. Western blotting and immunostaining were performed to explore the pathological mechanism of ACTRT1 deficiency. ICSI combined with artificial oocyte activation (AOA) was applied for one proband. MAIN RESULTS AND THE ROLE OF CHANCE We identified a whole-gene deletion variant of ACTRT1 in two infertile males, which was inherited from their mothers, respectively. The probands exhibited sperm head deformations owing to acrosomal detachment, which is consistent with our previous observations on Actrt1-KO mice. Decreased expression and ectopic distribution of ACTL7A and phospholipase C zeta were observed in sperm samples from the probands. ICSI combined with AOA effectively solved the fertilization problem in Actrt1-KO mice and in one of the two probands. LIMITATIONS, REASONS FOR CAUTION Additional cases are needed to further confirm the genetic contribution of ACTRT1 variants to male infertility. WIDER IMPLICATIONS OF THE FINDINGS Our results reveal a gene-disease relation between the ACTRT1 deletion described here and human male infertility owing to acrosomal detachment and fertilization failure. This report also describes a good reproductive outcome of ART with ICSI-AOA for a proband. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau, 2023MSXM008 and 2023MSXM054). There are no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Qi Zhang
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Huijuan Jin
- Key Laboratory of Cell Proliferation and Regulation Biology, Ministry of Education, College of Life Sciences, Beijing Normal University, Beijing, China
| | - Shunhua Long
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Xiangrong Tang
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jiaxun Li
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Weiwei Liu
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Wei Han
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Haiyuan Liao
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Tao Fu
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Guoning Huang
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Suren Chen
- Key Laboratory of Cell Proliferation and Regulation Biology, Ministry of Education, College of Life Sciences, Beijing Normal University, Beijing, China
| | - Tingting Lin
- Chongqing Key Laboratory of Human Embryo Engineering, Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
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Firmin J, Ecker N, Rivet Danon D, Özgüç Ö, Barraud Lange V, Turlier H, Patrat C, Maître JL. Mechanics of human embryo compaction. Nature 2024; 629:646-651. [PMID: 38693259 DOI: 10.1038/s41586-024-07351-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
The shaping of human embryos begins with compaction, during which cells come into close contact1,2. Assisted reproductive technology studies indicate that human embryos fail compaction primarily because of defective adhesion3,4. On the basis of our current understanding of animal morphogenesis5,6, other morphogenetic engines, such as cell contractility, could be involved in shaping human embryos. However, the molecular, cellular and physical mechanisms driving human embryo morphogenesis remain uncharacterized. Using micropipette aspiration on human embryos donated to research, we have mapped cell surface tensions during compaction. This shows a fourfold increase of tension at the cell-medium interface whereas cell-cell contacts keep a steady tension. Therefore, increased tension at the cell-medium interface drives human embryo compaction, which is qualitatively similar to compaction in mouse embryos7. Further comparison between human and mouse shows qualitatively similar but quantitively different mechanical strategies, with human embryos being mechanically least efficient. Inhibition of cell contractility and cell-cell adhesion in human embryos shows that, whereas both cellular processes are required for compaction, only contractility controls the surface tensions responsible for compaction. Cell contractility and cell-cell adhesion exhibit distinct mechanical signatures when faulty. Analysing the mechanical signature of naturally failing embryos, we find evidence that non-compacting or partially compacting embryos containing excluded cells have defective contractility. Together, our study shows that an evolutionarily conserved increase in cell contractility is required to generate the forces driving the first morphogenetic movement shaping the human body.
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Affiliation(s)
- Julie Firmin
- Institut Curie, Université PSL, CNRS UMR3215, INSERM U934, Paris, France
- Université de Paris, Paris, France
- Service de Biologie de la Reproduction - CECOS, Paris Centre Hospital, APHP centre, FHU Prema, Paris, France
| | - Nicolas Ecker
- Center for Interdisciplinary Research in Biology, Collège de France, CNRS, INSERM, Université PSL, FHU Prema, Paris, France
| | - Diane Rivet Danon
- Service de Biologie de la Reproduction - CECOS, Paris Centre Hospital, APHP centre, FHU Prema, Paris, France
| | - Özge Özgüç
- Institut Curie, Université PSL, CNRS UMR3215, INSERM U934, Paris, France
| | - Virginie Barraud Lange
- Service de Biologie de la Reproduction - CECOS, Paris Centre Hospital, APHP centre, FHU Prema, Paris, France
- Institut Cochin, Université de Paris, CNRS UMR1016, Paris, France
| | - Hervé Turlier
- Center for Interdisciplinary Research in Biology, Collège de France, CNRS, INSERM, Université PSL, FHU Prema, Paris, France
| | - Catherine Patrat
- Service de Biologie de la Reproduction - CECOS, Paris Centre Hospital, APHP centre, FHU Prema, Paris, France
- Institut Cochin, Université de Paris, CNRS UMR1016, Paris, France
| | - Jean-Léon Maître
- Institut Curie, Université PSL, CNRS UMR3215, INSERM U934, Paris, France.
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21
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Guarneri C, Reschini M, Pinna M, Perego L, Sanzani E, Somigliana E, Sorrentino U, Cassina M, Zuccarello D, Ciaffaglione M. The impact of a second embryo biopsy for preimplantation genetic testing for monogenic diseases (PGT-M) with inconclusive results on pregnancy potential: results from a matched case-control study. J Assist Reprod Genet 2024; 41:1173-1179. [PMID: 38557804 PMCID: PMC11143113 DOI: 10.1007/s10815-024-03078-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: 11/16/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE To evaluate whether a second biopsy, following a first diagnostic failure on blastocysts tested for preimplantation genetic testing for monogenic diseases (PGT-M), allows to obtain genetic diagnosis and to what extent this procedure can influence clinical pregnancy and live birth rates compared to the PGT-M process with a successful genetic diagnosis from the first biopsy. METHODS Embryos from women who underwent PGT-M in an infertility centre and who had been transferred after two biopsies for genetic analysis (n = 27) were matched in a 1:1 ratio accordingly to women's age (± 1 year) and fertility status (fertile vs infertile), as well as with the study period, with embryos who were transferred after receiving a conclusive PGT result straight after the first biopsy (n = 27). The main evaluated outcome was clinical pregnancy rate following embryo transfers in which healthy embryos were transferred after only one biopsy and those in which an embryo was transferred after being re-biopsied. Live birth rate was the secondary outcome. RESULTS Clinical pregnancy rate was 52% (95% CI: 34-69) following the transfer of a single-biopsy blastocyst and 30% (95% CI: 16-48) following the transfer of a re-biopsied blastocyst. The likelihood to have a healthy baby was 33% (95% CI: 19-52) following the transfer of a blastocyst biopsied once and 22% (95% CI: 11-41) following the transfer of a re-biopsied blastocyst. CONCLUSIONS The re-biopsy intervention seems to considerably reduce the pregnancy potential of a blastocyst. However, a greater sample size is necessary to clarify this issue definitively.
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Affiliation(s)
- Cristina Guarneri
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy.
| | - Marco Reschini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Monica Pinna
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Lucia Perego
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Elena Sanzani
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Ugo Sorrentino
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Matteo Cassina
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Daniela Zuccarello
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Marta Ciaffaglione
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
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22
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Wang R, Zhang L, Liao J, Ma F, Ma Q. In vitro fertilization and pregnancy outcomes of women with X chromosome abnormality: A case series. Birth Defects Res 2024; 116:e2349. [PMID: 38778782 DOI: 10.1002/bdr2.2349] [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: 01/07/2023] [Revised: 01/22/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND To describe and conclude the in vitro fertilization (IVF) results of patients with X chromosome abnormality. METHODS A retrospective case series was conducted. According to the number of normal X, patients were allocated into two groups: Group A (patients with only a normal X, while other X has any types of abnormalities) and Group B (patients have two or more normal X chromosomes). Clinical data, including basic information, fertility information, and IVF outcomes, were collected. RESULTS Fourteen patients with X chromosome abnormality were included, among which 13 patients underwent a total of 29 cycles. Patients in Group B had five successful pregnancies and three live births, while no patient in Group A had a clinical pregnancy. Furthermore, the blastocyst formation rate and incidence of pregnancy were significantly lower in Group A (Z = -3.135, p = .002; Z = -2.946, p = .003, respectively). When controlled covariates, the karyotype of one normal X was also a risk factor for both blastocyst formation rate and success pregnancy (β = .820, 95% confidence interval [CI] = 0.458-1.116, β = .333, 95% CI = 0.017-0.494, respectively). CONCLUSIONS Our results revealed that women with only one normal X might suffer from worse IVF outcomes, mainly blastocyst formation rate, compared with those who had two or more normal X, including mosaic Turner syndrome and 47,XXX.
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Affiliation(s)
- Ruohan Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Obstetrics and Gynecology, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Linyu Zhang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Obstetrics and Gynecology, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jia Liao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fang Ma
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Obstetrics and Gynecology, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianhong Ma
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Obstetrics/Gynecology, Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Karagianni M, Papadopoulou MI, Oraiopoulou C, Christoforidis N, Papatheodorou A, Chatziparasidou A. Embryos from vitrified vs. fresh oocytes in an oocyte donation program: a comparative morphokinetic analysis. F&S SCIENCE 2024; 5:174-181. [PMID: 38580180 DOI: 10.1016/j.xfss.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/29/2024] [Accepted: 03/29/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE To compare the morphokinetic patterns of human embryos originating from vitrified oocytes (VITRI group) with those derived from freshly collected oocytes (CONTROL group) in oocyte donation cycles. DESIGN This is a retrospective observational study. SETTING Embryolab Fertility Clinic, Embryology Lab, Thessaloniki, Greece. PATIENT(S) The study included embryos from 421 vitrified oocytes from 58 oocyte donation cycles and 196 fresh oocytes from 23 oocyte donation cycles. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Key time parameters, dynamic events, fertilization rates, degeneration rates, cleavage rates, blastocyst rates, pregnancy rates, clinical pregnancy rates, implantation rates, and live birth rates were estimated. RESULTS The mean survival rate of vitrified oocytes was 92.58% (±7.42%). Fertilization rates were significantly different between the 2 groups (VITRI group: 71.92% ± 20.29% and CONTROL group: 80.65% ± 15.22%) whereas the degeneration, cleavage, blastocyst, pregnancy, clinical pregnancy, ongoing pregnancy, implantation, and live birth rates were not significantly different between embryos derived from fresh or vitrified oocytes. Time-lapse analysis showed no significant difference in any key time parameter. However, when examining dynamic parameters, first cell cycle (CC1) (t2 - tPB2: from the second polar body extrusion (tPB2) up to 2 cells (t2)) showed a significant difference whereas CC1a (t2 - tPNf: from fading of the pronuclei (tPNf) up to 2 cells (t2)) was at the threshold of significance. CONCLUSION(S) CC1 in vitrified oocytes exhibited a comparatively slower progression in contrast to fresh oocytes. Conversely, CC1a in vitrified oocytes demonstrated faster progression compared with fresh oocytes. It is worth noting that these temporary deviations had minimal impact on the subsequent development. Despite the clinical outcomes showing a decrease in the vitrified group, none of them reached statistical significance. This lack of significance could be attributed to the limited sample size of the study.
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Affiliation(s)
- Mary Karagianni
- Embryology Department, Embryolab Fertility Clinic, Thessaloniki, Greece.
| | | | - Chara Oraiopoulou
- Embryology Department, Embryolab Fertility Clinic, Thessaloniki, Greece
| | - Nikolaos Christoforidis
- Clinical Department, Embryolab Fertility Clinic, Thessaloniki, Greece; Embryolab Academy, Thessaloniki, Greece
| | | | - Alexia Chatziparasidou
- Embryology Department, Embryolab Fertility Clinic, Thessaloniki, Greece; Embryolab Academy, Thessaloniki, Greece
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24
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Wang R, Li D, Zhao L, Zhu Q, Sun L, Xue S, Lyu Q. External bending of cryodevice during vitrification leads to cryoprotectant cracks and damage to embryo blastomeres. Reprod Biomed Online 2024; 48:103763. [PMID: 38452604 DOI: 10.1016/j.rbmo.2023.103763] [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: 08/10/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 03/09/2024]
Abstract
RESEARCH QUESTION Embryo blastomeres and the zona pellucida are occasionally damaged during vitrification; is this a result of crack-induced mechanical damage in the glass state, caused by external bending of the device? DESIGN A stereomicroscope was used to observe external bending-induced cracks in a cryoprotectant. Thereafter, 309 human cleavage-stage embryos derived from abnormally fertilized eggs were used to assess embryo damage under two external bending conditions: forward bending and backward bending, with three bending degrees applied. Three distinct embryo positions were used to examine the correlation between bending and embryo damage. Damage was assessed by looking at blastomere lysis rates, and overall rates of damaged and surviving embryos. RESULTS A series of parallel cracks were identified in the cryoprotectant used for external bending, which led to damage to the embryo blastomeres. Compared with forward bending and control, the embryos were found to be more easily damaged by backward bending, indicated by significantly higher blastomere lysis and embryo damage rates, and lower embryo survival rate of backward bending than forward bending (P < 0.001). The degree of embryo damage also increased as the degree of external forces increased. Embryo position correlated with degree of embryo damage. CONCLUSIONS Cryoprotectant crack-induced damage was identified as the cause of embryo damage. Mechanical damage to the glass state occurs because of improper external bending of the cryodevice strip in liquid nitrogen during vitrification. To prevent damage, bending of the strip should be avoided and the embryos should be placed near the tip of the strip.
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Affiliation(s)
- Rongxiang Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China.; Center for Reproductive Medicine, Shanghai East Hospital, Tongji University School of Medicine, 1800 Yuntai Rd, Shanghai 200120, China.; School of Life Sciences and Technology, Tongji University, 1239 Siping Rd, Shanghai 200092, China
| | - Danjun Li
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China
| | - Leiwen Zhao
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China
| | - Qianqian Zhu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China
| | - Lihua Sun
- Center for Reproductive Medicine, Shanghai East Hospital, Tongji University School of Medicine, 1800 Yuntai Rd, Shanghai 200120, China
| | - Songguo Xue
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China.; Center for Reproductive Medicine, Shanghai East Hospital, Tongji University School of Medicine, 1800 Yuntai Rd, Shanghai 200120, China..
| | - Qifeng Lyu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China..
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25
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Pandya RK, Jijo A, Cheredath A, Uppangala S, Salian SR, Lakshmi VR, Kumar P, Kalthur G, Gupta S, Adiga SK. Differential sperm histone retention in normozoospermic ejaculates of infertile men negatively affects sperm functional competence and embryo quality. Andrology 2024; 12:881-890. [PMID: 37801310 DOI: 10.1111/andr.13541] [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: 06/22/2023] [Revised: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND The unique epigenetic architecture that sperm cells acquire during spermiogenesis by retaining <15% of either canonical or variant histone proteins in their genome is essential for normal embryogenesis. Whilst heterogeneous levels of retained histones are found in morphologically normal spermatozoa, their effect on reproductive outcomes is not fully understood. METHODS Processed spermatozoa (n = 62) were tested for DNA integrity by sperm chromatin dispersion assay, and retained histones were extracted and subjected to dot-blot analysis. The impact of retained histone modifications in normozoospermic patients on sperm functional characteristics, embryo quality, metabolic signature in embryo spent culture medium and pregnancy outcome was studied. RESULTS Dot-blot analysis showed heterogeneous levels of retained histones in the genome of normozoospermic ejaculates. Post-wash sperm yield was affected by an increase in H3K27Me3 and H4K20Me3 levels in the sperm chromatin (p < 0.05). Also, spermatozoa with higher histone H3 retention had increased DNA damage (p < 0.05). Spermatozoa from these cohorts, when injected into donor oocytes, correlated to a significant decrease in the fertilisation rate with an increase in sperm histone H3 (p < 0.05) and H3K27Me3 (p < 0.01). An increase in histone H3 negatively affected embryo quality (p < 0.01) and clinical pregnancy outcome post-embryo transfer (p < 0.05). On the other hand, spent culture medium metabolites assessed by high-resolution (800 MHz) nuclear magnetic resonance showed an increased intensity of the amino acid methionine in the non-pregnant group than in the pregnant group (p < 0.05) and a negative correlation with sperm histone H3 in the pregnant group (p < 0.05). DISCUSSION AND CONCLUSION Histone retention in spermatozoa can be one of the factors behind the development of idiopathic male infertility. Such spermatozoa may influence embryonic behaviour and thereby affect the success rate of assisted reproductive technology procedures. These results, although descriptive in nature, warrant further research to address the underlying mechanisms behind these clinically important observations.
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Affiliation(s)
- Riddhi Kirit Pandya
- Centre of Excellence in Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Ameya Jijo
- Centre of Excellence in Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Aswathi Cheredath
- Centre of Excellence in Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Shubhashree Uppangala
- Division of Reproductive Genetics, Department of Reproductive Science, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Sujith Raj Salian
- Centre of Excellence in Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Vani R Lakshmi
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Pratap Kumar
- Department of Reproductive Medicine and Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Guruprasad Kalthur
- Division of Reproductive Biology, Department of Reproductive Science, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Sanjay Gupta
- KS313, Epigenetics and Chromatin Biology Group, Gupta Lab, Cancer Research Institute, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
| | - Satish Kumar Adiga
- Centre of Excellence in Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
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Metello J, Tomás C, Ferreira P, Natário I, Santos-Ribeiro S. Impact of dydrogesterone use in cycles with low progesterone levels on the day of frozen embryo transfer. J Assist Reprod Genet 2024:10.1007/s10815-024-03118-5. [PMID: 38676842 DOI: 10.1007/s10815-024-03118-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE This study aims to evaluate whether the clinical outcomes of cycles with frozen embryo transfer (FET) in hormonal replacement treatment supplemented with dydrogesterone (DYD) following detection of low circulating levels of progesterone (P4) were comparable to the results of cycles with otherwise normal serum P4 values. METHODS Extended analyses of a retrospective cohort that included FET cycles performed between July 2019 and March 2022 after a cycle of artificial endometrial preparation using valerate-estradiol and micronized vaginal P4 (400 mg twice daily). Whenever the serum P4 value was considered low on the morning of the planned transfer, 10 mg of DYD three times a day was added as a supplement. Only single-embryo transfers of a blastocyst were considered. The primary endpoint was live birth rate. RESULTS Five-hundred thirty-five FET cycles were analyzed, of which 136 (25.4%) underwent treatment with DYD. There were 337 pregnancies (63%), 207 live births (38.6%), and 130 miscarriages (38.5%). The P4 values could be modeled by a gamma distribution, with a mean of 14.5 ng/ml and a standard deviation of 1.95 ng/ml. The variables female age on the day of FET, ethnicity, and weight were associated with a variation in the serum P4 values. There were no differences in the results between cycles with or without the indication for DYD supplementation. CONCLUSIONS Live birth rate did not vary significantly in females with low and normal serum P4 levels on the day of FET when DYD was used as rescue therapy.
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Affiliation(s)
- Jose Metello
- Serviço de Ginecologia e Obstetricia, Hospital Garcia de Orta, Almada, Portugal.
| | | | | | - Isabel Natário
- NOVA MATH & Department of Mathematics, NOVA School of Science and Technology, NOVA University of Lisbon, Almada, Portugal
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Hu X, Feng G, Chen Q, Sang Y, Chen Q, Wang S, Liu S, Bai L, Zhu Y. The impact and inflammatory characteristics of SARS-CoV-2 infection during ovarian stimulation on the outcomes of assisted reproductive treatment. Front Endocrinol (Lausanne) 2024; 15:1353068. [PMID: 38726341 PMCID: PMC11079226 DOI: 10.3389/fendo.2024.1353068] [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: 12/09/2023] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Despite the global prevalence of coronavirus disease 2019 (COVID-19), limited research has been conducted on the effects of SARS-CoV-2 infection on human reproduction. The aims of this study were to investigate the impact of SARS-CoV-2 infection during controlled ovarian stimulation (COS) on the outcomes of assisted reproductive treatment (ART) and the cytokine status of patients. Methods This retrospective cohort study included 202 couples who received ART treatment, 101 couples infected with SARS-CoV-2 during COS and 101 matched uninfected couples. The parameters of ovarian stimulation and pregnancy outcomes were compared between the two groups. The All-Human Inflammation Array Q3 kit was utilized to measure cytokine levels in both blood and follicular fluid. Results No difference was found in the number of good-quality embryos (3.3 ± 3.1 vs. 3.0 ± 2.2, P = 0.553) between the infected and uninfected groups. Among couples who received fresh embryo transfers, no difference was observed in clinical pregnancy rate (53.3% vs. 51.5%, P = 0.907). The rates of fertilization, implantation, miscarriage, ectopic pregnancy and live birth were also comparable between the two groups. After adjustments were made for confounders, regression models indicated that the quality of embryos (B = 0.16, P = 0.605) and clinical pregnancy rate (P = 0.206) remained unaffected by SARS-CoV-2 infection. The serum levels of MCP-1, TIMP-1, I-309, TNF-RI and TNF-RII were increased, while that of eotaxin-2 was decreased in COVID-19 patients. No significant difference was found in the levels of cytokines in follicular fluid between the two groups. Conclusion Asymptomatic or mild COVID-19 during COS had no adverse effects on ART outcomes. Although mild inflammation was present in the serum, it was not detected in the follicular fluid of these patients. The subsequent immune response needs further investigation.
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Affiliation(s)
- Xiaoling Hu
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Guofang Feng
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qichao Chen
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yimiao Sang
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qingqing Chen
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Sisi Wang
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shuangying Liu
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Long Bai
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Yimin Zhu
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
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Chen K, Cai J, Tong J, Liu L, Liu Z, Chen J, Yang X, Yang C, Geng J, Ma C, Ren J, Jiang X. Body mass index modified the effectiveness of low dose aspirin treatment on frozen-thawed embryo transfer outcome: a propensity score-matched study. Front Endocrinol (Lausanne) 2024; 15:1365467. [PMID: 38706702 PMCID: PMC11067524 DOI: 10.3389/fendo.2024.1365467] [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: 01/04/2024] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
Background Low-dose aspirin is one of the widely used adjuvants in assisted reproductive technologies with the hope of improving the live birth rate. However, the studies regarding its effects are conflicting. The study aimed to investigate the association between aspirin administration and live birth following frozen-thawed embryo transfer (FET) in patients with different body mass index (BMI). Methods A retrospective cohort study was performed on 11,993 patients receiving FET treatments. 644 of which received a low-dose aspirin (100 mg/day) during endometrial preparation until 10 weeks after transfer. Propensity score matching was performed to avoid selection biases and potential confounders. Results The clinical pregnancy rate and live birth rate were similar before matching (54.4% versus 55.4%, RR: 1.02, 95%CI: 0.95-1.09, and 46.3 versus 47.8, RR: 1.03, 95%CI: 0.95-1.12 respectively). A weak association in favor of aspirin administration was found in the matched cohort (49.5% versus 55.4%, RR: 1.12, 95%CI: 1.01-1.24, and 41.9% versus 47.8%, RR: 1.14, 95%CI: 1.01-1.29 respectively). However, when stratified the patients with WHO BMI criteria, a significant increase in live birth rate associated with aspirin treatment was found only in patients with low BMI (<18.5 kg/m2) in either unmatched (46.4% versus 59.8%, RR:1.29, 95%CI:1.07-1.55) or matched cohort (44% versus 59.8%, RR: 1.36, 95%CI: 1.01-1.83) but not in patients with higher BMI categories. With the interaction analysis, less association between aspirin and live birth appeared in patients with normal BMI (Ratio of OR:0.49, 95%CI: 0.29-0.81) and high BMI (Ratio of OR:0.57, 95%CI: 0.27-1.2) compared with patients with low BMI. Conclusion BMI may be considered when evaluating aspirin's effect in FET cycles.
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Affiliation(s)
- Kaijie Chen
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jiali Cai
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jie Tong
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Lanlan Liu
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Zhenfang Liu
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jinhua Chen
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Xiaolian Yang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Chao Yang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jie Geng
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Caihui Ma
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jianzhi Ren
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
| | - Xiaoming Jiang
- Reproductive Medicine Center, The Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
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Qiu P, Ye R, Li P, Huang H, Ding L. Effect of Day 3 cell number on the live birth rate of vitrified-warmed Day 5 single blastocyst transfer in young women. BMC Pregnancy Childbirth 2024; 24:289. [PMID: 38641596 PMCID: PMC11027403 DOI: 10.1186/s12884-024-06468-1] [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: 02/26/2023] [Accepted: 03/29/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Previous studies have reported inconsistent results regarding blastocyst selection with a high day 3 (D3) cell number and the eventual pregnancy outcomes. Thus, in this study, the relationship between the D3 cell number and clinical outcomes of day 5 single blastocyst transfer (SBT) in vitrified-warmed transfer cycles was investigated. METHODS Our retrospective study included 1144 day 5 SBT in vitrified-warmed cycles between February 2016 and February 2021. All cycles were the first vitrified-warmed cycles, and the female patients were less than 35 years of age. Based on the D3 cell number, the cycles were divided into four groups, as follows: group A (3-7 cells, n = 130); group B (8-9 cells, n = 621); group C (10-12 cells, n = 328); and group D (13-16 cells, n = 65). The differences in the live birth rate (LBR), clinical pregnancy rate, and miscarriage rate were examined among the four groups. RESULTS The LBR and clinical pregnancy rate increased with the D3 cell number (P < 0.01). No significant difference was found in the miscarriage rate among the groups (P = 0.055). After adjusting for confounding factors, the LBR was significantly higher in groups C (odds ratio [OR] = 1.477, 95% confidence interval [CI]: 1.124-1.941, P = 0.005) and D (OR = 2.000, 95% CI: 1.166-3.429, P = 0.012) than in group B. CONCLUSIONS A high D3 cell number (> 9 cells) was associated with a high LBR in the vitrified-warmed day 5 SBT cycles of patients < 35 years of age. The cell number of D3 embryos can be an important reference indicator for blastocyst selection. Among blastocysts with the same morphological score, those with > 9 cells on D3 can be preferentially selected for transplantation.
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Affiliation(s)
- Pingping Qiu
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361000, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, 361000, Fujian, China
- Xiamen Assisted Reproductive Technology Quality Control Center, Xiamen, 361000, Fujian, China
| | - Ronghui Ye
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361000, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, 361000, Fujian, China
| | - Ping Li
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361000, Fujian, China.
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, 361000, Fujian, China.
- Xiamen Assisted Reproductive Technology Quality Control Center, Xiamen, 361000, Fujian, China.
| | - Hui Huang
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361000, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, 361000, Fujian, China
| | - Lu Ding
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361000, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, 361000, Fujian, China
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Liang Z, Huang Q, Huang J, Wu J, Zeng D, Huang P. High progesterone levels on the day after HCG injection has no effect on clinical pregnancy outcomes in in vitro fertilization-embryo transfer. Front Endocrinol (Lausanne) 2024; 15:1372753. [PMID: 38689731 PMCID: PMC11059087 DOI: 10.3389/fendo.2024.1372753] [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: 01/18/2024] [Accepted: 03/25/2024] [Indexed: 05/02/2024] Open
Abstract
Background This study investigates the potential impact of high progesterone (P) level on the day following human chorionic gonadotropin (HCG) injection on the clinical pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET). Methods Retrospective analysis was conducted on 6418 cycles of IVF-ET performed at Liuzhou Maternal and Child Health Hospital between August 2020 to December 2021. Excluding cycles with progesterone levels ≥1.5ng/ml on HCG injection, a total of 781 cycles were identified according to the standard, and they were divided into five groups according to the progesterone level on the day after HCG: Group A: progesterone level < 2.5 ng/ml (n = 128); Group B: 2.5 ng/ml ≤ progesterone level < 3.5 ng/ml (n = 174); Group C: 3.5 ng/ml ≤ progesterone level < 4.5 ng/ml (n = 153); Group D: 4.5 ng/ml ≤ progesterone level < 5.5 ng/ml (n = 132); Group E progesterone level ≥5.5 ng/ml(n=194). Comparative analyses of clinical data, including general clinical data, and clinical pregnancy outcomes such as clinical pregnancy rate, miscarriage rate, and live birth rate were performed among these groups. Results There were significant differences in estradiol levels on HCG injection, but there were no differences in available embryo rate, clinical pregnancy rate, miscarriage rate, and live birth rate. Binary logistic regression analysis showed that there was no significant correlation between P level on the day after HCG injection and the live birth rate. Conclusion Under the condition of low P level on HCG injection, high progesterone levels on the day after HCG injection does not affect the clinical pregnancy outcomes of IVF-ET.
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Affiliation(s)
- Zhuo Liang
- Center of Reproductive Medicine, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Guangxi Clinical Research Center for Obstetrics and Gynecology, Liuzhou, Guangxi, China
- Obstetrics and Gynecology Institute, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Center of Reproductive Medicine, Liuzhou Maternal and Child Health Hospital, Liuzhou, Guangxi, China
- Graduate School, Guilin Medical College, Guilin, Guangxi, China
| | - Qiuyan Huang
- Department of Obstetrics and Gynecology, The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
| | - Jiwei Huang
- Center of Reproductive Medicine, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Guangxi Clinical Research Center for Obstetrics and Gynecology, Liuzhou, Guangxi, China
- Obstetrics and Gynecology Institute, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Center of Reproductive Medicine, Liuzhou Maternal and Child Health Hospital, Liuzhou, Guangxi, China
| | - Jinxiang Wu
- Department of Reproductive Medicine, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Dingyuan Zeng
- Center of Reproductive Medicine, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Guangxi Clinical Research Center for Obstetrics and Gynecology, Liuzhou, Guangxi, China
- Obstetrics and Gynecology Institute, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Center of Reproductive Medicine, Liuzhou Maternal and Child Health Hospital, Liuzhou, Guangxi, China
| | - Pinxiu Huang
- Center of Reproductive Medicine, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Guangxi Clinical Research Center for Obstetrics and Gynecology, Liuzhou, Guangxi, China
- Obstetrics and Gynecology Institute, Guangzhou Women and Children’s Medical Center-Liuzhou Hospital, Liuzhou, Guangxi, China
- Center of Reproductive Medicine, Liuzhou Maternal and Child Health Hospital, Liuzhou, Guangxi, China
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Wang J, Xiong S, Hao X, Gao Y, Xia F, Liao H, Zou J, Huang G, Han W. Evaluating the developmental potential of 2.1PN-derived embryos and associated chromosomal analysis. J Assist Reprod Genet 2024:10.1007/s10815-024-03113-w. [PMID: 38613651 DOI: 10.1007/s10815-024-03113-w] [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: 01/19/2024] [Accepted: 03/28/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE Zygotes with 2.1 pronuclei (2.1PN) present with two normal-sized pronuclei, and an additional smaller pronucleus, that is approximately smaller than two thirds the size of a normal pronucleus. It remains unclear whether the additional pronucleus causes embryonic chromosome abnormalities. In the majority of cases, in vitro fertilization (IVF) clinics discarded 2.1PN zygotes. Thus, the present study aimed to evaluate the developmental potential and value of 2.1PN zygotes. METHODS 2.1PN-derived embryos from 164 patients who underwent IVF or intracytoplasmic sperm injection (ICSI) treatment between January 2021 and December 2022 were included in the present study. All embryos were monitored using a time-lapse system, and blastocyst formation was used to assess 2.1PN-derived embryo developmental potential. The blastocyst formation was quantified using generalized estimating equations, and chromosome euploidy was analyzed using next-generation sequencing (NGS). In addition, the potential association between age and occurrence of 2.1PN zygotes was determined. RESULTS The present study demonstrated that numerous 2.1PN zygotes developed into blastocysts. Early cleavage patterns and embryo quality on Day 3 were the independent predictors for the blastocyst formation of 2.1PN-derived embryos. The 2.1PN zygotes displayed a comparable developmental potential compared to 2PN zygotes in advanced age patients (≥ 38). Moreover, there was a tendency that 2.1PN-derived blastocysts showed a similar euploidy rate compared to 2PN-derived blastocysts. CONCLUSION Clinicians should consider using 2.1PN-derived euploid embryos for transfer after preimplantation genetic testing in the absence of available 2PN embryo cycles. 2.1PN-derived embryos could be a candidate, particularly beneficial for patients at advanced age.
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Affiliation(s)
- Jiang Wang
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Shun Xiong
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Xiangwei Hao
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yang Gao
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Fei Xia
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Haiyuan Liao
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jiayi Zou
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China
| | - Guoning Huang
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China.
| | - Wei Han
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Clinical Research Center for Reproductive Medicine, Chongqing Health Center for Women and Children, Chongqing, China.
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Hattori H, Okuyama N, Ashikawa K, Sakuraba Y, Igarashi H, Kyono K. The utility of human two plus one small pronucleated zygotes (2.1PN) based on clinical outcomes and the focused ploidy analysis. J Assist Reprod Genet 2024:10.1007/s10815-024-03114-9. [PMID: 38613650 DOI: 10.1007/s10815-024-03114-9] [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: 01/30/2024] [Accepted: 03/26/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE Are human embryos arising from two plus one small pronucleated zygotes, called 2.1 pronuclei (PN), clinically useful? METHODS In a retrospective embryo cohort study and prospective experimental study, a total of 287 cycles in which at least one 2.1PN was identified in the fertilization check were included. Embryonic development and clinical outcome were compared for the 1395 2PN zygotes and 304 2.1PN zygotes that were siblings. All embryos were individually cultured in time-lapse systems. Twenty-five 2.1PN-derived blastocysts, donated for research, were used in focused single-nucleotide variant ploidy analysis to identify the distribution pattern of heterozygosity. RESULTS The average diameter of PN was 24.9 ± 2.4 µm for large PN and 10.2 ± 2.4 µm for small PN; 79.9% of small PN was derived from female pronuclei. Blastocyst formation rate and good-quality blastocyst rate were significantly lower with 2.1PN embryos than with 2PN embryos (40.0% vs. 57.7%, 21.4% vs. 33.5%, respectively). A total of 13 embryos derived from 2.1PN were transferred, and three healthy babies were born. In ploidy constitutions of trophectoderm (TE), 2.1PN-derived blastocyst TE was shown to be mostly diploid (95.8%, 23/24), and only one blastocyst showed triploid. CONCLUSIONS It was suggested that 2.1PN embryos have lower embryonic developmental potential than 2PN embryos, but most of the 2.1PN were diploid, indicating that they are likely to be clinically usable. It is recommended to perform embryo transfer following a combination of PGT-A and ploidy analysis.
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Affiliation(s)
- Hiromitsu Hattori
- Kyono ART Clinic Sendai, 1-1-1 3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa Tokyo, Minatoku, 108-0074, Japan
- Kyono ART Clinic Morioka, 3F, 15-5, Moriokaekimaedori, Morioka-Shi, Iwate, 020-0034, Japan
- HOPE (Human Ovarian-Tissue Preservation Enterprise), 4F 1-8-12 Shinagawa-Ku, Kitashinagawa, 140-0001, Japan
| | - Noriyuki Okuyama
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa Tokyo, Minatoku, 108-0074, Japan
- HOPE (Human Ovarian-Tissue Preservation Enterprise), 4F 1-8-12 Shinagawa-Ku, Kitashinagawa, 140-0001, Japan
| | - Kyota Ashikawa
- Varinos Inc, DiverCity Tokyo Office Tower 21F, 1-1-20 Aomi, Koutou-Ku, Tokyo, Japan
| | - Yoshiyuki Sakuraba
- Varinos Inc, DiverCity Tokyo Office Tower 21F, 1-1-20 Aomi, Koutou-Ku, Tokyo, Japan
| | - Hideki Igarashi
- Kyono ART Clinic Sendai, 1-1-1 3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - Koichi Kyono
- Kyono ART Clinic Sendai, 1-1-1 3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan.
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa Tokyo, Minatoku, 108-0074, Japan.
- Kyono ART Clinic Morioka, 3F, 15-5, Moriokaekimaedori, Morioka-Shi, Iwate, 020-0034, Japan.
- HOPE (Human Ovarian-Tissue Preservation Enterprise), 4F 1-8-12 Shinagawa-Ku, Kitashinagawa, 140-0001, Japan.
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Wang L, Qiu P, Jiang L, Li P, Jiang Y. Competent blastocyst and receptivity endometrium improved clinical pregnancy in fresh embryo transfer cycles: a retrospective cohort study. BMC Pregnancy Childbirth 2024; 24:258. [PMID: 38605294 PMCID: PMC11007979 DOI: 10.1186/s12884-024-06399-x] [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: 10/12/2023] [Accepted: 03/08/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Embryo quality is usually regarded as a key predictor of successful implantation and clinical pregnancy potential. The identification of embryos that have the capacity to implant and result in a healthy pregnancy is a crucial part of in vitro fertilization (IVF). Usually, morphologically high-quality embryos are chosen for embryo transfer in IVF treatment. The aim of this study was to assess the association between the available blastocyst formation rate and the clinical pregnancy outcome following the first fresh embryo transfer cycle and provide systematic individual treatment to adjust endometrial receptivity for the next transfer cycle. METHODS This retrospective, single-center study included 512 fresh embryo transfers conducted between 11/2019 and 08/2021, which consisted of 385 cleavage-stage (Day 3) and 127 blastocyst-stage (Day 5) embryo transfers. The two groups were divided into a clinical pregnancy group and a nonclinical pregnancy group for comparison. The association between the available blastocyst formation rate and the clinical pregnancy rate in the Day 3 and Day 5 transfer groups were considered. RESULTS In the Day 3 group, there were 275 clinical pregnancies, and the clinical pregnancy rate was 71.43%. Although the two pronuclei (2PN) oocyte rate and available embryo rate at Day 3 were significantly higher in the clinical pregnancy group than the nonclinical pregnancy group (P < 0.05), the blastocyst formation rate and the available blastocyst formation rate were not significantly different between the clinical pregnancy group and the nonclinical pregnancy group (P > 0.05). In the Day 5 group, there were 81 clinical pregnancies, and the clinical pregnancy rate was 63.78%. No baseline characteristics showed any obvious differences between the clinical pregnancy group and nonclinical pregnancy group (P > 0.05). The blastocyst formation rate in the nonclinical pregnancy group was higher than that in the clinical pregnancy group, but the difference was not statistically significant (81.06% vs. 77.03%, P = 0.083). Interestingly, the available blastocyst formation rate and the Day 5 available blastocyst formation rate were significantly higher in the nonclinical pregnancy group than the clinical pregnancy group (66.19% vs. 60.79%, P = 0.014; 54.58% vs. 46.98%, P = 0.007). CONCLUSIONS In fresh cycles, the available blastocyst formation rate was not associated with the clinical pregnancy outcome for Day 3 embryo transfers, and the available blastocyst formation rate was not positively correlated with the clinical pregnancy outcome for Day 5 embryo transfers.
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Affiliation(s)
- Longmei Wang
- Xiamen Key Laboratory of Reproduction and Genetics, Department of Reproductive Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China
| | - Pingping Qiu
- Xiamen Key Laboratory of Reproduction and Genetics, Department of Reproductive Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China
| | - Lizhi Jiang
- Xiamen Key Laboratory of Reproduction and Genetics, Department of Reproductive Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China
| | - Ping Li
- Xiamen Key Laboratory of Reproduction and Genetics, Department of Reproductive Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China.
| | - Yufei Jiang
- Xiamen Key Laboratory of Reproduction and Genetics, Department of Reproductive Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China.
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Liu Y, Peng X, Liu C, Zhang S, Weng Z, Yu L, Zhou S, Huang X. Live birth derived from a markedly large polar body oocyte: a rare case report. ZYGOTE 2024; 32:170-174. [PMID: 38619002 DOI: 10.1017/s0967199424000054] [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] [Indexed: 04/16/2024]
Abstract
Oocytes with excessively large first polar bodies (PB1) often occur in assisted reproductive procedures. Many times these oocytes are discarded without insemination and, as a result, the application of this portion of oocytes has scarcely been reported to date. Few studies have examined large PB1 oocytes in infertile women and have virtually entirely studied genetic variations for large PB1 oocyte abnormalities. Here, we describe an unusual case of a live birth from a remarkably large PB1 oocyte in a frozen embryo transfer (FET) cycle. This is the first instance of a successful live birth resulting from a PB1 oocyte with an extremely large polar body measuring 80 μM × 40 μM in size. The large PB1 oocyte was performed by an early rescue intracytoplasmic sperm injection (r-ICSI) and was formed into a blastocyst on day 5. Following FET, a healthy boy baby weighing 3100 g was finally delivered by caesarean section at 37 weeks and 5 days after conception. Additionally, there were no complications throughout the antenatal period or the perinatal phase of this following full-term delivery. In this study, it is revealed for the first time that a huge PB1 oocyte can be fertilized, resulting in the growth of a blastocyst, a subsequent pregnancy, and a live birth. This new information prompts us to reconsider the use of large PB1 oocytes. More insightful talks should be given attention to prevent the waste of embryos because not all oocytes with aberrant morphology are unavailable.
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Affiliation(s)
- Yongxiang Liu
- Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
| | - Xinliang Peng
- Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
| | - Caifeng Liu
- Health Center of Chini Town, Huadu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Shuting Zhang
- Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
| | - Zhiwei Weng
- Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
| | - Li Yu
- Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
| | - Shaohu Zhou
- Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
| | - Xuekun Huang
- Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
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Parriego M, Coll L, Carrasco B, Garcia S, Boada M, Polyzos NP, Vidal F, Veiga A. Blastocysts from partial compaction morulae are not defined by their early mistakes. Reprod Biomed Online 2024; 48:103729. [PMID: 38367593 DOI: 10.1016/j.rbmo.2023.103729] [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: 07/10/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 02/19/2024]
Abstract
RESEARCH QUESTION Is partial compaction during morula formation associated with an embryo's developmental ability and implantation potential? DESIGN Retrospective analysis of data from 196 preimplantation genetic testing for aneuploidy (PGT-A) cycles. Embryos starting compaction were grouped according to the inclusion or not of all the blastomeres in the forming morula (full compaction or partial compaction). The possible effect of maternal age and ovarian response on compaction was analysed. Morphokinetic characteristics, blastocyst formation rate, morphology and cytogenetic constitution of the obtained blastocysts were compared. Comparisons of reproductive outcomes after the transfer of euploid blastocysts from both groups were established. Finally, in a subset of embryos, the chromosomal constitution concordance of the abandoned cells and the corresponding blastocyst through trophectoderm biopsies was assessed. RESULTS A total of 430 embryos failed to include at least one cell during compaction (partial compaction group [49.3%]), whereas the 442 remaining embryos formed a fully compacted morula (full compaction group [50.7%]). Neither female age nor the number of oocytes collected affected the prevalence of partial compaction morulae. Morphokinetic parameters were altered in embryos from partial compaction morulae compared with full compaction. Although an impairment in blastocyst formation rate was observed in partial compaction morulae (57.2% versus 70.8%, P < 0.001), both chromosomal constitution (euploidy rate: partial compaction [38.4%] versus full compaction [34.2%]) and reproductive outcomes (live birth rate: partial compaction [51.9%] versus full compaction [46.2%]) of the obtained blastocysts were equivalent between groups. A high ploidy correlation of excluded cells-trophectoderm duos was observed. CONCLUSIONS Partial compaction morulae show a reduced developmental ability compared with full compaction morulae. Resulting blastocysts from both groups, however, have similar euploidy rates and reproductive outcomes. Cell exclusion might be a consequence of a compromised embryo development regardless of the chromosomal constitution of the excluded cells.
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Affiliation(s)
- Monica Parriego
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction. Dexeus Mujer. Dexeus University Hospital. Gran Via Carles III, 71-75. 08028 Barcelona, Spain.
| | - Lluc Coll
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction. Dexeus Mujer. Dexeus University Hospital. Gran Via Carles III, 71-75. 08028 Barcelona, Spain
| | - Beatriz Carrasco
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction. Dexeus Mujer. Dexeus University Hospital. Gran Via Carles III, 71-75. 08028 Barcelona, Spain
| | - Sandra Garcia
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction. Dexeus Mujer. Dexeus University Hospital. Gran Via Carles III, 71-75. 08028 Barcelona, Spain
| | - Montserrat Boada
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction. Dexeus Mujer. Dexeus University Hospital. Gran Via Carles III, 71-75. 08028 Barcelona, Spain
| | - Nikolaos P Polyzos
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproduction. Dexeus Mujer. Dexeus University Hospital. Gran Via Carles III, 71-75. 08028 Barcelona, Spain
| | - Francesca Vidal
- Unitat de Biologia Cel·lular, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, 08908 L'Hospitalet de Llobregat, Spain
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Cimadomo D, Innocenti F, Taggi M, Saturno G, Campitiello MR, Guido M, Vaiarelli A, Ubaldi FM, Rienzi L. How should the best human embryo in vitro be? Current and future challenges for embryo selection. Minerva Obstet Gynecol 2024; 76:159-173. [PMID: 37326354 DOI: 10.23736/s2724-606x.23.05296-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
In-vitro fertilization (IVF) aims at overcoming the causes of infertility and lead to a healthy live birth. To maximize IVF efficiency, it is critical to identify and transfer the most competent embryo within a cohort produced by a couple during a cycle. Conventional static embryo morphological assessment involves sequential observations under a light microscope at specific timepoints. The introduction of time-lapse technology enhanced morphological evaluation via the continuous monitoring of embryo preimplantation in vitro development, thereby unveiling features otherwise undetectable via multiple static assessments. Although an association exists, blastocyst morphology poorly predicts chromosomal competence. In fact, the only reliable approach currently available to diagnose the embryonic karyotype is trophectoderm biopsy and comprehensive chromosome testing to assess non-mosaic aneuploidies, namely preimplantation genetic testing for aneuploidies (PGT-A). Lately, the focus is shifting towards the fine-tuning of non-invasive technologies, such as "omic" analyses of waste products of IVF (e.g., spent culture media) and/or artificial intelligence-powered morphologic/morphodynamic evaluations. This review summarizes the main tools currently available to assess (or predict) embryo developmental, chromosomal, and reproductive competence, their strengths, the limitations, and the most probable future challenges.
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Affiliation(s)
- Danilo Cimadomo
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy -
| | - Federica Innocenti
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Marilena Taggi
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
- Lazzaro Spallanzani Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Gaia Saturno
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
- Lazzaro Spallanzani Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Maria R Campitiello
- Department of Obstetrics and Gynecology and Physiopathology of Human Reproduction, ASL Salerno, Salerno, Italy
| | - Maurizio Guido
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Vaiarelli
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Filippo M Ubaldi
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Laura Rienzi
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
- Department of Biomolecular Sciences, Carlo Bo University of Urbino, Urbino, Italy
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Rubod C, de Prémare C, Kerbage Y, Kyheng M, Plouvier P, Chossegros C, Robin G. Does surgery for colorectal endometriosis prior to IVF±ICSI have an impact on cumulative live birth rates? Reprod Biomed Online 2024; 48:103649. [PMID: 38335899 DOI: 10.1016/j.rbmo.2023.103649] [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: 07/02/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 02/12/2024]
Abstract
RESEARCH QUESTION Does colorectal endometriosis surgery prior to IVF ± intracytoplasmic sperm injection (ICSI) impact cumulative live birth rates? DESIGN This retrospective, monocentric study (Lille University Hospital) was conducted between 1 January 2007 and 31 December 2018. Two groups of patients from the JFIV database were included: a group undergoing IVF±ICSI alone (120 patients, 215 oocyte retrievals), and a group undergoing surgery and then IVF±ICSI (69 patients, 109 oocyte retrievals). The mode of management was decided after a multidisciplinary team meeting. Different criteria such as age (cut-off 35 years), anti-Müllerian hormone concentration (cut off 2 ng/ml), imaging results and the patient's symptomatology were considered: the most symptomatic patients underwent surgery prior to IVF±ICSI. The cumulative clinical pregnancy and live birth rates obtained after four IVF attempts were estimated and compared between the two groups using competing risk survival methods. RESULTS The cumulative live birth rates after four IVF attempts in the two groups were not statistically significantly different (50.8% in the IVF±ICSI group versus 52.2% in the surgery followed by IVF±ICSI group, P = 0.43). The results for the cumulative clinical pregnancy rates were the same (56.7% in the IVF±ICSI group versus 58% in the surgery followed by IVF±ICSI group, P = 0.47). CONCLUSION The study shows that cumulative live birth and pregnancy rates were similar in infertile patients with colorectal endometriosis who underwent IVF±ICSI either with or without prior colorectal endometriosis surgery.
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Affiliation(s)
- Chrystèle Rubod
- Service de chirurgie gynécologique, CHU Lille, Lille, France.; Univ. Lille, CHU Lille, Lille, France
| | | | - Yohan Kerbage
- Service de chirurgie gynécologique, CHU Lille, Lille, France
| | - Maeva Kyheng
- Service de Biostatistiques, CHU Lille, Lille, France
| | - Pauline Plouvier
- Service d'Assistance Médicale à la Procréation et Préservation de la Fertilité, CHU Lille, Lille, France
| | | | - Geoffroy Robin
- Univ. Lille, CHU Lille, Lille, France.; Service d'Assistance Médicale à la Procréation et Préservation de la Fertilité, CHU Lille, Lille, France
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Duc Thang L, Bao Long H, Thi Thu Trang D, Ngoc Quy P, Thi Mai Phuong G, Thi Hanh B, Trong Thach T, Thi Lien Huong N, Hoang L, Hugues JN. Non-inferiority of progestin-primed ovarian stimulation versus GnRH antagonist protocol: A propensity score-weighted analysis. J Formos Med Assoc 2024; 123:523-529. [PMID: 38092654 DOI: 10.1016/j.jfma.2023.12.008] [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: 10/05/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 04/13/2024] Open
Abstract
PURPOSE To evaluate the effectiveness of the progestin-primed ovarian stimulation (PPOS) protocol versus the gonadotropin-releasing hormone antagonist (GnRH-ant) protocol in ovarian stimulation. METHODS In this retrospective cohort study, we included 804 patients who were treated between January 1st, 2022, and July 1st, 2023. Outcomes of ovarian stimulation were compared between the PPOS (n = 206) and GnRH-ant (n = 598). The primary outcome was the number of good cleavage embryos. RESULTS Baseline characteristics were comparable in both groups. In both unadjusted and adjusted analysis, the mean number of good cleavage embryos in PPOS (6.33) was non-inferior to GnRH-ant (6.44; unadjusted ratio of two means 1.02, 95%CI 0.92, 1.13). The trigger-day estradiol level in patients with PPOS was higher than in patients with GnRH-ant (4,420 vs 3,830 pg/ml, respectively) despite similar total follicle stimulating hormone dose and fewer days of ovarian stimulation. The number of oocytes, MII oocytes, cleavage and blastocyst embryos were comparable between the two protocols. After the first transfer of embryos, the clinical pregnancy rate and implantation rate were higher in the PPOS group, while the pregnancy rate and ongoing pregnancy were not significantly different. None of the PPOS patients had an unexpected LH surge, and serum LH levels decreased slightly during ovarian stimulation. CONCLUSIONS The PPOS protocol with dydrogesterone provided similar embryo outcomes to the GnRH-ant protocol, with notable distinctions in clinical pregnancy and implantation rate. The serum LH concentration during ovarian stimulation using PPOS was well-controlled.
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Affiliation(s)
| | - Hoang Bao Long
- Institute of Gastroenterology and Hepatology, Hanoi, Viet Nam
| | | | | | | | | | - Than Trong Thach
- Department of Obstetrics and Gynaecology, Ho Chi Minh City Medicine and Pharmacy University, Ho Chi Minh City, Viet Nam
| | | | - Le Hoang
- Tam Anh General Hospital, Hanoi, Viet Nam
| | - Jean-Noël Hugues
- Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, UFR SMBH, Bobigny, France
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Shi H, Ge Q, Pan M, Sheng Y, Qi T, Zhou Y, Sun Y, Bai Y, Cai L. Agarose amplification based sequencing characterization cell-free RNA in preimplantation spent embryo medium. Anal Chim Acta 2024; 1296:342331. [PMID: 38401939 DOI: 10.1016/j.aca.2024.342331] [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: 09/15/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND The cell-free RNA (cf-RNA) of spent embryo medium (SEM) has aroused a concern of academic and clinical researchers for its potential use in non-invasive embryo screening. However, comprehensive characterization of cf-RNA from SEM still presents significant technical challenges, primarily due to the limited volume of SEM. Hence, there is urgently need to a small input liquid volume and ultralow amount of cf-RNA library preparation method to unbiased cf-RNA sequencing from SEM. (75) RESULT: Here, we report a high sensitivity agarose amplification-based cf-RNA sequencing method (SEM-Acf) for human preimplantation SEM cf-RNA analysis. It is a cf-RNA sequencing library preparation method by adding agarose amplification. The agarose amplification sensitivity (0.005 pg) and efficiency (105.35 %) were increased than that of without agarose addition (0.45 pg and 96.06 %) by ∼ 90 fold and 9.29 %, respectively. Compared with SMART sequencing (SMART-seq), the correlation of gene expression was stronger in different SEM samples by using SEM-Acf. The cf-RNA number of detected and coverage uniformity of 3' end were significantly increased. The proportion of 5' end adenine, alternative splicing events and short fragments (<400 bp) were increased. It is also found that 4-mer end motifs of cf-RNA fragments was significantly differences between different embryonic stage by day3 spent cleavage medium and day5/6 spent blastocyst medium. (141) SIGNIFICANCE: This study established an efficient SEM amplification and library preparation method. Additionally, we successfully described the characterizations of SEM cf-RNA in preimplantation embryo using SEM-Acf, including expression features and fragment lengths. SEM-Acf facilitates the exploration of cf-RNA as a noninvasive embryo screening biomarker, and opens up potential clinical utilities of small input liquid volume and ultralow amount cf-RNA sequencing. (59).
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Affiliation(s)
- Huajuan Shi
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Qinyu Ge
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Min Pan
- School of Medicine, Southeast University, Nanjing, 210097, China
| | - Yuqi Sheng
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Ting Qi
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Ying Zhou
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Yuqing Sun
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Yunfei Bai
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Lingbo Cai
- Clinical Center of Reproductive Medicine, State Key Laboratory of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
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Vishwakarma N, Pareek C, Nair N, Badge A, Bawaskar PA, Kalbande A. SERa-Positive Oocyte Intracytoplasmic Injection and Its Outcome: A Case Report. Cureus 2024; 16:e58836. [PMID: 38784363 PMCID: PMC11112545 DOI: 10.7759/cureus.58836] [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] [Received: 03/01/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
This case report describes the use of smooth endoplasmic reticulum aggregates-positive (SERa+) oocytes along with intracytoplasmic sperm injection (ICSI), supplemented with granulocyte-macrophage colony-stimulating factor (GM-CSF), aiming to enhance fertilization rates and reproductive outcomes. A 39-year-old woman, facing primary infertility for the past seven years, received assisted reproductive treatment (ART), which included adding GM-CSF to the culture medium and culture SERa+ oocytes before ICSI. Clinical results, embryo quality, fertilization rates, and other fertility parameters were used to track the patient's progress toward this individualized approach that led to a positive twin pregnancy and healthy twin babies.
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Affiliation(s)
- Neeraj Vishwakarma
- Clinical Embryology, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
| | - Charu Pareek
- Clinical Embryology, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
| | - Nancy Nair
- Clinical Embryology, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
| | - Ankit Badge
- Microbiology, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
| | - Pranita A Bawaskar
- Clinical Embryology, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
| | - Avanti Kalbande
- Obstetrics and Gynaecology, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
- Obstetrics and Gynaecology, Shalinitai Meghe Hospital & Research Centre, Nagpur, IND
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Wang L, Liu HR, Wang T, Feng ML, Jiang ZY, Yang Q, Sun D, Song CR, Zhang XJ, Liang CG. C-phycocyanin improves the developmental potential of cryopreserved human oocytes by minimizing ROS production and cell apoptosis. PLoS One 2024; 19:e0300538. [PMID: 38558076 PMCID: PMC10984518 DOI: 10.1371/journal.pone.0300538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE The cryopreservation process damages oocytes and impairs development potential. As a potent antioxidant, C-phycocyanin (PC) regulates reproductive performance. However, its beneficial effects on vitrified human oocytes remain unknown. METHODS In this study, human GV-stage oocytes obtained from controlled ovarian hyperstimulation (COH) cycles were randomly allocated to three groups: fresh oocyte without freezing (F group), vitrification in medium supplemented with PC (P group), and vitrification in medium without PC as control group (C group). After warming, viable oocytes underwent in vitro maturation. RESULTS Our results showed that 3 μg/mL PC treatment increased the oocyte maturation rate after cryopreservation. We also found that PC treatment maintains the regular morphological features of oocytes. After PC treatment, confocal fluorescence staining showed a significant increase in the mitochondrial membrane potential of the vitrified oocytes, along with a notable decrease in intracellular reactive oxygen species and the early apoptosis rate. Finally, after in vitro maturation and parthenogenetic activation, vitrified oocytes had a higher potential for cleavage and blastocyst formation after PC treatment. CONCLUSION Our results suggest that PC improves the developmental potential of cryopreserved human GV-stage oocytes by attenuating oxidative stress and early apoptosis and increasing the mitochondrial membrane potential.
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Affiliation(s)
- Lu Wang
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, Inner Mongolia Baogang Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Hao-Ran Liu
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
| | - Teng Wang
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
| | - Meng-Lei Feng
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
| | - Zhao-Yu Jiang
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
| | - Qi Yang
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
| | - Dui Sun
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
| | - Chun-Ru Song
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
| | - Xiu-Juan Zhang
- Inner Mongolia Academy of Science and Technology, Hohhot, Inner Mongolia, People’s Republic of China
| | - Cheng-Guang Liang
- State Key Laboratory of Reproductive Regulation & Breeding of Grassland Livestock, Institutes of Biomedical Sciences, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, People’s Republic of China
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Du S, Shen C, Zhang J. A comparative analysis of the clinical pregnancy and perinatal outcomes between oocyte vitrification and embryo vitrification based on the propensity score matching method. J Assist Reprod Genet 2024; 41:875-883. [PMID: 38366240 PMCID: PMC11052731 DOI: 10.1007/s10815-024-03055-3] [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: 08/21/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
PURPOSE This study investigated the safety and effectiveness of oocyte vitrification by comparing the clinical pregnancy and perinatal outcomes between transfer cycles of vitrified oocytes and those of vitrified embryos. METHODS A retrospective cohort study was conducted to analyze the clinical data of patients who underwent cleavage-stage embryo transfer at the Department of Reproductive Medicine between January 2011 and June 2021. Seventy-seven transfer cycles of fresh cleavage-stage embryos developed from vitrified-thawed oocytes (oocyte vitrification group) and 2170 transfer cycles of vitrified-thawed cleavage-stage embryos developed from fresh oocytes (embryo vitrification group) were included. Further, 293 cases were selected from the embryo vitrification group after applying propensity score matching at 1:4. The primary outcomes were miscarriage rate, live birth rate, and neonatal birth weight. RESULTS No statistically significant differences were observed in the baseline data, pregnancy, perinatal outcomes, or neonatal outcomes for either singleton or twin births between the two groups after matching. Backwards stepwise regression was used to analyze the length of gestation. The age of female participants (β = - 0.410, 95% CI = - 1.339 ~ - 0.620, P < 0.001) had a statistically significant effect. CONCLUSION Oocyte vitrification results in similar clinical pregnancy and perinatal outcomes as does embryo vitrification; hence, it is a relatively safe assisted reproductive technique.
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Affiliation(s)
- Shanshan Du
- The Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Chunyan Shen
- The Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianrui Zhang
- The Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Ouyang Y, Peng Y, Mao Y, Zheng M, Gong F, Li Y, Li X. An endometrial receptivity scoring system evaluated by ultrasonography in patients undergoing frozen-thawed embryo transfer: a prospective cohort study. Front Med (Lausanne) 2024; 11:1354363. [PMID: 38576706 PMCID: PMC10991689 DOI: 10.3389/fmed.2024.1354363] [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] [Received: 12/12/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Ultrasound has become a routine method for endometrial receptivity (ER) evaluation. However, there is controversy over the independent evaluation values of various ultrasound indicators. Some researchers have designed multi-indicator prediction systems, but their prediction values are uneven. To further our understanding of ER, we conducted this prospective cohort study to estimate ER noninvasively and effectively. Methods Women who underwent the first frozen-thawed embryo transfer (FET) cycle from April 2019 to July 2021 were included in the study. On the day of transfer, transvaginal three-dimensional ultrasound examination was performed to evaluate ER, including endometrial thickness, morphology, volume, movement, blood flow and flow index. The clinical pregnancy rate was the primary outcome. Based on whether clinical pregnancy was achieved, enrolled patients were divided into pregnant and nonpregnant groups. Results This study analyzed 197 FET patients (139 pregnancies in total, 70.5%). The protective factors for clinical pregnancy included primary infertility [adjusted odds ratio (aOR), 1.98; 95% confidence interval (CI), 1.01-3.882; p = 0.047] and more frequent endometrial peristalsis (aOR, 1.33; 95% CI, 1.028-1.722; p = 0.03). Scores of 1-2 were assigned according to the relationship between different ultrasound indicators and the clinical pregnancy rate (CPR). The ER score of the patient was the sum of the scores of the 6 items. The ER score of the pregnant group was significantly higher than that of the nonpregnant group (7.40 ± 1.73 vs. 6.33 ± 1.99, p = 0.001). The CPR increased with an increasing ER score. The CPR in the ER < 6 group was significantly lower than that in the ER >6 group (45.5% vs. 75.6%, p = 0.001). Conclusion A noninvasive ultrasound scoring system for ER was proposed. This system may provide a non-invasive guidance perspective, in conjunction with invasive assessments currently used in clinical practice, to achieve more effective embryo transfer.
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Affiliation(s)
- Yan Ouyang
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Centre for Reproduction and Genetics in Hunan Province, Changsha, China
| | - Yangqin Peng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Centre for Reproduction and Genetics in Hunan Province, Changsha, China
| | - Yuyao Mao
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Centre for Reproduction and Genetics in Hunan Province, Changsha, China
| | - Mingxiang Zheng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- School of Medicine, Hunan Normal University, Changsha, China
| | - Fei Gong
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Centre for Reproduction and Genetics in Hunan Province, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, China
| | - Yuan Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Centre for Reproduction and Genetics in Hunan Province, Changsha, China
| | - Xihong Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Centre for Reproduction and Genetics in Hunan Province, Changsha, China
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Canosa S, Licheri N, Bergandi L, Gennarelli G, Paschero C, Beccuti M, Cimadomo D, Coticchio G, Rienzi L, Benedetto C, Cordero F, Revelli A. A novel machine-learning framework based on early embryo morphokinetics identifies a feature signature associated with blastocyst development. J Ovarian Res 2024; 17:63. [PMID: 38491534 PMCID: PMC10941455 DOI: 10.1186/s13048-024-01376-6] [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: 08/25/2023] [Accepted: 02/16/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Artificial Intelligence entails the application of computer algorithms to the huge and heterogeneous amount of morphodynamic data produced by Time-Lapse Technology. In this context, Machine Learning (ML) methods were developed in order to assist embryologists with automatized and objective predictive models able to standardize human embryo assessment. In this study, we aimed at developing a novel ML-based strategy to identify relevant patterns associated with the prediction of blastocyst development stage on day 5. METHODS We retrospectively analysed the morphokinetics of 575 embryos obtained from 80 women who underwent IVF at our Unit. Embryo morphokinetics was registered using the Geri plus® time-lapse system. Overall, 30 clinical, morphological and morphokinetic variables related to women and embryos were recorded and combined. Some embryos reached the expanded blastocyst stage on day 5 (BL Group, n = 210), some others did not (nBL Group, n = 365). RESULTS The novel EmbryoMLSelection framework was developed following four-steps: Feature Selection, Rules Extraction, Rules Selection and Rules Evaluation. Six rules composed by a combination of 8 variables were finally selected, and provided a predictive power described by an AUC of 0.84 and an accuracy of 81%. CONCLUSIONS We provided herein a new feature-signature able to identify with an high performance embryos with the best developmental competence to reach the expanded blastocyst stage on day 5. Clear and clinically relevant cut-offs were identified for each considered variable, providing an objective tool for early embryo developmental assessment.
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Affiliation(s)
- S Canosa
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Turin, Turin, Italy.
- IVIRMA Global Research Alliance, Livet, Turin, Italy.
| | - N Licheri
- Department of Computer Science, University di Turin, Turin, Italy
| | - L Bergandi
- Department of Oncology, University of Turin, Turin, Italy
| | - G Gennarelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Turin, Turin, Italy
- IVIRMA Global Research Alliance, Livet, Turin, Italy
| | - C Paschero
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Turin, Turin, Italy
| | - M Beccuti
- Department of Computer Science, University di Turin, Turin, Italy
| | - D Cimadomo
- IVIRMA Global Research Alliance, Genera, Clinica Valle Giulia, Rome, Italy
| | - G Coticchio
- IVIRMA Global Research Alliance, 9.Baby, Bologna, Italy
| | - L Rienzi
- IVIRMA Global Research Alliance, Genera, Clinica Valle Giulia, Rome, Italy
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - C Benedetto
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Turin, Turin, Italy
| | - F Cordero
- Department of Computer Science, University di Turin, Turin, Italy
| | - A Revelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Turin, Turin, Italy
- Gynecology and Obstetrics 2U, Department of Surgical Sciences, S. Anna Hospital, University of Turin, Turin, Italy
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Zhu M, Dong Q, Zhu Y, Le Y, Wang T, Zhou Y, Yang S. Developmental potential of non- and mono-pronuclear zygotes and associated clinical outcomes in IVF cycles. Front Endocrinol (Lausanne) 2024; 15:1361734. [PMID: 38532894 PMCID: PMC10964251 DOI: 10.3389/fendo.2024.1361734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
Purpose This study aims to evaluate the developmental potential of 0PN, 1PN, and 2PN zygotes in IVF cycles and compare their clinical outcomes. Methods We conducted a retrospective cohort study involving IVF patients. Blastocyst formation rates were assessed with 0PN, 1PN, and 2PN zygotes. Subsequently, we collected clinical outcome data following the transfer of these zygotes. Results The overall blastulation rate was similar between 0PN (29.6%) and 2PN (32.1%) zygotes, but 1PN zygotes exhibited a significantly lower blastulation rate (17.0%) compared to both 0PN and 2PN zygotes. Similarly, the overall rate of good-quality blastulation was comparable between 0PN (15.3%) and 2PN (17.5%) zygotes, while 1PN zygotes showed a significantly lower rate (7.0%) compared to both 0PN and 2PN. Clinical pregnancy, ectopic pregnancy, implantation, and live birth rates were similar among single blastocyst frozen embryo transfers (FET) of 0PN, 1PN, and 2PN. Additionally, no significant differences were observed between single- and double-blastocyst FET of 0PN and 2PN. Conclusions Our findings suggest that 0PN and 2PN zygotes have comparable developmental potential, while 1PN embryos exhibit lower developmental potential. Blastocyst FET outcomes appear similar among 0PN, 1PN, and 2PN zygotes.
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Affiliation(s)
| | | | | | | | | | | | - Sheng Yang
- Department of Assisted Reproduction, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang, China
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Wang Y, Li R, Yang R, Zheng D, Zeng L, Lian Y, Zhu Y, Zhao J, Liang X, Li W, Liu J, Tang L, Cao Y, Hao G, Wang H, Zhang H, Wang R, Mol BW, Huang H, Qiao J. Intracytoplasmic sperm injection versus conventional in-vitro fertilisation for couples with infertility with non-severe male factor: a multicentre, open-label, randomised controlled trial. Lancet 2024; 403:924-934. [PMID: 38330980 DOI: 10.1016/s0140-6736(23)02416-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Introduced in 1992, intracytoplasmic sperm injection (ICSI) was initially indicated for severe male infertility; however, its use has since been expanded to non-severe male infertility. We aimed to compare the efficacy and safety of ICSI versus conventional in-vitro fertilisation (IVF) in couples with infertility with non-severe male factor. METHODS We conducted an investigator-initiated, multicentre, open-label, randomised controlled trial in ten reproductive medicine centres across China. Couples with infertility with non-severe male factor without a history of poor fertilisation were randomly assigned (1:1) to undergo either ICSI or conventional IVF. The primary outcome was live birth after first embryo transfer. We performed the primary analysis in the intention-to-treat population using log-binomial regression models for categorical outcomes or linear regression models for continuous outcomes, adjusting for centre. This trial is registered with Clinicaltrials.gov, NCT03298633, and is completed. FINDINGS Between April 4, 2018, and Nov 15, 2021, 3879 couples were screened, of whom 2387 (61·5%) couples were randomly assigned (1184 [49·6%] to the ICSI group and 1203 [50·4%] to the conventional IVF group). After excluding couples who were ineligible, randomised twice, or withdrew consent, 1154 (97·5%) in the ICSI group and 1175 (97·7%) in the conventional IVF group were included in the primary analysis. Live birth after first embryo transfer occurred in 390 (33·8%) couples in the ICSI group and in 430 (36·6%) couples in the conventional IVF group (adjusted risk ratio [RR] 0·92 [95% CI 0·83-1·03]; p=0·16). Two (0·2%) neonatal deaths were reported in the ICSI group and one (0·1%) in the conventional IVF group. INTERPRETATION In couples with infertility with non-severe male factor, ICSI did not improve live birth rate compared with conventional IVF. Given that ICSI is an invasive procedure associated with additional costs and potential increased risks to offspring health, routine use is not recommended in this population. FUNDING National Natural Science Foundation of China, National Key Research and Development Program, Beijing Municipal Science & Technology Commission, and Peking University Third Hospital.
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Affiliation(s)
- Yuanyuan Wang
- National Clinical Research Centre for Obstetrical and Gynaecological Diseases, State Key Laboratory of Female Fertility Promotion, Ministry of Education Key Laboratory of Assisted Reproduction, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Rong Li
- National Clinical Research Centre for Obstetrical and Gynaecological Diseases, State Key Laboratory of Female Fertility Promotion, Ministry of Education Key Laboratory of Assisted Reproduction, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Rui Yang
- National Clinical Research Centre for Obstetrical and Gynaecological Diseases, State Key Laboratory of Female Fertility Promotion, Ministry of Education Key Laboratory of Assisted Reproduction, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Danni Zheng
- National Clinical Research Centre for Obstetrical and Gynaecological Diseases, State Key Laboratory of Female Fertility Promotion, Ministry of Education Key Laboratory of Assisted Reproduction, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Research Centre for Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Ying Lian
- National Clinical Research Centre for Obstetrical and Gynaecological Diseases, State Key Laboratory of Female Fertility Promotion, Ministry of Education Key Laboratory of Assisted Reproduction, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Yimin Zhu
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Junli Zhao
- General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xiaoyan Liang
- The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wen Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianqiao Liu
- The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Li Tang
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yunxia Cao
- First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guimin Hao
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huichun Wang
- Haidian Maternal and Child Health Hospital, Beijing, China
| | - Hua Zhang
- Research Centre for Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Rui Wang
- Department of Obstetrics and Gynaecology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Hefeng Huang
- Obstetrics and Gynaecology Hospital, Ministry of Education Key Laboratory of Reproductive Genetics, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Jie Qiao
- National Clinical Research Centre for Obstetrical and Gynaecological Diseases, State Key Laboratory of Female Fertility Promotion, Ministry of Education Key Laboratory of Assisted Reproduction, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China.
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Huang W, Liu C, Ding L, Li Y, Zhou H, Wang S, Yang H. The effect of β-cell dysfunction on reproductive outcomes of PCOS undergoing IVF or ICSI embryo transfer cycles: a retrospective cohort study. Front Endocrinol (Lausanne) 2024; 15:1327041. [PMID: 38505754 PMCID: PMC10948421 DOI: 10.3389/fendo.2024.1327041] [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: 10/24/2023] [Accepted: 02/09/2024] [Indexed: 03/21/2024] Open
Abstract
Objective To investigate the effects of β-cell dysfunction on IVF outcomes in women with PCOS. Methods This retrospective cohort study includes 1,212 women with PCOS undergoing their first IVF cycle between September 2010 and December 2019. Beta-cell dysfunction was measured by homeostasis model assessment of β-cell function (HOMA-β) index. Results In quartiles of HOMA-β, the incidence of miscarriage dramatically increased from 10.2% (Q1) to 31.1% (Q4) (P for trend <0.001). Likewise, the incidence of miscarriage in quartiles of HOMA-β also showed a similar trend (P for trend <0.001). After adjusting for confounding factors, logistic regression analyses showed that high HOMA-IR values were independently associated with a high risk of miscarriage, with the odds ratios (OR) and 95% confidence intervals for quartiles 2-4 versus quartile 1 were 1.30 (0.69-2.46), 1.82 (0.97-3.43), and 3.57 (1.86-6.85), respectively (P for trend <0.001). When analyzed jointly, women in the highest HOMA-IR and highest HOMA-β group exhibited the highest risk for miscarriage compared with all other groups. Furthermore, higher HOMA-IR values were associated with higher risks of miscarriage among PCOS women regardless of HOMA-β values. Conclusions β-cell dysfunction is independently associated with increased miscarriage rate and decreased live birth rate in women with PCOS. It also plays a synergistic role with IR in terms of the reproductive outcomes, while the influence of IR overweighs that of β-cell dysfunction.
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Affiliation(s)
- Wenle Huang
- Department of Obstetrics and Gynecology, Wenzhou Central Hospital, Wenzhou, Zhejiang, China
| | - Chang Liu
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lin Ding
- Department of Endocrinology, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Yan Li
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haisu Zhou
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shuwei Wang
- Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haiyan Yang
- Reproductive Medicine Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Papamentzelopoulou MS, Prifti IN, Mavrogianni D, Tseva T, Soyhan N, Athanasiou A, Athanasiou A, Athanasiou A, Vogiatzi P, Konomos G, Loutradis D, Sakellariou M. Assessment of artificial intelligence model and manual morphokinetic annotation system as embryo grading methods for successful live birth prediction: a retrospective monocentric study. Reprod Biol Endocrinol 2024; 22:27. [PMID: 38443941 PMCID: PMC10913268 DOI: 10.1186/s12958-024-01198-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The introduction of the time-lapse monitoring system (TMS) and the development of predictive algorithms could contribute to the optimal embryos selection for transfer. Therefore, the present study aims at investigating the efficiency of KIDScore and iDAScore systems for blastocyst stage embryos in predicting live birth events. METHODS The present retrospective study was conducted in a private IVF Unit setting throughout a 10-month period from October 2021 to July 2022, and included the analysis of 429 embryos deriving from 91 IVF/ICSI cycles conducted due to infertility of various etiologies. Embryos incubated at the Embryoscope+ timelapse incubator were analyzed through the established scoring systems: KIDScore and iDAScore®. The main outcome measure was the comparison of the two scoring systems in terms of live birth prediction. Embryos with the higher scores at day 5 (KID5 score/iDA5 score) were transferred or cryopreserved for later use. RESULTS Embryos with high KID5 and iDA5 scores positively correlated with the probability of successful live birth, with KID5 score yielding a higher efficiency in predicting a successful reproductive outcome compared to a proportionally high iDA5 score. KID5 demonstrated conservative performance in successfully predicting live birth compared to iDA5 score, indicating that an efficient prediction can be either provided by a relatively lower KID5 score or a relatively higher iDA5 score. CONCLUSION The developed artificial intelligence tools should be implemented in clinical practice in conjunction with the conventional morphological assessment for the conduction of optimized embryo transfer in terms of a successful live birth.
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Affiliation(s)
- Myrto-Sotiria Papamentzelopoulou
- Molecular Biology Unit, Division of Human Reproduction, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, 80, Vasilissis Sofias Ave., Athens, 11528, Greece.
| | | | - Despoina Mavrogianni
- Molecular Biology Unit, Division of Human Reproduction, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, 80, Vasilissis Sofias Ave., Athens, 11528, Greece
| | - Thomais Tseva
- IVF Athens Reproduction Center V. Athanassiou, Maroussi, Greece
| | - Ntilay Soyhan
- IVF Athens Reproduction Center V. Athanassiou, Maroussi, Greece
| | - Aikaterini Athanasiou
- IVF Athens Reproduction Center V. Athanassiou, Maroussi, Greece
- HUG (Hôpitaux universitaires de Genève), Rue Gabrielle-Perret-Gentil 4, Genève 14, Genève, 1211, Switzerland
| | - Antonia Athanasiou
- IVF Athens Reproduction Center V. Athanassiou, Maroussi, Greece
- RHNe (Réseau hospitalier neuchâtelois), Chasseral 20, La Chaux-de-Fonds, 2303, Switzerland
| | - Adamantios Athanasiou
- IVF Athens Reproduction Center V. Athanassiou, Maroussi, Greece
- Department of Gynecology Oncology, Agios Savvas, General Anti-Cancer Hospital, Athens, Greece
| | - Paraskevi Vogiatzi
- IVF Athens Reproduction Center V. Athanassiou, Maroussi, Greece
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
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Giacomini E, Pagliardini L, Minetto S, Pinna M, Kleeman F, Bonesi F, Makieva S, Pavone V, Reschini M, Papaleo E, Candiani M, Somigliana E, Viganò P. The relationship between CYP19A1 gene expression in luteinized granulosa cells and follicular estradiol output in women with endometriosis. J Steroid Biochem Mol Biol 2024; 237:106439. [PMID: 38048918 DOI: 10.1016/j.jsbmb.2023.106439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023]
Abstract
Endometriosis was claimed to negatively affect the intrafollicular environment, hindering oocyte competence. Previous studies evaluated expression levels of cytochrome P450 aromatase (CYP19A) in granulosa and cumulus oophorus cells collected from endometriosis women, but results are controversial. To further investigate the intrafollicular environment whose alteration may potentially disturb ovarian steroidogenesis in endometriosis, gene expression of CYP19A and of its upstream enzymes, StAR and 3βHSD was assessed in luteinized granulosa cells isolated from follicular fluids (FF) collected during Assisted Reproduction Technology (ART) procedures in women with stage III-IV disease and from subjects without the condition. In a subgroup of patients, cumulus oophorus cells (COCs) were also assessed for CYP19A, StAR and 3βHSD gene expression. No difference in mRNA expression of CYP19A1, StAR and 3βHSD in both granulosa cells and COCs was observed between the two groups of patients. No significant difference was also found between estradiol FF levels detected in endometriosis patients (median=873, IQR=522-1221 ng/ml)) and control patients (median=878, IQR=609-1137 ng/ml). To gain more insight into the intrafollicular regulation of CYP19A in patients with endometriosis, associations between expression of the analyzed genes, systemic and follicular 17β-estradiol levels and ART outcomes were assessed. While in the control group, levels of CYP19A1, StAR and 3βHSD transcripts significantly correlated with follicular estradiol levels (adjusted R² of 0.60), no significant association was detected in affected women (adjusted R² of 0.23). After stratification of the populations based on the presence of the disease, CYP19A1 expression was shown to correlate with the number of oocytes retrieved [β:- 1.214;95%CI: - 2.085 - (-0.343); p = 0.007] in the control group while this association was not present in patients with endometriosis [β:- 0.003; 95%CI:- 0.468-0.461; p = 0.988)]. These results do not support data from the literature indicating a reduced aromatase expression in granulosa cells of affected women, but they highlight a potential subtle mechanism affecting the ovulation process in these women.
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Affiliation(s)
- Elisa Giacomini
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Pagliardini
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Sabrina Minetto
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Monica Pinna
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Fabiola Kleeman
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Bonesi
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sofia Makieva
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valentina Pavone
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Reschini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Enrico Papaleo
- Centro Scienze della Natalità, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Paola Viganò
- Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Liao Z, Yan C, Wang J, Zhang N, Yang H, Lin C, Zhang H, Wang W, Li W. A clinical consensus-compliant deep learning approach to quantitatively evaluate human in vitro fertilization early embryonic development with optical microscope images. Artif Intell Med 2024; 149:102773. [PMID: 38462274 DOI: 10.1016/j.artmed.2024.102773] [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: 08/22/2022] [Revised: 12/13/2023] [Accepted: 01/14/2024] [Indexed: 03/12/2024]
Abstract
The selection of embryos is a key for the success of in vitro fertilization (IVF). However, automatic quality assessment on human IVF embryos with optical microscope images is still challenging. In this study, we developed a clinical consensus-compliant deep learning approach, named Esava (Embryo Segmentation and Viability Assessment), to quantitatively evaluate the development of IVF embryos using optical microscope images. In total 551 optical microscope images of human IVF embryos of day-2 to day-3 were collected, preprocessed, and annotated. Using the Faster R-CNN model as baseline, our Esava model was constructed, refined, trained, and validated for precise and robust blastomere detection. A novel algorithm Crowd-NMS was proposed and employed in Esava to enhance the object detection and to precisely quantify the embryonic cells and their size uniformity. Additionally, an innovative GrabCut-based unsupervised module was integrated for the segmentation of blastomeres and embryos. Independently tested on 94 embryo images for blastomere detection, Esava obtained the high rates of 0.9940, 0.9121, and 0.9531 for precision, recall, and mAP respectively, and gained significant advances compared with previous computational methods. Intraclass correlation coefficients indicated the consistency between Esava and three experienced embryologists. Another test on 51 extra images demonstrated that Esava surpassed other tools significantly, achieving the highest average precision 0.9025. Moreover, it also accurately identified the borders of blastomeres with mIoU over 0.88 on the independent testing dataset. Esava is compliant with the Istanbul clinical consensus and compatible to senior embryologists. Taken together, Esava improves the accuracy and efficiency of embryonic development assessment with optical microscope images.
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Affiliation(s)
- Zaowen Liao
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chaoyu Yan
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jianbo Wang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Ningfeng Zhang
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huan Yang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Medical Big Data Center, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chenghao Lin
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Haiyue Zhang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Wenjun Wang
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Weizhong Li
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Center for Precision Medicine, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Tropical Disease Control (Ministry of Education), Sun Yat-Sen University, Guangzhou, China.
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