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Shah S, Lucke-Wold B. Image-Guided Mesenchymal Stem Cell Sodium Iodide Symporter (NIS) Radionuclide Therapy for Glioblastoma. Cancers (Basel) 2024; 16:2892. [PMID: 39199662 PMCID: PMC11352884 DOI: 10.3390/cancers16162892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/12/2024] [Accepted: 08/20/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Glioblastoma (GBM) is a highly aggressive, invasive, and growth factor-independent grade IV glioma. Survival following the diagnosis is generally poor, with a median survival of approximately 15 months, and it is considered the most aggressive and lethal central nervous system tumor. Conventional treatments based on surgery, chemotherapy, and radiation therapy only delay progression, and death is inevitable. Malignant glioma cells are resistant to traditional therapies, potentially due to a subpopulation of glioma stem cells that are invasive and capable of rapid regrowth. METHODS This is a literature review. The systematic retrieval of information was performed on PubMed, Embase, and Google Scholar. Specified keywords were used in PubMed and the articles retrieved were published in peer-reviewed scientific journals and were associated with brain GBM cancer and the sodium iodide symporter (NIS). Additionally, the words 'radionuclide therapy OR mesenchyma, OR radioiodine OR iodine-131 OR molecular imaging OR gene therapy OR translational imaging OR targeted OR theranostic OR symporter OR virus OR solid tumor OR combined therapy OR pituitary OR plasmid AND glioblastoma OR GBM OR GB OR glioma' were also used in the appropriate literature databases of PubMed and Google Scholar. A total of 68,244 articles were found in this search on Mesenchymal Stem Cell Sodium Iodide Symporter and GBM. These articles were found till 2024. To study recent advances, a filter was added to include articles only from 2014 to 2024, duplicates were removed, and articles not related to the title were excluded. These came out to be 78 articles. From these, nine were not retrieved and only seven were selected after the removal of keyword mismatched articles. Appropriate studies were isolated, and important information from each of them was understood and entered into a database from which the information was used in this article. RESULTS As a result of their natural capacity to identify malignancies, MSCs are employed as tumor therapy vehicles. Because MSCs may be transplanted using several methods, they have been proposed as the ideal vehicles for NIS gene transfer. MSCs have been used as a delivery vector for anticancer drugs in many tumor models due to their capacity to move precisely to malignancies. Also, by directly injecting radiolabeled MSCs into malignant tumors, a therapeutic dosage of beta radiation may be deposited, with the added benefit that the tumor would only localize and not spread to the surrounding healthy tissues. CONCLUSION The non-invasive imaging-based detection of glioma stem cells presents an alternate means to monitor the tumor and diagnose and evaluate recurrence. The sodium iodide symporter gene is a specific gene in a variety of human thyroid diseases that functions to move iodine into the cell. In recent years, an increasing number of studies related to the sodium iodide symporter gene have been reported in a variety of tumors and as therapeutic vectors for imaging and therapy. Gene therapy and nuclear medicine therapy for GBM provide a new direction. In all the preclinical studies reviewed, image-guided cell therapy led to greater survival benefits and, therefore, has the potential to be translated into techniques in glioblastoma treatment trials.
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Affiliation(s)
- Siddharth Shah
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA;
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Sciorio R, Rinaudo P. Culture conditions in the IVF laboratory: state of the ART and possible new directions. J Assist Reprod Genet 2023; 40:2591-2607. [PMID: 37725178 PMCID: PMC10643723 DOI: 10.1007/s10815-023-02934-5] [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: 05/09/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
In the last four decades, the assisted reproductive technology (ART) field has witnessed advances, resulting in improving pregnancy rates and diminishing complications, in particular reduced incidence of multiple births. These improvements are secondary to advanced knowledge on embryonic physiology and metabolism, resulting in the ability to design new and improved culture conditions. Indeed, the incubator represents only a surrogate of the oviduct and uterus, and the culture conditions are only imitating the physiological environment of the female reproductive tract. In vivo, the embryo travels through a dynamic and changing environment from the oviduct to the uterus, while in vitro, the embryo is cultured in a static fashion. Importantly, while culture media play a critical role in optimising embryo development, a large host of additional factors are equally important. Additional potential variables, including but not limited to pH, temperature, osmolality, gas concentrations and light exposure need to be carefully controlled to prevent stress and permit optimal implantation potential. This manuscript will provide an overview of how different current culture conditions may affect oocyte and embryo viability with particular focus on human literature.
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Affiliation(s)
- Romualdo Sciorio
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman-Mother-Child, CHUV-Lausanne University Hospital, 1011, Lausanne, Switzerland.
| | - Paolo Rinaudo
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA
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Adanacıoglu F, Çetin Ç, Tokat G, Adanacıoglu D, Karasu AFG, Çetin MT. Comparison of the Effects of GMCSF-Containing and Traditional Culture Media on Embryo Development and Pregnancy Success Rates. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:1047-1051. [PMID: 36580949 PMCID: PMC9800067 DOI: 10.1055/s-0042-1759630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The use of granulocyte macrophage colony-stimulating factor (GM-CSF)-containing medium, which is a commercial medium that is used for cultivation of embryos in in vitro fertilization (IVF) treatments, has been suggested to increase the efficiency of this procedure in patients with previous multiple unsuccessful attempts. In this retrospective study, we analyzed GM-CSF-containing embryo culture media compared with traditional culture media in terms of development of embryos, pregnancy, and ongoing pregnancy success and live birth rates. METHODS This is a prospective case control study conducted in a single center. A total of 131 unexplained infertility patients were included in the study. A cohort of 69 patients whose embryos were cultured in GM-CSF-containing medium and a control group of 62 age-matched patients whose embryos were cultured in conventional Sage One Step medium were included in the study. The major study outcomes were achievement of pregnancy and ongoing pregnancy rate at 12 weeks of gestation. RESULTS The pregnancy and ongoing pregnancy rates of the patients whose embryos were cultured in GM-CSF-containing medium were 39.13% and 36.23%, respectively. These were higher than the rates of the control group, which were 30.65% and 29.03%, respectively, although this difference was not statistically significant. In addition, the 5th-day embryo transfer percentage in the GM-CSF group was higher than in the control group (34.78% versus 27.4%). CONCLUSION The main findings of our study were that there was no difference between the GM-CSF-enhanced medium and the control group in terms of our major study outcomes. However, blastomere inequality rate and embryo fragmentation rates were lower in the GM-CSF group.
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Affiliation(s)
| | - Çağlar Çetin
- Department of Obstetrics and Gynecology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Gozde Tokat
- Department of Embryology, Turan Cetin Private IVF Center, Adana, Turkey
| | | | - Ayse Filiz Gokmen Karasu
- Department of Obstetrics and Gynecology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey,Address for correspondence Ayse Filiz Gokmen Karasu İskender Paşa Mh, Adnan Menderes Blv.34093 Fatih/İstanbulTurkey
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Malhotra J, Malhotra K, Kamat S, Mishra A, Chatterjee C, Nair S, Ghosh P, Mehta R, Bhadraka H, Srinivas S, Kumar L, Mistry R, Goenka D, Kant G. ISAR Consensus Guidelines on Add-Ons Treatment in In vitro Fertilization. J Hum Reprod Sci 2021; 14:S3-S30. [PMID: 34975243 PMCID: PMC8656316 DOI: 10.4103/0974-1208.330501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
STUDY QUESTION What are the good practices for the use of ADD-ON Treatments in IVF cycles in INDIA? WHAT IS ALREADY KNOWN Add on treatments in IVF are procedures and technologies which are offered to patients in hope of improving the success rates. A lot of add on treatments exist; most of them have limited evidence and data for the Indian patient population is miniscule. These interventions may have limited effects, so it is imperative that any new technology that is offered is evaluated properly and has enough evidence to suggest that it is safe and effective. STUDY DESIGN SIZE DURATION This is the report of a 2-day consensus meeting where two moderators were assigned to a group of experts to collate information on Add on treatments in IVF in INDIA. This meeting utilised surveys, available scientific evidence and personal laboratory experience into various presentations by experts on pre-decided specific topics. PARTICIPANTS/MATERIALS SETTING METHODS Expert professionals from ISAR representing clinical and embryology fields. MAIN RESULTS AND THE ROLE OF CHANCE The report is divided in various components including the health of the Offspring, the various ADD ons available to an ART center, consensus points for each technology & qualifications and trainings for embryologists, the report and recommendations of the expert panel reflect the discussion on each of the topics and try to lay down good practice points for labs to follow. LIMITATIONS REASONS FOR CAUTION The recommendations are solely based on expert opinion. Future availability of data may warrant an update of the same. WIDER IMPLICATIONS OF THE FINDINGS These guidelines can help labs across the country to standardise their ART services and improve clinical outcomes, it will also motivate clinics to collect data and report the use of Add ons to the national registry. STUDY FUNDING/COMPETING INTERESTS The consensus meeting and writing of the paper was supported by funds from CooperSurgical India.
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Affiliation(s)
- Jaideep Malhotra
- Managing Director, Rainbow IVF, Agra, Uttar Pradesh, President ISAR (2019), India
| | - Keshav Malhotra
- MBBS, MCE, Chief Embryologist & Director-Rainbow IVF, Agra (Uttar Pradesh), India
| | - Sudesh Kamat
- M.Sc., Laboratory Director, Bloom IVF Group, Mumbai, India
| | | | - Charulata Chatterjee
- Scentific Head and Consultant Embryologist Ferty9 Fertility Center, Secunderabad, Telangana, India
| | - Seema Nair
- Senior Embryologist, Coopersurgical India Pvt Ltd, Mumbai, Maharashtra, India
| | - Pranay Ghosh
- Director and Chief Embryologist, Elixir Fertility Centre, Delhi, India
| | - Rajvi Mehta
- PhD, Consultant, Cooper Surgicals, Scientific Consultant, Trivector Biomed, Mumbai, India
| | - Harsha Bhadraka
- Director - IVF lab., Chief Embryologist, Akanksha Hospital and Research Institute, Anand, Gujarat; Lab Director - ZIVYA IVF, Mumbai, Maharashtra; Secretory - SKHPL Institutional Ethics Committee, Anand, Gujarat, India
| | - Sapna Srinivas
- Lab Director, Mamta Fertility Hospital, Hyderabad, India
| | - Lalith Kumar
- Senior Scientist, Department of Women and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Rushika Mistry
- Senior Embryologist at Lilavati Hospital and Research Center (IVF Department), Mumbai, Maharashtra, India
| | - Deepak Goenka
- Director, Institute of Human Reproduction, Guwahati, India
| | - Gaurav Kant
- Director - IVF Lab, Akanksha IVF Center New Delhi, India
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Sipahi M, Mümüşoğlu S, Coşkun Akçay N, Sever A, Yeğenoğlu H, Bozdağ G, Karakoç Sökmensüer L. The impact of using culture media containing granulocyte-macrophage colony-stimulating factor on live birth rates in patients with a history of embryonic developmental arrest in previous in vitro fertilization cycles. J Turk Ger Gynecol Assoc 2021; 22:181-186. [PMID: 33631877 PMCID: PMC8420754 DOI: 10.4274/jtgga.galenos.2021.2020.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To investigate the effect of using culture media containing granulocyte-macrophage colony-stimulating factor (GM-CSF) on embryological data and reproductive outcomes in patients with early embryonic developmental arrest. Material and Methods: Retrospective case-control study. A total of 39 patients, whose embryos were incubated with culture media containing GM-CSF due to embryonic developmental arrest in two previous in vitro fertilization (IVF) cycles in-between January 2016 and November 2017 at Hacettepe University IVF Center, were enrolled. Control group was generated among patients with first IVF attempts due to tubal factor in the same time period. All embryos in the control group were incubated with single step culture medium (without GM-CSF). For the control group selection, matching was done 1:2 ratio considering female age, body mass index, number of M-II oocyte retrieved, and number of embryo transferred (n=80). Results: Demographic features and embryological data were comparable between two groups. Number of fertilized oocytes (2-pronuclear) was 3.7±2.0 in GM-CSF group and 3.9±2.5 in the control (p=0.576). Overall, number of embryos transferred (1.3±0.5 vs 1.3±0.5, respectively) and blastocyst transfer rate (67.6% vs 59.2%, respectively; p=0.401) were similar. For the reproductive outcomes, implantation rate (32.3% vs 33.1%, respectively; p=0.937), clinical pregnancy rate (33.3% vs 32.5%, respectively; p=0.770), and live birth rate (25.2% vs 26.2%, respectively; p=0.943) were similar. Conclusion: Using GM-CSF-containing culture media in patients with two previous failed IVF attempts due to embryonic developmental arrest might rectify embryological data and reproductive outcomes. To make solid conclusion further randomized controlled trials are warranted.
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Affiliation(s)
- Mehmet Sipahi
- Department of Obstetrics and Gynecology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Sezcan Mümüşoğlu
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Neslihan Coşkun Akçay
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayten Sever
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hande Yeğenoğlu
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gürkan Bozdağ
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Lale Karakoç Sökmensüer
- Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Armstrong S, MacKenzie J, Woodward B, Pacey A, Farquhar C. GM-CSF (granulocyte macrophage colony-stimulating factor) supplementation in culture media for women undergoing assisted reproduction. Cochrane Database Syst Rev 2020; 7:CD013497. [PMID: 32672358 PMCID: PMC7390393 DOI: 10.1002/14651858.cd013497.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND GM-CSF (granulocyte macrophage colony-stimulating factor) is a growth factor that is used to supplement culture media in an effort to improve clinical outcomes for those undergoing assisted reproduction. It is worth noting that the use of GM-CSF-supplemented culture media often adds a further cost to the price of an in vitro fertilisation (IVF) cycle. The purpose of this review was to assess the available evidence from randomised controlled trials (RCTs) on the effectiveness and safety of GM-CSF-supplemented culture media. OBJECTIVES To assess the effectiveness and safety of GM-CSF-supplemented human embryo culture media versus culture media not supplemented with GM-CSF, in women or couples undergoing assisted reproduction. SEARCH METHODS We used standard methodology recommended by Cochrane. We searched the Cochrane Gynaecology and Fertility Group Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, LILACS, DARE, OpenGrey, PubMed, Google Scholar, and two trials registers on 15 October 2019, checked references of relevant papers and communicated with experts in the field. SELECTION CRITERIA We included RCTs comparing GM-CSF (including G-CSF (granulocyte colony-stimulating factor))-supplemented embryo culture media versus any other non-GM-CSF-supplemented embryo culture media (control) in women undergoing assisted reproduction. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. The primary review outcomes were live birth and miscarriage rate. The secondary outcomes were clinical pregnancy, multiple gestation, preterm birth, birth defects, aneuploidy, and stillbirth rates. We assessed the quality of the evidence using GRADE methodology. We undertook one comparison, GM-CSF-supplemented culture media versus culture media not supplemented with GM-CSF, for those undergoing assisted reproduction. MAIN RESULTS We included five studies, the data for three of which (1532 participants) were meta-analysed. We are uncertain whether GM-CSF-supplemented culture media makes any difference to the live-birth rate when compared to using conventional culture media not supplemented with GM-CSF (odds ratio (OR) 1.19, 95% confidence interval (CI) 0.93 to 1.52, 2 RCTs, N = 1432, I2 = 69%, low-quality evidence). The evidence suggests that if the rate of live birth associated with conventional culture media not supplemented with GM-CSF was 22%, the rate with the use of GM-CSF-supplemented culture media would be between 21% and 30%. We are uncertain whether GM-CSF-supplemented culture media makes any difference to the miscarriage rate when compared to using conventional culture media not supplemented with GM-CSF (OR 0.75, 95% CI 0.41 to 1.36, 2 RCTs, N = 1432, I2 = 0%, low-quality evidence). This evidence suggests that if the miscarriage rate associated with conventional culture media not supplemented with GM-CSF was 4%, the rate with the use of GM-CSF-supplemented culture media would be between 2% and 5%. Furthermore, we are uncertain whether GM-CSF-supplemented culture media makes any difference to the following outcomes: clinical pregnancy (OR 1.16, 95% CI 0.93 to 1.45, 3 RCTs, N = 1532 women, I2 = 67%, low-quality evidence); multiple gestation (OR 1.24, 95% CI 0.73 to 2.10, 2 RCTs, N = 1432, I2 = 35%, very low-quality evidence); preterm birth (OR 1.20, 95% CI 0.70 to 2.04, 2 RCTs, N = 1432, I2 = 76%, very low-quality evidence); birth defects (OR 1.33, 95% CI 0.59 to 3.01, I2 = 0%, 2 RCTs, N = 1432, low-quality evidence); and aneuploidy (OR 0.34, 95% CI 0.03 to 3.26, I2 = 0%, 2 RCTs, N = 1432, low-quality evidence). We were unable to undertake analysis of stillbirth, as there were no events in either arm of the two studies that assessed this outcome. AUTHORS' CONCLUSIONS Due to the very low to low quality of the evidence, we cannot be certain whether GM-CSF is any more or less effective than culture media not supplemented with GM-CSF for clinical outcomes that reflect effectiveness and safety. It is important that independent information on the available evidence is made accessible to those considering using GM-CSF-supplemented culture media. The claims from marketing information that GM-CSF has a positive effect on pregnancy rates are not supported by the available evidence presented here; further well-designed, properly powered RCTs are needed to lend certainty to the evidence.
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Affiliation(s)
- Sarah Armstrong
- Department of Oncology & Metabolism, Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield, Sheffield, UK
| | - Jeanette MacKenzie
- Fertility Plus, Women's Health, Auckland District Health Board, Auckland, New Zealand
| | | | - Allan Pacey
- Department of Oncology & Metabolism, Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield, Sheffield, UK
| | - Cindy Farquhar
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
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Eapen A, Lissauer D, Coomarasamy A. Reply: G-CSF and repeated spontaneous abortions: what's new; comparability of inclusion and exclusion criteria in existing RCT-studies; deficiency is an indication, previous live births and 'unexplained' situations are not. Hum Reprod 2020; 35:1472-1473. [PMID: 32424405 DOI: 10.1093/humrep/deaa081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Eapen
- REI Division, Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - D Lissauer
- Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, West Midlands, B152TG, UK
| | - Arri Coomarasamy
- Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, West Midlands, B152TG, UK
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The BlastGen study: a randomized controlled trial of blastocyst media supplemented with granulocyte-macrophage colony-stimulating factor. Reprod Biomed Online 2020; 40:645-652. [PMID: 32220517 DOI: 10.1016/j.rbmo.2020.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/19/2019] [Accepted: 01/14/2020] [Indexed: 11/21/2022]
Abstract
RESEARCH QUESTION Does Embryogen®/BlastGen™ culture medium improve live birth rates compared with standard culture medium for women undergoing IVF and intracytoplasmic sperm injection (ICSI) with poor prognosis. DESIGN Randomized clinical trial. A total of 100 couples undergoing IVF/ICSI were randomly allocated to having their inseminated oocytes incubated in either Embryogen®/BlastGen™ sequential culture media or standard Cleavage/Blastocyst sequential culture media for 5 days (ClinicalTrials.gov Identifier: NCT02305420). RESULTS No statistically significant difference in live birth rate was found between the control group and the Embryogen®/BlastGen™ group (17 [34%] versus 11 [22%], respectively) (OR 0.55; 95% CI 0.22 to 1.32; P = 0.18). After adjustment for maternal age, body mass index and fertilization procedure, the blastulation rate reduced (40.6 ± 26.5 versus 24.6 ± 26.7; RR 0.70, CI 0.52 to 0.95; P < 0.05), and grade of the embryo transferred (OR 0.35, CI 0.16 to 0.77; P < 0.01) when Embryogen®/BlastGen™ medium was used. CONCLUSION A significant reduction in day-5 embryo outcome parameters was found using Embryogen®/BlastGen™ compared with standard medium, and insufficient evidence of a difference in pregnancy outcomes. Taking into consideration the small samples size, study limitations and strict inclusion criteria of this single-centre study, further research is needed to determine the efficacy of Embryogen®/BlastGen™ medium in couples undergoing IVF/ICSI.
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Armstrong S, MacKenzie J, Woodward B, Pacey A, Farquhar C. GM-CSF (granulocyte macrophage colony stimulating factor) supplementation in culture media for women undergoing assisted reproductive technology (ART). Hippokratia 2019. [DOI: 10.1002/14651858.cd013497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Sarah Armstrong
- The University of Sheffield; Department of Oncology & Metabolism, Academic Unit of Reproductive and Developmental Medicine; Academic Unit of Reproductive and Developmental Medicine Level 4, The Jessop Wing Sheffield UK S10 2SF
| | - Jeanette MacKenzie
- Fertility Plus, Women's Health, Auckland District Health Board; Auckland New Zealand
| | | | - Allan Pacey
- The University of Sheffield; Department of Oncology & Metabolism, Academic Unit of Reproductive and Developmental Medicine; Academic Unit of Reproductive and Developmental Medicine Level 4, The Jessop Wing Sheffield UK S10 2SF
| | - Cindy Farquhar
- University of Auckland; Department of Obstetrics and Gynaecology; FMHS Park Road Grafton Auckland New Zealand 1003
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Zeyneloglu HB, Tohma YA, Onalan G, Moran U. Granulocyte colony-stimulating factor for intracytoplasmic sperm injection patients with repeated implantation failure: which route is best?†. J OBSTET GYNAECOL 2019; 40:526-530. [PMID: 31496328 DOI: 10.1080/01443615.2019.1631772] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to assess whether the dual administration of granulocyte colony-stimulating factor (G-CSF) increases the effect of only systemic administration in patients with RIF. This retrospective study included 111 infertile normoresponder cases with two or more unsuccessful in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) treatments, despite the transfer of good quality embryos. Patients were divided into three groups according to using G-CSF and administration route; Group 1 included patients who received subcutaneous (SC) G-CSF only (n = 38), Group 2 comprised patients who received both intrauterine (IU) and SC G-CSF (n = 39), the control group included patients who did not receive G-CSF who were matched by age (n = 34). The IU route of G-CSF was employed on ovulation triggering day. G-CSF was administered via an IU insemination catheter. SC injection was started on the day of oocyte retrieval and administered for 15 days at 100,000 IU/kg. Foetal cardiac activity (clinical pregnancy) was present in 50 patients (46.2%) after embryo transfer, with 20 patients included in SC group (Group 1) (52.6%), 25 in SC + IU group (Group 2) (64.1%) and 8 (23.5%) in control group and significant difference was observed between groups (p: .001). Pregnancy resulted in live birth in 43 patients (39.8%), with 13 patients belonging in Group 1 (34.2%), 25 in Group 2 (61.5%) and 8 (23.5%) in control group; significant differences were observed between groups (p: .001). In conclusion, our results showed that dual administration of G-CSF was significantly more effective that the SC only method.Impact statementWhat is already known on this subject? A number of studies reported the possible benefits of granulocyte colony-stimulating factor (G-CSF) administration in recurrent implantation failure (RIF) and recurrent pregnancy loss patients; however, it is unclear which administration route is better.What do the results of this study add? Our results showed that G-CSF is a promising and safe agent for increasing live birth rates in patients with RIF. Additionally, dual administration is considered the better method than SC only administration.What are the implications of these findings for clinical practice and/or further research? Clinicians should consider a combination of IU use before ovulation triggering with SC administration starting from the day of oocyte collection for using G-CSF for the treatment of recurrent implantation failure. Additionally, our data show the need for research in the field of administration route of G-CSF for RIF. We suggest that further studies be performed in this field.
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Affiliation(s)
| | - Yusuf Aytac Tohma
- Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey
| | - Gogsen Onalan
- Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey
| | - Utkun Moran
- Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey
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The role of immunotherapy in in vitro fertilization: a guideline. Fertil Steril 2019; 110:387-400. [PMID: 30098685 DOI: 10.1016/j.fertnstert.2018.05.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 12/22/2022]
Abstract
Adjuvant immunotherapy treatments in in vitro fertilization (IVF) aim to improve the outcome of assisted reproductive technology (ART) in both the general ART population as well as subgroups such as patients with recurrent miscarriage or implantation failure. The purpose of this guideline is to evaluate the role of immunomodulating therapy in ART. Unfortunately, many of the evaluated therapies lack robust evidence from well-designed adequately powered randomized controlled trials to support their use. Immunotherapies reviewed in the present document are either not associated with improved live-birth outcome in IVF or have been insufficiently studied to make definitive recommendations.
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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Sigalos G, Triantafyllidou O, Vlahos N. How do laboratory embryo transfer techniques affect IVF outcomes? A review of current literature. HUM FERTIL 2016; 20:3-13. [PMID: 27844488 DOI: 10.1080/14647273.2016.1255357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Over the last few years, many studies have focused on embryo selection methods, whereas little attention has been given to the standardization of the procedure of embryo transfer. In this review, several parameters of the embryo transfer procedure are examined, such as the: (i) culture medium volume and loading technique; (ii) syringe and catheters used for embryo transfer; (iii) viscosity and composition of the embryo transfer medium; (iv) environment of embryo culture; (v) timing of embryo transfer; (vi) and standardization of the embryo transfer techniques. The aim of this manuscript is to review these factors and compare the existing embryo transfer techniques and highlight the need for better embryo transfer standardization.
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Affiliation(s)
- George Sigalos
- a 2nd Department of Obstetrics and Gynaecology , Aretaieion Hospital University of Athens , Athens, Greece.,b Reproductive Medicine Unit , "Lito" Maternity Hospital , Athens , Greece
| | | | - Nikos Vlahos
- a 2nd Department of Obstetrics and Gynaecology , Aretaieion Hospital University of Athens , Athens, Greece
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Zhou W, Chu D, Sha W, Fu L, Li Y. Effects of granulocyte-macrophage colony-stimulating factor supplementation in culture medium on embryo quality and pregnancy outcome of women aged over 35 years. J Assist Reprod Genet 2015; 33:39-47. [PMID: 26660059 DOI: 10.1007/s10815-015-0627-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The purpose of this study is to explore whether a low concentration of granulocyte-macrophage colony-stimulating factor (GM-CSF) supplementation in culture medium is beneficial to infertile women aged over 35 years. METHODS A retrospective cohort study was performed to analyze the embryo quality and pregnancy outcome of 212 controlled ovarian stimulation (COH) cycles with or without GM-CSF addition (n = 117 [GM-CSF, 0.2 ng/mL] vs n = 95 [control]). RESULTS No significant difference was observed in cleavage rate (96.2 vs 96.5 %), blastocyst formation rate (53.2 vs 54.0 %), good blastocyst rate (26.8 vs 26.8 %), or available embryo rate (54.2 vs 49.7 %) between the GM-CSF group and the control group. However, the average age of the GM-CSF group (38.41 ± 3.13 years) was significantly 1 year older than that of the corresponding control group (37.45 ± 2.74 years) (P < 0.05). GM-CSF addition greatly decreased the occurrence of biochemical pregnancy (55.6 % [control] vs 20.8 % [GM-CSF], P < 0.05). No case of neonatal malformation was observed in the present study. CONCLUSION Although no benefit of GM-CSF on embryo quality was observed, the addition of this factor significantly decreased the occurrence of chemical pregnancy of women aged over 35 years, indicating the role of GM-CSF in improving implantation competence of embryos derived from elderly infertile women.
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Affiliation(s)
- Wenhui Zhou
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China
| | - Dapeng Chu
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China
| | - Wei Sha
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China
| | - Lei Fu
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China
| | - Yuan Li
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China.
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Ménézo Y, Guérin P, Elder K. The oviduct: a neglected organ due for re-assessment in IVF. Reprod Biomed Online 2015; 30:233-40. [DOI: 10.1016/j.rbmo.2014.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
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