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Jiesisibieke D, Tian T, Zhu X, Fang S, Zhang N, Ma J, Xia Y, Li R, Liu P, Qiao J, Yang R. Reproductive Outcomes of Conventional In Vitro Fertilization and Intracytoplasmic Sperm Injection in Patients with Non-Severe Male Infertility Across Poor and Different Sub-Optimal Ovarian Response Categories: A Cohort Study Based on 30,352 Fresh Cycles from 2009-2019. Reprod Sci 2024; 31:1353-1362. [PMID: 38228973 PMCID: PMC11090916 DOI: 10.1007/s43032-023-01444-0] [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: 03/21/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024]
Abstract
Due to the influence of economic, social and many other factors, there are more and more reproductive problems. Originally introduced for managing male factor infertility, intracytoplasmic sperm injection had become the most commonly used fertilization treatment in the world, with broadened indications including low oocyte yield, prior fertilization failure with conventional in vitro fertilization etc. However, academic evidence for better live-birth outcomes of intracytoplasmic sperm injection over conventional in vitro fertilization is limited. Thus, we aimed to compare the reproductive outcomes of conventional in vitro fertilization and intracytoplasmic sperm injection in patients with non-severe male factor infertility across poor and different sub-optimal ovarian response categories. The fertility rate, implantation rate, clinical pregnancy rate, live birth rate and other obstetric outcomes were mainly compared. Our results showed that independent of the number of oocytes retrieved, intracytoplasmic sperm injection significantly increased the fertilization rate, while conventional in vitro fertilization cycles showed a higher implantation rate, clinical pregnancy rate, and live birth rate. No differences were observed in most obstetric outcomes. Our study indicates that poor ovarian response is not an indication for intracytoplasmic sperm injection in couples with non-severe male infertility.
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Affiliation(s)
| | - Tian Tian
- Peking University Third Hospital, Beijing, 100191, China
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, 100191, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China
| | - Xiaxuan Zhu
- Peking University Third Hospital, Beijing, 100191, China
| | - Shilin Fang
- Peking University Third Hospital, Beijing, 100191, China
| | - Nan Zhang
- Peking University Third Hospital, Beijing, 100191, China
| | - Jinxi Ma
- Peking University Third Hospital, Beijing, 100191, China
| | - Yuqi Xia
- Peking University Third Hospital, Beijing, 100191, China
| | - Rong Li
- Peking University Third Hospital, Beijing, 100191, China
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, 100191, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China
| | - Ping Liu
- Peking University Third Hospital, Beijing, 100191, China
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, 100191, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China
| | - Jie Qiao
- Peking University Third Hospital, Beijing, 100191, China
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, 100191, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China
| | - Rui Yang
- Peking University Third Hospital, Beijing, 100191, China.
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, 100191, Beijing, China.
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China.
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Wang T, Zhu L, Yin M, Yu W, Dong J, Jin W, Lyu Q, Jin L, Long H. Sex ratio shift after frozen single blastocyst transfer in relation to blastocyst morphology parameters. Sci Rep 2024; 14:9539. [PMID: 38664459 PMCID: PMC11045847 DOI: 10.1038/s41598-024-59939-y] [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: 08/09/2023] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
The sex ratio shift was observed in peoples who underwent ART treatment. Moreover, there is limited evidence on differences in sex ratio between single frozen-thawed blastocyst morphology, insemination type and transfer days. So further research is needed in this area with regard to factors possibly affecting the sex ratio. Retrospective study based on multicenter including two large assisted reproduction centers in Shanghai and Wuhan in China. A total of 6361 singleton delivery offspring after frozen-thawed blastocyst transfer. Propensity score weighting and logistic regression models were used to estimate the associations between blastocyst morphology grading and child sex ratio. The main outcome measures is singleton sex ratio. In our study, the primary outcome measure was sex ratio which was calculated as the proportion of male newborns among all live births. Higher quality blastocysts resulted in a higher sex ratio than single poor-quality frozen-thawed blastocyst transfer. Among the three blastocyst morphological parameters of trophectoderm (TE), Grade A and B were significantly associated with a higher sex ratio than Grade C. The similar trend was observed in both IVF and ICSI treated subgroups. As compared with expansion (4 + 3), expansion degree 6 achieved a higher sex ratio in overall populations and IVF treated subgroup. Transferring blastocysts of day 6 had the highest sex ratio both in IVF group and ICSI group. A 6.95% higher sex ratio in transferring blastocysts of day 5 in IVF group than those in ICSI group. No significant association between inner cell mass degree and sex ratio was observed. However, as compared with IVF treatment, all morphology parameters achieved the similar or the biased sex ratio favoring female in ICSI treated subgroup. Quality of blastocysts was positively associated with sex ratio. TE score and expansion degree rather than ICM were significantly associated with sex ratio at birth. ICSI treatment promotes the biased sex ratio favoring female.
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Affiliation(s)
- Tiantian Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 300559, China
| | - Mingru Yin
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Weina Yu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jing Dong
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wei Jin
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Qifeng Lyu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 300559, China.
| | - Hui Long
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Zhao J, Shen H, Zhu Q, Liu J, Han J, Yi R, Li J, Lin Y, Liu T, Zhong X. Assisted reproductive technology induces different secondary sex ratio: parental and embryonic impacts. Reprod Health 2023; 20:184. [PMID: 38097997 PMCID: PMC10722851 DOI: 10.1186/s12978-023-01723-8] [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: 08/12/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Assisted reproduction technology (ART) has advanced significantly, raising concerns regarding its impact on the secondary sex ratio (SSR), which is the sex ratio at birth in offspring. This study aimed to explore factors affecting SSR in singletons, singletons from twin gestation, and twins from twin gestation within the context of ART. METHODS A retrospective analysis was conducted on data from 8335 births involving 6,223 couples undergoing ART. Binary logistic regression assessed relationships between parental and embryonic factors and SSR in singletons and singletons from twin gestation. Multinomial logistic regression models were utilized to identify factors influencing SSR in twins from twin gestation. RESULTS Secondary infertility (OR = 1.164, 95% CI: 1.009-1.342), advanced paternal age (OR = 1.261, 95% CI: 1.038-1.534), and blastocyst embryo transfer (OR = 1.339, 95% CI: 1.030-1.742) were associated with an increased SSR, while frozen embryo transfer (FET) showed a negative association with SSR (OR = 0.738, 95% CI: 0.597-0.912) in singletons. A longer duration of gonadotropin (Gn) usage reduced SSR in singletons (OR = 0.961, 95% CI: 0.932-0.990) and singletons from twin gestation (OR = 0.906, 95% CI: 0.838-0.980). In singletons from twin gestation, male-induced infertility (OR = 2.208, 95% CI: 1.120-4.348) and higher Gn dosage (OR = 1.250, 95% CI: 1.010-1.548) were significantly associated with an increased SSR. Women aged > 35 years and intracytoplasmic sperm injection (ICSI) were associated with lower SSR (OR = 0.539, 95% CI: 0.293-0.990 and OR = 0.331, 95% CI: 0.158-0.690, respectively). In twins from twin gestation, paternal age exceeded maternal age (OR = 0.682, 95% CI: 0.492-0.945) and higher Gn dosage (OR = 0.837, 95% CI: 0.715-0.980) were associated with a higher proportion of male twins. Cleavage stage transfer (OR = 1.754, 95% CI: 1.133-2.716) resulted in a higher percentage of boy-girl twins compared to blastocyst transfer. CONCLUSION This study demonstrates the complex interplay of various factors in determining the SSR in ART, highlighting the importance of considering infertility type, paternal age, fertilization method, embryo transfer stage, and Gn use duration when assessing SSR. Nevertheless, further research with a large sample size is necessary to confirm and expand upon the findings of this study.
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Affiliation(s)
- Jiansen Zhao
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Haoran Shen
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Jiong Liu
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jianhua Han
- Nanshan School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Ruiting Yi
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Junxing Li
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Yanshan Lin
- Department of Reproductive Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, 510150, China.
| | - Tao Liu
- China Greater Bay Area Research Center of Environment Health, School of Medicine, Jinan University, Guangzhou, 510006, China.
| | - Xinqi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, 510150, China.
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Mao Y, Zeng M, Meng YM, Wang C, Luo Y, Luo Y, Li L. Effect of blastocyst quality on human sex ratio at birth in a single blastocyst frozen thawed embryo transfer cycle. Gynecol Endocrinol 2023; 39:2216787. [PMID: 37247635 DOI: 10.1080/09513590.2023.2216787] [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: 12/28/2022] [Revised: 04/12/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
RESEARCH QUESTION To determine whether blastocyst quality affects the sex ratio at birth through a single blastocyst frozen - thawed embryo transfer (SBFET) cycle. DESIGN In this retrospective analysis, we examined 3,041 singleton infants born following SBFET between 2017 and 2020 at a single institution. We compared the sex ratios of these infants with respect to the blastocyst quality, embryo growth rate, and morphology. RESULTS The main outcomes of this study were that the sex ratio (M/F) at birth of SBFET was 1.24. Mothers >40 years old had a considerably lower sex ratio than mothers <40 years old (0.39 vs. 1.23-1.28, p < .05). Transplanting high-quality blastocysts significantly increased the proportion of boys born (1.29 vs. 0.88, p < .05). There were no significant differences in the sex ratio with respect to the inner cell mass (ICM) score and expansion degree. Additionally, a high trophoblastic cell (TE) score resulted in a significantly higher sex ratio than the TE score with C (1.62 vs. 1.15 vs. 0.85, p < .001). Multivariable logistic regression analysis was performed to determine which variables were significant factors affecting sex ratio, and the outcomes were consistent with previous findings. CONCLUSIONS Our study indicated that high-quality, especially good TE score, had a higher chance of resulting in a male infant than a female infant.
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Affiliation(s)
- Yuling Mao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ming Zeng
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ya-Ming Meng
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunyan Wang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanfen Luo
- Department of Medicine Laboratory, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Medicine Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yang Luo
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lei Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Du T, Xie Q, Ye J, Wang X, Qiu J, Yan Z, Zhang S, Zhao D, Lin J, Li B. Factors affecting male-to-female ratio at birth in frozen-thawed embryo transfer cycles: a large retrospective cohort study. Front Endocrinol (Lausanne) 2023; 14:1188433. [PMID: 37800141 PMCID: PMC10548202 DOI: 10.3389/fendo.2023.1188433] [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: 03/17/2023] [Accepted: 07/31/2023] [Indexed: 10/07/2023] Open
Abstract
Background ICSI (intracytoplasmic sperm injection) leads to a reduced male-to-female ratio at birth, whereas blastocyst transfer results in an increased male-to-female ratio. However, limited knowledge exists regarding the impact of these factors on the live birth rate for each gender. This study aimed to investigate the influence of patient characteristics and treatment parameters on the live birth rate for each gender, as well as the ultimate male-to-female ratio at birth in frozen-thawed embryo transfer (FET) cycles. Method This retrospective cohort study involved a total of 28,376 FET cycles and 9,217 subsequent deliveries, spanning from January 2003 to December 2015. The study consisted of two parts. First, logistic regression models were constructed to determine the factors influencing the male-to-female ratio among babies born after FET. Second, we aimed to investigate the mechanisms underlying this sex ratio imbalance by analyzing data from all transfer cycles. Generalized estimated equations were employed to assess the impact of risk factors on rates of male and female live births separately. Results ICSI resulted in a lower proportion of male offspring compared to in vitro fertilization (IVF) (50.1% vs. 53.7%, aOR: 0.87, 95% CI: 0.80-0.96). Conversely, blastocyst transfer yielded a higher proportion of male offspring than cleavage-stage embryo transfer (58.7% vs. 51.6%, aOR: 1.32, 95% CI: 1.17-1.48). Analysis of all cycles indicated that ICSI resulted in a reduced likelihood of male live birth in comparison to IVF (19.8% vs. 21.6%, aOR: 0.90, 95% CI: 0.83-0.97). However, the transfer of blastocysts rather than cleavage-stage embryos not only increased the chance of male live birth (26.9% vs. 20.2%, aOR: 1.70, 95% CI:1.56-1.85) but also facilitated female live birth (20.3% vs. 19.3%, aOR: 1.26, 95% CI: 1.15-1.39). Conclusion ICSI was associated with a reduction in the male-to-female sex ratio and a lower rate of male live births, while blastocyst transfer was associated with an increased male-to-female sex ratio at birth and a higher rate of male live births.
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Affiliation(s)
- Tong Du
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Xie
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Ye
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xindi Wang
- Department of Integrative Physiology and Biochemistry, University of Colorado at Boulder, Boulder, NV, United States
| | - Jiaxin Qiu
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Yan
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Suqun Zhang
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Zhao
- Department of Obstetrics and Gynaecology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaying Lin
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Li
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Carrasco B, Pons MC, Parriego M, Boada M, García S, Polyzos NP, Veiga A. Male and female blastocyst: any difference other than the sex? Reprod Biomed Online 2022; 45:851-857. [DOI: 10.1016/j.rbmo.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/29/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022]
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Lin Y, Chen Q, Huang X, Wang Z, Chen C, Chen H, Jin F. Obstetric and Perinatal Outcomes After Assisted Reproductive Technology in Women With Cesarean Scar. Front Physiol 2022; 13:808079. [PMID: 35250614 PMCID: PMC8891634 DOI: 10.3389/fphys.2022.808079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/25/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Assisted reproductive technology (ART) and previous Cesarean section (CS) are independently associated with the risk of adverse obstetric and perinatal outcomes in general. Few studies have focused on the association between adverse obstetric and perinatal outcomes and ART used in the high-risk population of women with previous CS. Materials and Methods A retrospective cohort study including 14,099 women with a previous delivery and a subsequent delivery between April 2014 and April 2020 was conducted at our hospital. We assessed the risk of adverse obstetric and perinatal outcomes in pregnancies conceived by ART in women with previous CS, using log-binomial regression models. Results In women with previous CS, ART singleton pregnancies were associated with an increased risk of maternal complications, such as pregnancy complications, placental anomalies of implantation, postpartum hemorrhage, and preterm birth (PTB), as compared to spontaneously conceived pregnancies. The implementation of ART and previous CS interacted in a synergistic manner to increase the likelihood of the placenta accreta spectrum in women with singleton pregnancies [adjusted relative risk (aRR) 5.30, 95% confidence interval (CI) 4.01–7.00; relative risk due to interaction: 1.41, 95%CI 0.07–2.75]. In women with previous CS who underwent ART, women with singletons conceived through intracytoplasmic sperm injection were at increased risk of velamentous placenta (aRR 2.46, 95%CI 1.35–4.48) compared with those with singletons conceived through in vitro fertilization (IVF), whereas women with singletons conceived through cleavage-stage embryo transfer (ET) were at increased risk of gestational diabetes mellitus (GDM) (aRR 1.74, 95%CI 1.16-2.60) than those with singletons conceived through blastocyst–stage ET. Conclusion Pregnancies conceived through ART were at increased risk for adverse obstetric and perinatal outcomes in women who had previously delivered by CS, particularly for placental anomalies of implantation. In women with previous CS undergoing ART, IVF and blastocyst–stage ET may be a relatively safe treatment.
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Affiliation(s)
- Yue Lin
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qianqian Chen
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xuefeng Huang
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziliang Wang
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
| | - Cuie Chen
- Department of Obstetrics and Gynecology, Affiliated Yueqing Hospital of Wenzhou Medical University, Wenzhou, China
| | - Haiying Chen
- Department of Obstetrics and Gynecology, Wenzhou Central Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, China
| | - Fan Jin
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Women’s Reproductive Health Laboratory of Zhejiang Province, Key Laboratory of Reproductive Genetics, National Ministry of Education (Zhejiang University), Hangzhou, China
- *Correspondence: Fan Jin,
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Cai H, Ren W, Wang H, Shi J. Sex ratio imbalance following blastocyst transfer is associated with ICSI but not with IVF: an analysis of 14,892 single embryo transfer cycles. J Assist Reprod Genet 2022; 39:211-218. [PMID: 34993711 PMCID: PMC8866591 DOI: 10.1007/s10815-021-02387-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/21/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Assisted reproductive technology (ART) has an impact on secondary sex ratio (SSR), which is seemed to be elevated after blastocyst transfer (BT) but decreased following ICSI procedure. We aim to assess whether the higher SSR associated with BT could be influenced by fertilization method used. METHODS All consecutive IVF/ICSI cycles (fresh and frozen) involving single embryo transfer (SET) resulting in a live birth between 2015 and 2019 were retrospective analyzed. Logistic regression was used to model the effect on the SSR of maternal and specific ART characteristics. RESULTS Six thousand nine hundred twenty-two women were included with the crude SSR of 54.8%. The impact of BT on SSR is influenced by the fertilization method used. After adjustment for potential confounders, the SSR in the ICSI BT group was significantly higher when compared to ICSI cleavage-stage embryo SET (aOR 1.24; 95% CI 1.10-1.40, P < 0.001). However, this effect was not detected among SBT with IVF treatment (aOR 1.04; 95% CI 0.97-1.12, P = 0.260). Assessing blastocyst morphological parameters, high trophectoderm quality was significantly associated with elevated SSR (aOR 1.76, 95% CI 1.34-2.31 [A vs. C], and aOR 1.28, 95% CI 1.14-1.44 [B vs. C]). No significant difference was shown in expansion, inner cell mass, or days of blastocyst formation between male and female blastocysts. CONCLUSIONS The impact of BT on SSR could be influenced by the fertilization method used. The higher SSR was observed after BT with ICSI procedures but not with IVF. Interpretation of the findings is limited by the potential for selection and confounding bias.
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Affiliation(s)
- He Cai
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
| | - Wenjuan Ren
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
| | - Hui Wang
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
| | - Juanzi Shi
- grid.440257.00000 0004 1758 3118Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, Xi’An, China
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Afnan MAM, Liu Y, Conitzer V, Rudin C, Mishra A, Savulescu J, Afnan M. Interpretable, not black-box, artificial intelligence should be used for embryo selection. Hum Reprod Open 2021; 2021:hoab040. [PMID: 34938903 PMCID: PMC8687137 DOI: 10.1093/hropen/hoab040] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/18/2021] [Indexed: 11/23/2022] Open
Abstract
Artificial intelligence (AI) techniques are starting to be used in IVF, in particular for selecting which embryos to transfer to the woman. AI has the potential to process complex data sets, to be better at identifying subtle but important patterns, and to be more objective than humans when evaluating embryos. However, a current review of the literature shows much work is still needed before AI can be ethically implemented for this purpose. No randomized controlled trials (RCTs) have been published, and the efficacy studies which exist demonstrate that algorithms can broadly differentiate well between 'good-' and 'poor-' quality embryos but not necessarily between embryos of similar quality, which is the actual clinical need. Almost universally, the AI models were opaque ('black-box') in that at least some part of the process was uninterpretable. This gives rise to a number of epistemic and ethical concerns, including problems with trust, the possibility of using algorithms that generalize poorly to different populations, adverse economic implications for IVF clinics, potential misrepresentation of patient values, broader societal implications, a responsibility gap in the case of poor selection choices and introduction of a more paternalistic decision-making process. Use of interpretable models, which are constrained so that a human can easily understand and explain them, could overcome these concerns. The contribution of AI to IVF is potentially significant, but we recommend that AI models used in this field should be interpretable, and rigorously evaluated with RCTs before implementation. We also recommend long-term follow-up of children born after AI for embryo selection, regulatory oversight for implementation, and public availability of data and code to enable research teams to independently reproduce and validate existing models.
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Affiliation(s)
| | - Yanhe Liu
- Monash IVF Group, Southport, Australia
- School of Human Sciences, University of Western
Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan
University, Joondalup, Australia
- School of Health Sciences and Medicine, Bond
University, Robina, Australia
| | - Vincent Conitzer
- Department of Computer Science, Duke
University, Durham, NC, USA
- Department of Economics, Duke
University, Durham, NC, USA
- Department of Philosophy, Duke
University, Durham, NC, USA
- Department of Computer Science, Institute for Ethics
in AI, University of Oxford, Oxford, UK
- Department of Philosophy, Institute for Ethics in
AI, University of Oxford, Oxford, UK
| | - Cynthia Rudin
- Department of Computer Science, Duke
University, Durham, NC, USA
- Department of Electrical Engineering, Duke
University, Durham, NC, USA
- Department of Statistical Science, Duke
University, Durham, NC, USA
| | - Abhishek Mishra
- Uehiro Centre for Practical Ethics, University of
Oxford, Oxford, UK
| | - Julian Savulescu
- Uehiro Centre for Practical Ethics, University of
Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities,
University of Oxford, Oxford, UK
- Murdoch Children’s Research Institute, Royal
Children's Hospital, Parkville, Australia
| | - Masoud Afnan
- Department of Obstetrics & Gynaecology,
Qingdao United Family Hospital, Qingdao, China
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10
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Nagata C, Mekaru K, Gibo K, Nakamura R, Oishi S, Miyagi M, Akamine K, Aoki Y. Sex ratio of infants born through in vitro fertilization and embryo transfer: Results of a single-institution study and literature review. JBRA Assist Reprod 2021; 25:337-340. [PMID: 33507723 PMCID: PMC8312283 DOI: 10.5935/1518-0557.20200096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: The possible effects of Assisted Reproductive Technology (ART) on sex ratio at birth are extremely significant. This study aimed to determine whether ART affects the sex ratio of infants born through in vitro fertilization and embryo transfer (IVF-ET). Materials and Methods: We ran this retrospective study on 290 singleton infants born following IVF-ET from February 2014 to August 2018 at a single institution. We compared the sex ratios of these infants with respect to insemination versus intracytoplasmic sperm injection (ICSI), early-cleavage embryo versus blastocyst transfer, fresh versus frozen-thawed embryo transfer and normal sperm versus asthenospermia. Results: There were no significant differences in the sex ratio with respect to the fertilization method, transfer time, fresh embryo or frozen-thawed embryo transfer. In addition, the multiple logistic regression analysis revealed that these factors did not significantly affect the sex ratio. Conclusions: Our study indicated that the differences in the fertilization method transfer time and sperm motility rate did not affect the sex ratio of IVF live births. However, with increasing numbers of ICSI and blastocyst transfer cycles, factors possibly affecting the sex ratio need to be further investigated.
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Affiliation(s)
- Chinatsu Nagata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Keiko Mekaru
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Keiya Gibo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Rie Nakamura
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Sugiko Oishi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Maho Miyagi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Kozue Akamine
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Yoichi Aoki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
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11
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Sindiani AM, Zayed F, Alshdaifat EH, Rawashdeh HM, Al-Woshah W, Zayed N. Pre-Implantation Gender Selection: Family Balancing in Jordan. Risk Manag Healthc Policy 2021; 14:2797-2801. [PMID: 34239335 PMCID: PMC8259936 DOI: 10.2147/rmhp.s306124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To find out whether couples with predominant female offspring have more chances to produce more female embryos during non-medical pre-implantation genetic diagnosis (PGD) for male sex selection. Methods A total of 125 couples who had three or more female offspring and underwent non-medical PGD for male sex selection between 2015 and 2019 were included. Nuclear DNA was analyzed by fluorescent in situ hybridization (FISH). Two-chromosome (X, Y), 3-chromosome (21, X, Y), and 5-chromosome (13, 18, 21, X, Y) probes were used for FISH. The standard protocol was followed for sperm processing and embryo culture for IVF and PGD. Results In 83.2% of the couples, the ratio of female embryos was higher than male embryos. Independent sample t-test showed that there is no significant difference between equal and unequal embryonic groups in patients' age, husbands' age, sperm count, sperm motility, total male embryos, total female embryos, normal male embryos, and normal female embryos. For patients with positive pregnancy outcome, 84.6% had unequal embryonic ratio while 15.4% had equal embryonic ratio. Similarly, patients who were treated by short protocol had 85% of unequal embryonic ratio and 15% had equal ratio. Conclusion A greater variability in the female to male embryonic ratio is produced in couples having predominantly female offspring and seeking non-medical PGD for male sex selection.
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Affiliation(s)
- Amer Mahmoud Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Faheem Zayed
- Department of Obstetrics and Gynecology, Irbid Speciality Hospital, Irbid, Jordan
| | | | - Hasan M Rawashdeh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Wesam Al-Woshah
- Department of Obstetrics and Gynecology, IBN Al-Nafis Hospital, Irbid, Jordan
| | - Nada Zayed
- Department of Dermatology, Albalqa Applied University, Salt, Jordan
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12
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Moutos CP, Kearns WG, Farmer SE, Richards JP, Saad AF, Crochet JR. Embryo quality, ploidy, and transfer outcomes in male versus female blastocysts. J Assist Reprod Genet 2021; 38:2363-2370. [PMID: 34086149 DOI: 10.1007/s10815-021-02250-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The goal is to determine if variations exist between male and female blastocysts in preimplantation measurements of quality and ploidy and in vitro fertilization elective single-embryo transfer (eSET) outcomes. METHODS A retrospective chart review was conducted from a private fertility center's database of blastocysts undergoing preimplantation genetic testing for aneuploidy, along with details of eSET from this screened cohort. Main outcomes included preimplantation embryo quality and sex-specific eSET outcomes. RESULTS A total of 3708 embryos from 578 women were evaluated, with 45.9% male and 54.1% female. The majority were High grade. No difference existed between embryo sex and overall morphological grade, inner cell mass or trophectoderm grade, or blastocyst transformation day. Female blastocysts had a higher aneuploidy rate than male blastocysts (P < 0.001). Five hundred thirty-nine eSETs from 392 women were evaluated, with High grade embryos more likely to have implantation (P < 0.001), clinical pregnancy (P < 0.001), and ongoing pregnancy (P = 0.018) than Mid or Low grade embryos. Day 5 blastocysts were more likely to have implantation (P = 0.018), clinical pregnancy (P = 0.005), and ongoing pregnancy (P = 0.018) than day 6 blastocysts. Male and female embryos had similar transfer outcomes, although female day 5 blastocysts were more likely to result in clinical pregnancy (P = 0.012), but not ongoing pregnancy, than female day 6 blastocysts. Male eSET outcomes did not differ by blastocyst transformation day. CONCLUSION Male and female embryos have comparable grade and quality; however, female embryos were more likely to be aneuploid. Ongoing pregnancy rates did not differ by embryo sex. Day 5 embryos had more favorable transfer outcomes than day 6 embryos.
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Affiliation(s)
- Christopher P Moutos
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX, 77555, USA.
| | - William G Kearns
- AdvaGenix, 9430 Key West Ave. Suite 130, Rockville, MD, 20850, USA
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Sarah E Farmer
- Center of Reproductive Medicine, 7400 Fannin St. #1180, Houston, TX, 77054, USA
| | - Jon P Richards
- Center of Reproductive Medicine, 7400 Fannin St. #1180, Houston, TX, 77054, USA
| | - Antonio F Saad
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX, 77555, USA
| | - John R Crochet
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX, 77555, USA
- Center of Reproductive Medicine, 7400 Fannin St. #1180, Houston, TX, 77054, USA
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13
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Vaamonde D, Hackney AC, Garcia Manso JM, Arriaza Ardiles E, Vaquero M. Birth sex ratio in the offspring of professional male soccer players: influence of exercise training load. Hum Reprod 2021; 35:2613-2618. [PMID: 33006607 DOI: 10.1093/humrep/deaa225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/26/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Can the exercise training load of elite male athletes influence the sex ratio of their offspring? SUMMARY ANSWER This is the first study assessing the influence of exercise training load on the offspring sex ratio of children from male professional athletes, observing a bias toward more females being born as a result of both high-intensity and high-volume loads, with intensity having the greatest effect. WHAT IS KNOWN ALREADY There is a relatively constant population sex ratio of males to females among various species; however, certain events and circumstances may alter this population sex ratio favoring one sex over the other. STUDY DESIGN, SIZE, DURATION Observational, descriptive cross-sectional study with a duration of 3 months. PARTICIPANTS/MATERIALS, SETTING, METHODS Seventy-five male professional soccer players from First Division soccer teams. Offspring variables were sex of the offspring, number of children and order of birth. Exercise training variables were volume and intensity. MAIN RESULTS AND THE ROLE OF CHANCE Total offspring was 122 children (52 males (42.6%), 70 females (57.4%)). Analysis revealed that increase in either the volume (P < 0.001) or intensity (P < 0.001) of training by the players shifted the birth offspring ratio more toward females. Within the sample of females born, more births (i.e. number) were observed as a consequence of training at the highest intensity (45 out of 70; P < 0.001), no such pattern occurred within males (P > 0.05). When female versus male births were compared within each intensity, only the high-intensity comparison was significant (45 (75%) females vs 15 (25%) males, P < 0.001). LIMITATIONS, REASONS FOR CAUTION While this is the first study assessing differences in the sex ratio of the offspring of male athletes (i.e. soccer players), we acknowledge there are limitations and confounders within our approach; e.g. small sample size, ethnic background and variations in the timing of intercourse relative to ovulation as well as in sex hormone levels. As such, we propose that future research is needed to confirm or refute our findings. It is recommended that such work expand on the measurements obtained and conduct direct assessment of sperm characteristics. WIDER IMPLICATIONS OF THE FINDINGS The findings of the study support the fact that different stressors on the body may alter the sex of the offspring. While in the present study the stressor is the excessive training load of soccer players, other events may lead to similar results. The bias in offspring sex ratio may have important implications for demography and population dynamics, as well as genetic trait inheritance. STUDY FUNDING/COMPETING INTEREST(S) There is no funding nor competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- D Vaamonde
- Department of Morphological Sciences, School of Medicine and Nursing, Universidad de Cordoba, Cordoba, Spain.,International Network on Physical Exercise and Fertility (INPEF), Córdoba, Spain
| | - A C Hackney
- International Network on Physical Exercise and Fertility (INPEF), Córdoba, Spain.,Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - J M Garcia Manso
- International Network on Physical Exercise and Fertility (INPEF), Córdoba, Spain.,Department of Physical Education, School of Physical Activity and Sports, Universidad de Las Palmas de Gran Canaria, Las Palmas, Canary Islands, Spain
| | - E Arriaza Ardiles
- Center of Advanced Studies, Universidad de Playa Ancha, Valparaiso, Chile
| | - M Vaquero
- Department of Public Health, School of Medicine and Nursing, Universidad de Córdoba, Córdoba, Spain.,IMIBIC Clinical and Epidemiological Research in Primary Care, Córdoba, Spain
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14
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Spangmose AL, Ginström Ernstad E, Malchau S, Forman J, Tiitinen A, Gissler M, Opdahl S, Romundstad LB, Bergh C, Wennerholm UB, Henningsen AA, Pinborg A. Obstetric and perinatal risks in 4601 singletons and 884 twins conceived after fresh blastocyst transfers: a Nordic study from the CoNARTaS group. Hum Reprod 2021; 35:805-815. [PMID: 32294185 DOI: 10.1093/humrep/deaa032] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/13/2019] [Indexed: 01/01/2023] Open
Abstract
STUDY QUESTION Are obstetric and perinatal outcomes in pregnancies after fresh blastocyst transfer (BT) comparable with those born after fresh cleavage stage transfer (CT) and spontaneous conception (SC)? SUMMARY ANSWER Fresh BT is associated with a higher risk of placental and perinatal complications. WHAT IS KNOWN ALREADY BT optimizes the selection of top-quality embryos and increases pregnancy and live birth rates per transfer compared to CT. However, concerns have been raised as extended culture duration may increase obstetric complications and impair perinatal outcomes. Previous studies have shown a higher risk of preterm birth (PTB) among infants born after BT compared with CT. Pregnancies after BT are also prone to a higher risk of same-sex twins after single embryo transfer (SET). STUDY DESIGN, SIZE, DURATION A retrospective register-based cohort study used data from Denmark, Norway and Sweden including three cohorts: 56 557 singletons and 16 315 twins born after fresh IVF/ICSI cycles and 2 808 323 SC singletons in Denmark (birth years 1997-2014), Norway (2010-2015) and Sweden (2002-2015). Of the fresh IVF/ICSI singletons, 4601 were born after BT and 51 956 after CT. The twin cohort consisted of 884 fresh IVF/ICSI children born after BT and 15 431 fresh IVF/ICSI children born after CT. PARTICIPANTS/MATERIALS, SETTING, METHODS Data were obtained from a large Nordic cohort of children born after ART and SC initiated by the Committee of Nordic ART and Safety (CoNARTaS). The CoNARTaS cohort was established by cross-linking National ART-, Medical Birth-, and National Patients Registers using the unique personal identification number, allocated to every citizen in the Nordic countries. Obstetric and perinatal outcomes after BT, CT and SC were compared using logistic regression analysis. For perinatal outcomes, we calculated gestational age based on the date of oocyte pick-up (OPU) and in sensitivity analyses on data from Denmark and Norway, we also calculated gestational age based on the second-trimester ultrasonography (US) scan. Risk of pregnancies with same-sex twins after SET was used as a proxy for risk of monozygotic twins. Adjustments were made for child's sex, birth year, parity (0 or >1), maternal age, body mass index, smoking, educational level, fertilization method (IVF/ICSI), the number of aspirated oocytes, SET and country. Information on educational level and the number of aspirated oocytes was not available for Norway. Children born after frozen embryo transfer were not included. The birth cohorts were restricted according to the year in which BT was introduced in the different countries. MAIN RESULTS AND THE ROLE OF CHANCE A higher risk of placenta previa was found in singleton pregnancies after BT compared with CT (adjusted odds ratio [aOR] 2.11 [95% CI 1.76; 2.52]). Singletons born after BT had a higher risk of PTB (aOR 1.14 [95% CI 1.01; 1.29]) compared with CT singletons, when estimated based on OPU. Furthermore, an altered male/female ratio (aOR 1.13 [95% CI 1.06; 1.21]) with more males following BT compared with CT was seen. Risk of same-sex twins after SET was higher after single BT compared with single CT (aOR 1.94 [95% CI 1.42; 2.60]). LIMITATIONS, REASONS FOR CAUTION Residual confounding cannot be excluded, in particular related to duration and cause of infertility that we could not adjust for due to lack of reliable data. WIDER IMPLICATIONS OF THE FINDINGS Extended embryo culture to the blastocyst stage has the potential to compromise obstetric and perinatal outcomes in fresh cycles. These results are important since an increasing number of IVF/ICSI treatments are performed as BT. STUDY FUNDING/COMPETING INTEREST(S) NORDFORSK (project no: 71450). The Research Fund of Rigshospitalet, Copenhagen University Hospital. ReproUnion Collaborative study, co-financed by the European Union, Interreg V ÖKS. Grants from Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (LUA/ALF 70940), Hjalmar Svensson Research Foundation. The Research Council of Norway through its Centres of Excellence funding scheme, project number 262700. None of the authors has any conflicts of interests to declare regarding this study. TRIAL REGISTRATION NUMBER ISRCTN11780826.
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Affiliation(s)
- A L Spangmose
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - E Ginström Ernstad
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S Malchau
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - J Forman
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - A Tiitinen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - M Gissler
- Information Services Department, Finnish Institute for Health and Welfare (THL), Helsinki, Finland and Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - S Opdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - L B Romundstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Spiren Fertility Clinic, Trondheim, Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - C Bergh
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - U B Wennerholm
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - A A Henningsen
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A Pinborg
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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15
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Abstract
A wealth of demographic research has explored the determinants of sex ratios at birth, but few studies have considered the role of foetal loss (spontaneous abortion), in producing feminine sex ratios. One challenge is measuring the occurrence of foetal loss, which is difficult to recognize and report in survey research. This study uses the length of the birth interval as a proxy for foetal loss; foetal loss restarts the clock on time to conception and lengthens the birth interval. We use Demographic and Health Survey data on second births to women in 17 sub-Saharan African countries. Results show that longer second birth intervals are significantly related to lower odds of a male second birth and to feminine sex ratios at birth. These findings suggest that high levels of foetal loss, which could signal underlying poor maternal health in a population, have dramatic effects on the sex ratio at birth.
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16
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Kawase Y, Tachibe T, Kamada N, Jishage K, Watanabe H, Suzuki H. Male advantage observed for in vitro fertilization mouse embryos exhibiting early cleavage. Reprod Med Biol 2021; 20:83-87. [PMID: 33488287 PMCID: PMC7812486 DOI: 10.1002/rmb2.12355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/02/2020] [Accepted: 10/08/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Mouse embryos forming blastocoele early vs those forming late are predominantly male. We examined whether the male advantage could be recognized at an earlier stage of development. METHODS The IVF embryos were classified into early, intermediate, and late development groups based on the time of the third cleavage, and the Zfy and Xist genes were detected to identify their sex in the classified embryos. Furthermore, embryos that were classified based on the time of the third cleavage were transferred to recipient animals and the sex ratio of the fetuses was determined at birth. RESULTS Approximately 90% of the early-developing embryos that exhibited third cleavage as early as 47 hours after insemination were male when analyzed using PCR at the blastocyst stage. PCR analysis showed that 61% of the intermediate-developing embryos (third cleavage occurring 48-50 hours after insemination) and 45% of late-developing embryos (third cleavage occurring at 51 hours or later postinsemination) were male. After embryo transfer, the early-developing embryos produced 80% males, while intermediate- and late-developing embryos produced 56% and 45% males, respectively. CONCLUSIONS Male embryos tend to develop faster than female embryos during early stage of preimplantation in mice.
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Affiliation(s)
- Yosuke Kawase
- Chugai Institute for Medical Science, IncGotembaJapan
| | | | - Nobuo Kamada
- Chugai Institute for Medical Science, IncGotembaJapan
| | | | - Hiroyuki Watanabe
- Obihiro University of Agriculture and Veterinary MedicineObihiroJapan
| | - Hiroshi Suzuki
- Obihiro University of Agriculture and Veterinary MedicineObihiroJapan
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17
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Garcia-Dominguez X, Juarez JD, Vicente JS, Marco-Jiménez F. Impact of embryo technologies on secondary sex ratio in rabbit. Cryobiology 2020; 97:60-65. [PMID: 33053364 DOI: 10.1016/j.cryobiol.2020.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/01/2020] [Accepted: 10/09/2020] [Indexed: 01/20/2023]
Abstract
Increasing evidence indicates that assisted reproductive technologies (ARTs) disturb skewed sex-ratio and induce sex-dimorphic postnatal effects. Undoubtedly, the combination of multiple ovulation and embryo transfer (MOET) together with the use of vitrification technique (MOVET) is currently being used in breeding programs. However, since the first case of sex skewing reported in 1991, the accumulative and long-term transmission of skewed sex-ratio to future generations has not been thoroughly evaluated. Here we test as MOVET program induce a skewed sex ratio, and we consider skewed sex ratio transmission to future generations. To this end, we first evaluated the F1 generation, demonstrating that a MOVET program causes a severe imbalance skewed secondary sex ratio (SSR) towards male by 12%. This imbalanced persist after a second MOVET program (F2 generation), with an accumulative skewed SSR towards male by 25%. Finally, using a crossbred generation derived from crossing F1 males derived from a MOVET program with naturally-conceived (NC) females, we show that the imbalance skewed SRR persist. Bodyweight comparison between MOVET animals and NC counterparts revealed significant changes at birth, weaning and adulthood. However, there was a significant interaction between F2 MOVET animals and sex, demonstrating an apparent accumulative sex-dimorphic effect. At adulthood, MOVET derived males presented a lower body weight. In conclusion, we show that the MOVET program causes a direct, accumulative and long-term transmission of skewed SSR.
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Affiliation(s)
- Ximo Garcia-Dominguez
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain
| | - Jorge D Juarez
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain
| | - José S Vicente
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain
| | - Francisco Marco-Jiménez
- Laboratory of Biotechnology of Reproduction, Institute for Animal Science and Technology (ICTA), Universitat Politècnica de València, 46022, Valencia, Spain.
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18
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Gerlinskaya LA, Litvinova EA, Kontsevaya GV, Feofanova NA, Achasova KM, Anisimova MV, Maslennikova SO, Zolotykh MA, Moshkin YM, Moshkin MP. Phenotypic variations in transferred progeny due to genotype of surrogate mother. Mol Hum Reprod 2020; 25:88-99. [PMID: 30445548 DOI: 10.1093/molehr/gay052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 11/15/2018] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION Does the genotype of the surrogate mother modulate the body composition and immunity of her offspring? SUMMARY ANSWER C57BL/6J (B6) progenies carried by immunodeficient NOD SCID (NS) mothers had increased adaptive but decreased innate, immune responsiveness in comparison with the same genotype offspring carried by immunocompetent mothers, B6 and BALB/c (C); the B6 progenies carried by the same genotype mothers also showed higher body fat than the others. WHAT IS KNOWN ALREADY Differences in the major histocompatibility complex (MHC) genes between mother and foetus is considered as an important factor in prenatal embryo development, whereas the impact of such dissimilarity on the phenotype of the mature progeny is unclear. STUDY DESIGN, SIZE, DURATION Transplantation of two-cell mouse embryos into recipient females of the different MHC (H2) genotypes was used as an approach to simulate three variants of the immunogenic mother-foetus interaction: (i) bidirectional immunogenic dialogue between B6 (H2b haplotype) embryos and C (H2d haplotype) surrogate mother; (ii) one-way immunogenic interaction between B6 embryos and immunodeficient NS (H2g7 haplotype) surrogate mother and (iii) reduced immunogenetic dialogue between embryos and surrogate mother of the same H2b haplotype resulting in only a maternal response to HY antigens of male foetuses. Delivered by Caesarean section, pups were fostered by lactating B6 females and weighed after weaning (n = 171). Body mass and composition and innate and adaptive immunity were assessed in selected progeny groups at 9-11 weeks of age. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was performed on the specific pathogen-free mouse, inbred strains C57BL/6J, NOD SCID and BALB/c. Plasma progesterone in pregnant females was measured by enzyme-linked immunosorbent assay (ELISA). Body composition was determined by magnetic resonance spectroscopy using a low-field NMR spectrometer (EchoMRI, USA). To assess peritoneal macrophage responses (innate immunity) to anthrax, lactate dehydrogenase (LDH) and interleukin-1 (IL-1β) were measured in a culture medium 24 h after the addition of both anthrax-lethal factor and anthrax-protective antigen. To assess adaptive immunity, 9-10 males in experimental groups were infected with Helicobacter hepaticus. Faeces collected 2 and 4 weeks after infection was used for quantitative assessment of the H. hepaticus DNA by real-time polymerase chain reaction. IgA, interferon (IFN-γ), tumour necrosis factor (TNFα), interleukin-17 (IL-17) and interleukin-10 (IL-10) in colon tissue and IgG in serum were determined in samples collected 4 weeks after gavage with H. hepaticus using ELISA. For statistical analyses, ANCOVA, post hoc least significant difference (LSD) test, Student's t-test, Spearman rank correlations and χ2 test were performed. P-value <0.05 was considered as a statistically significant difference. MAIN RESULTS AND THE ROLE OF CHANCE ANCOVA with litter size and age as covariates revealed significant effects of the surrogate mother genotype on body mass and percent of fat in their adult progeny (F2149 = 15.60, P < 0.001 and F2149 = 5.02, P = 0.007, respectively). Adult B6 mice carried by B6 surrogate mothers were characterized by a higher percentage of body fat in comparison with offspring that were carried by NS and C females. In comparison with the male offspring carried by the B6 and C mothers, male B6 progenies carried by immunodeficient NS mothers had a higher humoral immune response (serum IgG) against oral infection with H. hepaticus, but lower in vitro macrophage IL-1β reaction to the anthrax. Four weeks after the infection of offspring, concentrations of serum IgG and colon IL-10 correlated positively with maternal progesterone on Day 4 after embryo transfer and negatively with DNA of H. hepaticus. One-way ANOVA confirmed a statistically significant impact of surrogate mother genotype on adaptive (IgG) and innate (IL-1β) immunity (F2.26 = 26.39, P < 0.001 and F2.27 = 5.89, P = 0.008, respectively). LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION The main limitation of our study is the number of combinations of mother and foetus interactions, in particular, transfer of only one embryo genotype was used. Also, it is a descriptive study, which requires further analysis of the epigenetic mechanisms of the observed phenotypic effects of surrogate mother genotype. WIDER IMPLICATIONS OF THE FINDINGS Our experimental data demonstrate that the transfer of inbred embryos to surrogate mothers of the different genotypes is a prospective experimental model for the study of epigenetic effects of the immunogenetic interactions between mother and foetus. The experimental approach tested in our study will be in demand for the development of criteria for choosing surrogate mothers. In particular, immunocompetence of the surrogate mother along with genetic distance of her MHC alleles to the transferred embryos have a significant impact on offspring development. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Russian FPI (6/099/2017), budget projects (0324-2016-0002 and 0324-2018-0016) and implemented using the equipment of the Centre for Genetic Resources of Laboratory Animals at ICG SB RAS, supported by the Ministry of Education and Science of Russia (Unique project identifier RFMEFI62117X0015). The authors report no conflicts of interest.
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Affiliation(s)
- Ludmila A Gerlinskaya
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Ekaterina A Litvinova
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Galina V Kontsevaya
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Natalia A Feofanova
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia.,Laboratory of clinical immunopathology, Research Institute of Fundamental and Clinical Immunology, Novosibirsk, Russia
| | - Ksenia M Achasova
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Margarita V Anisimova
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Svetlana O Maslennikova
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Maria A Zolotykh
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Yuri M Moshkin
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
| | - Mikhail P Moshkin
- Department of Experimental Animal Genetic Resources, Laboratory of the Genetics of Experimental Animals, Institute of Cytology and Genetics SB RAS, Novosibirsk, Russia
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19
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Supramaniam PR, Granne I, Ohuma EO, Lim LN, McVeigh E, Venkatakrishnan R, Becker CM, Mittal M. ICSI does not improve reproductive outcomes in autologous ovarian response cycles with non-male factor subfertility. Hum Reprod 2020; 35:583-594. [DOI: 10.1093/humrep/dez301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 12/12/2019] [Accepted: 12/18/2019] [Indexed: 12/27/2022] Open
Abstract
Abstract
STUDY QUESTION
Does the method of fertilisation improve reproductive outcomes in poor ovarian response (POR) cycles when compared to all other ovarian response categories in the absence of male factor subfertility?
SUMMARY ANSWER
ICSI does not confer any benefit in improving the clinical pregnancy or live birth (LB) outcome in autologous ovarian response cycles in the absence of male factor subfertility when compared to IVF.
WHAT IS KNOWN ALREADY
ICSI is associated with an improved outcome when compared to IVF in patients with severe male factor subfertility.
STUDY DESIGN, SIZE, DURATION
A retrospective study involving 1 376 454 ART cycles, of which 569 605 (41.4%) cycles fulfilled the inclusion and exclusion criteria for all autologous ovarian response categories: 272 433 (47.8%) IVF cycles and 297 172 (52.2%) ICSI cycles. Of these, the POR cohort represented 62 641 stimulated fresh cycles (11.0%): 33 436 (53.4%) IVF cycles and 29 205 (46.6%) ICSI cycles.
PARTICIPANTS/MATERIALS, SETTING, METHOD
All cycles recorded on the anonymised Human Fertilisation and Embryology Authority (HFEA) registry database between 1991 and 2016 were analysed. All fresh cycles with normal sperm parameters, performed after 1998 were included: frozen cycles, donor oocyte and sperm usage, intrauterine insemination cycles, preimplantation genetic testing (PGT) for aneuploidies (PGT-A), PGT for monogenic/single gene defects (PGT-M), PGT for chromosomal structural arrangements (PGT-SR) cycles, where the reason for stimulation was for storage and unstimulated cycles were excluded.
MAIN RESULTS AND THE ROLE OF CHANCE
ICSI did not confer any benefit in improving the LB outcome when compared to conventional IVF per treatment cycle (PTC), when adjusted for female age, number of previous ART treatment cycles, number of previous live births through ART, oocyte yield, stage of transfer, method of fertilisation and number of embryos transferred in the POR cohort (adjusted odds ratio [a OR] 1.03, 99.5% confidence interval [CI] 0.96–1.11, P = 0.261) and all autologous ovarian response categories (aOR 1.00, 99.5% CI 0.98–1.02, P = 0.900). The mean fertilisation rate was statistically lower for IVF treatment cycles (64.7%) when compared to ICSI treatment cycles (67.2%) in the POR cohort (mean difference −2.5%, 99.5% CI −3.3 to −1.6, P < 0.001). The failed fertilisation rate was marginally higher in IVF treatment cycles (17.3%, 95% binomial exact 16.9 to 17.7%) when compared to ICSI treatment cycles (17.0%, 95% binomial exact 16.6 to 17.4%); however, this did not reach statistical significance (P = 0.199). The results followed a similar trend when analysed for all autologous ovarian response categories with a higher rate of failed fertilisation in IVF treatment cycles (4.8%, 95% binomial exact 4.7 to 4.9%) when compared to ICSI treatment cycles (3.2%, 95% binomial exact 3.1 to 3.3%) (P < 0.001).
LIMITATIONS, REASONS FOR CAUTION
The quality of data is reliant on the reporting system. Furthermore, success rates through ART have improved since 1991, with an increased number of blastocyst-stage embryo transfers. The inability to link the treatment cycle to the individual patient meant that we were unable to calculate the cumulative LB outcome per patient.
WIDER IMPLICATIONS OF THE FINDINGS
This is the largest study to date which evaluates the impact of method of fertilisation in the POR patient and compares this to all autologous ovarian response categories. The results demonstrate that ICSI does not confer any benefit in improving reproductive outcomes in the absence of male factor subfertility, with no improvement seen in the clinical pregnancy or LB outcomes following a fresh treatment cycle.
STUDY FUNDING/COMPETING INTEREST(S)
The study received no funding. C.M.B. is a member of the independent data monitoring group for a clinical endometriosis trial by ObsEva. He is on the scientific advisory board for Myovant and medical advisory board for Flo Health. He has received research grants from Bayer AG, MDNA Life Sciences, Volition Rx and Roche Diagnostics as well as from Wellbeing of Women, Medical Research Council UK, the NIH, the UK National Institute for Health Research and the European Union. He is the current Chair of the Endometriosis Guideline Development Group for ESHRE and was a co-opted member of the Endometriosis Guideline Group by the UK National Institute for Health and Care Excellence (NICE). I.G. has received research grants from Bayer AG, Wellbeing of Women, the European Union and Finox.
TRIAL REGISTRATION NUMBER
Not applicable.
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Affiliation(s)
- P R Supramaniam
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - I Granne
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - E O Ohuma
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
- Centre for Global Child Health & Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada M5G 2L3
| | - L N Lim
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - E McVeigh
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - R Venkatakrishnan
- Department of Obstetrics and Gynaecology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK
| | - C M Becker
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
- Oxford Reproductive Medicine, The Manor Hospital, Oxford OX3 7RP, UK
| | - M Mittal
- Department of Obstetrics and Gynaecology, Wolfson Fertility Center, St Mary’s and Hammersmith Hospitals, Imperial College Healthcare NHS Trust, London W2 1NY, UK
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20
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Widen EM, Nichols AR, Kahn LG, Factor-Litvak P, Insel BJ, Hoepner L, Dube SM, Rauh V, Perera F, Rundle A. Prepregnancy obesity is associated with cognitive outcomes in boys in a low-income, multiethnic birth cohort. BMC Pediatr 2019; 19:507. [PMID: 31862007 PMCID: PMC6924019 DOI: 10.1186/s12887-019-1853-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 11/22/2019] [Indexed: 01/13/2023] Open
Abstract
Background Maternal obesity and high gestational weight gain (GWG) disproportionally affect low-income populations and may be associated with child neurodevelopment in a sex-specific manner. We examined sex-specific associations between prepregnancy BMI, GWG, and child neurodevelopment at age 7. Methods Data are from a prospective low-income cohort of African American and Dominican women (n = 368; 44.8% male offspring) enrolled during the second half of pregnancy from 1998 to 2006. Neurodevelopment was measured using the Wechsler Intelligence Scale for Children (WISC-IV) at approximately child age 7. Linear regression estimated associations between prepregnancy BMI, GWG, and child outcomes, adjusting for race/ethnicity, marital status, gestational age at delivery, maternal education, maternal IQ and child age. Results Overweight affected 23.9% of mothers and obesity affected 22.6%. At age 7, full-scale IQ was higher among girls (99.7 ± 11.6) compared to boys (96.9 ± 13.3). Among boys, but not girls, prepregnancy overweight and obesity were associated with lower full-scale IQ scores [overweight β: − 7.1, 95% CI: (− 12.1, − 2.0); obesity β: − 5.7, 95% CI: (− 10.7, − 0.7)]. GWG was not associated with full-scale IQ in either sex. Conclusions Prepregnancy overweight and obesity were associated with lower IQ among boys, but not girls, at 7 years. These findings are important considering overweight and obesity prevalence and the long-term implications of early cognitive development.
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Affiliation(s)
- Elizabeth M Widen
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, 103 W 24TH ST A2703, Austin, TX, 78712, USA. .,Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.
| | - Amy R Nichols
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, 103 W 24TH ST A2703, Austin, TX, 78712, USA.,Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University School of Medicine, 403 East 34th St, New York, NY, 10016, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA
| | - Beverly J Insel
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA.,Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lori Hoepner
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.,Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Environmental and Occupational Health Sciences, SUNY Downstate Medical Center, School of Public Health, 450 Clarkson Avenue, MSC 43, Brooklyn, NY, 11203, USA
| | - Sara M Dube
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, 103 W 24TH ST A2703, Austin, TX, 78712, USA.,Department of Nutritional Sciences, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Virginia Rauh
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B-2, Room 213, New York, NY, 10032, USA
| | - Frederica Perera
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA
| | - Andrew Rundle
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, 12th Floor, New York, NY, 10032, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168 Street Room 1614, New York, NY, 10032, USA
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21
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Kirshenbaum M, Feldman B, Aizer A, Haas J, Orvieto R. Preimplantation embryos sex ratios in couples with four or more children of same sex, what should be expected from a preimplantation genetic diagnosis cycle? Gynecol Endocrinol 2019; 35:515-517. [PMID: 30741052 DOI: 10.1080/09513590.2018.1563886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Our aim was to assess the preimplantation embryos' sex ratios in couples with four or more children of same sex, undergoing sex selection for nonmedical reasons. We conducted a cohort-historical study of all consecutive patients admitted to the IVF-PGD program in a large tertiary center. We reviewed the computerized files of all consecutive women admitted to our IVF for sex selection for nonmedical reasons. Patients and their PGD cycle characteristics were compared according to the desired sex of their embryo and the mode of fertilization. Nine patients underwent a total of 19 PGD cycle attempts during the study period. Of the 77 embryos with complete molecular diagnosis, 41 revealed a male embryo and 36 a female embryo. Thirty-five percent of all the diagnosed embryos were of the desired sex. For couples desiring a boy, IVF cycles achieved a higher ratio of the desired embryonal sex compared to ICSI (52% vs 18.7%, p = .03). For couples desiring a girl, ICSI cycles had a higher percentage of the desired embryonal sex compared to IVF cycles (38% vs 23%). Moreover, 29.7% of ICSI and 40% of IVF embryos achieved the desired sex. In conclusion, PGD for sex selection results in a relatively low percentage (35%) of embryos demonstrating the desired sex. Nonetheless, selecting the mode of fertilization (ICSI/IVF) might improve the success rate. Further studies are required to explore the appropriate and cost-effective method for sex selection for nonmedical reasons.
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Affiliation(s)
- Michal Kirshenbaum
- a Department of Obstetrics and Gynecology , Sheba Medical Center , Ramat-Gan , Israel
- b Sackler School of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Baruch Feldman
- a Department of Obstetrics and Gynecology , Sheba Medical Center , Ramat-Gan , Israel
- b Sackler School of Medicine , Tel Aviv University , Tel Aviv , Israel
- c Sheba Medical Center , Danek Gertner Institute of Human Genetics , Ramat-Gan , Israel
| | - Adva Aizer
- a Department of Obstetrics and Gynecology , Sheba Medical Center , Ramat-Gan , Israel
| | - Jigal Haas
- a Department of Obstetrics and Gynecology , Sheba Medical Center , Ramat-Gan , Israel
- b Sackler School of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Raoul Orvieto
- a Department of Obstetrics and Gynecology , Sheba Medical Center , Ramat-Gan , Israel
- b Sackler School of Medicine , Tel Aviv University , Tel Aviv , Israel
- d The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine , Tel-Aviv University , Israel
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22
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Zhou Q, Wang T, Leng L, Zheng W, Huang J, Fang F, Yang L, Chen F, Lin G, Wang WJ, Kristiansen K. Single-cell RNA-seq reveals distinct dynamic behavior of sex chromosomes during early human embryogenesis. Mol Reprod Dev 2019; 86:871-882. [PMID: 31094050 DOI: 10.1002/mrd.23162] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/21/2019] [Accepted: 04/11/2019] [Indexed: 12/20/2022]
Abstract
Several animal and human studies have demonstrated that sex affects kinetics and metabolism during early embryo development. However, the mechanism governing these differences at the molecular level before the expression of the sex-determining gene SRY is unknown. We performed a systematic profiling of gene expression comparing male and female embryos using available single-cell RNA-sequencing data of 1607 individual cells from 99 human preimplantation embryos, covering development stages from 4-cell to late blastocyst. We observed consistent chromosome-wide transcription of autosomes, whereas expression from sex chromosomes exhibits significant differences after embryonic genome activation (EGA). Activation of the Y chromosome is initiated by expression of two genes, RPS4Y1 and DDX3Y, whereas the X chromosome is widely activated, with both copies in females being activated after EGA. In contrast to the stable activation of the Y chromosome, expression of X-linked genes in females declines at the late blastocyst stage, especially in trophectoderm cells, revealing a rapid process of dosage compensation. This dynamic behavior results in a dosage imbalance between male and female embryos, which influences genes involved in cell cycle, protein translation and metabolism. Our results reveal the dynamics of sex chromosomes expression and silencing during early embryogenesis. Studying sex differences during human embryogenesis, as well as understanding the process of X chromosome inactivation and their effects on the sex bias development of in vitro fertilized embryos, will expand the capabilities of assisted reproductive technology and possibly improve the treatment of infertility and enhance reproductive health.
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Affiliation(s)
- Qing Zhou
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China.,Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Taifu Wang
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China.,BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, China
| | - Lizhi Leng
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Key Laboratory of Reproductive and Stem Cells Engineering, Ministry of Health, Changsha, China
| | - Wei Zheng
- Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Jinrong Huang
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Fang Fang
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Ling Yang
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Fang Chen
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China.,Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Key Laboratory of Reproductive and Stem Cells Engineering, Ministry of Health, Changsha, China.,Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, China.,National Engineering and Research Center of Human Stem Cell, Changsha, China
| | - Wen-Jing Wang
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Karsten Kristiansen
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China.,Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
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23
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Comparison of perinatal outcomes following blastocyst and cleavage-stage embryo transfer: analysis of 10 years' data from a single centre. Reprod Biomed Online 2019; 38:967-978. [PMID: 30975585 DOI: 10.1016/j.rbmo.2018.12.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/28/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022]
Abstract
RESEARCH QUESTION Are there greater risks of adverse perinatal outcomes, in particular of congenital malformations, after blastocyst transfer compared with cleavage-stage embryo transfer in IVF? DESIGN This was a retrospective cohort analysis from a centre for assisted reproduction at a public hospital in China over the period 2006-2015. The analysis covered all women who conceived (15,254) and newborns (16,213) from IVF/intracytoplasmic sperm injection (ICSI) cycles with cleavage-stage embryo transfer or blastocyst transfer. The principal outcome measures were congenital malformations, preterm birth (PTB), low birthweight (LBW), small for gestational age (SGA) and large for gestational age (LGA). RESULTS Logistic regression analysis showed that the sex ratio was imbalanced towards male neonates after blastocyst transfer (P=0.001; adjusted OR 1.17, 95%CI 1.07-1.30) but there were no differences in rates of miscarriage, ectopic pregnancy, stillbirth, very preterm birth (<32 weeks), PTB (<37 weeks), LBW, SGA or LGA between blastocyst transfer and cleavage-stage embryo transfer. A total of 176 congenital malformations (123 cleavage-stage embryos versus 53 blastocysts) were identified both in newborns and aborted fetuses, but the difference between groups was not statistically significant. CONCLUSIONS There was no difference in the risks of adverse perinatal outcomes, and in particular of congenital malformation, after blastocyst transfer compared with cleavage-stage transfer, although there was a sex ratio imbalance towards male neonates after blastocyst transfer.
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24
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Win MC, Majeed N, Zheng C, Polyakov A, Pucci M, Tarmizi M. Secondary sex ratio of assisted reproductive technology babies. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2019. [DOI: 10.4103/2305-0500.254651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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25
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Effect of assisted reproductive technology on the molecular karyotype of missed abortion tissues. Biosci Rep 2018; 38:BSR20180605. [PMID: 30139813 PMCID: PMC6435534 DOI: 10.1042/bsr20180605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/16/2018] [Accepted: 08/07/2018] [Indexed: 12/14/2022] Open
Abstract
Missed abortion is one of the common complications of assisted reproductive technology (ART). Genetic abnormality is the most important factor. However, the effect of ART on the molecular karyotype of products of conception (POC) remains unknown. We explored the effect of ART on the molecular karyotype of POC in miscarriage. POC were obtained from women undergoing ART. Single nucleotide polymorphism (SNP) microarray was used to analyze the molecular karyotype. A total of 1493 POC were collected for SNP array analysis. The total rate of karyotypic abnormalities was 63.1% (943/1493). The proportion of karyotypic abnormalities was 70.4% (193/416) in >35-year-old group, which was significantly higher than that (60.6%) (343/566) in <30-year-old group and that (60%) (307/511) in the 30–35-year-old group. In natural conception (NC) group, the proportion of karyotypic abnormalities was 64.6% (201/311), whereas in ART group it was 62.7% (742/1182) and, there was no significant difference. The ratio between male and female fetuses was 1:1.13 (698/795). The rate of karyotypic abnormalities in male was 62.9% (439/698) and that in female was 63.4% (504/795), and these values did not differ significantly (P=0.84). Molecular karyotypic abnormality is the most important reason in miscarriage, and female age is a significant factor influencing the karyotypic abnormalities. Comparison with NC, ART, and gender of aborted embryos may not increase the rate of molecular karyotypic abnormality in miscarriage.
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26
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Al-Jaroudi D, Salim G, Baradwan S. Neonate female to male ratio after assisted reproduction following antagonist and agonist protocols. Medicine (Baltimore) 2018; 97:e12310. [PMID: 30235681 PMCID: PMC6160105 DOI: 10.1097/md.0000000000012310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 08/15/2018] [Indexed: 11/26/2022] Open
Abstract
We retrospectively compared neonatal sex after antagonist- versus long-stimulation protocols followed by fresh in vitro fertilization (IVF) or fresh intracytoplasmic sperm injection (ICSI) with either protocol. We reviewed data for 762 IVF/ICSI cycles in 2015, including 23 IVF procedures. We summarized sex outcomes in the entire cohort, and for the additional subgroups: embryo transfer day and number of embryos transferred, and number of oocytes recovered and maternal age. Among 169 live births for all protocols combined, 50.9% of babies were male, and we saw no difference between the antagonist versus long-stimulation groups (52.3% vs 48.3% male babies, respectively; P = .740). Our results also showed no significant difference in sex proportion when comparing IVF versus ICSI, although a higher proportion of babies were male with the antagonist-ICSI protocol. Differences between the additional subgroups were also neither clinically nor statistically significant.
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Affiliation(s)
| | - Gamar Salim
- Reproductive Endocrine and Infertility Medicine Department
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Saudi Arabia
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27
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Marei WFA, Khalil WA, Pushpakumara APG, El-Harairy MA, Abo El-Atta AMA, Wathes DC, Fouladi-Nashta A. Polyunsaturated fatty acids influence offspring sex ratio in cows. Int J Vet Sci Med 2018; 6:S36-S40. [PMID: 30761319 PMCID: PMC6161865 DOI: 10.1016/j.ijvsm.2018.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 01/14/2018] [Accepted: 01/30/2018] [Indexed: 01/08/2023] Open
Abstract
Dietary polyunsaturated fatty acids (PUFAs) can influence fertility in farm animals. Some evidence in mice and sheep have suggested that PUFAs may influence offspring sex ratio, which may have significant value for cattle production. To test this hypothesis, three groups of Holstein cows were supplemented with either 0%, 3% or 5% protected fat (PF) in the form of calcium salt of fatty acids (rich in omega-6) from 14–21 days pre-partum until conception. Proven-fertile frozen semen from the same ejaculate was used for insemination. Calf sex recorded at birth was 8/19 (42.1%) male offspring in the control group, increasing to 14/20 (70%, P > 0.05) and 17/20 (85%, P < 0.05) in 3% and 5% PF, respectively. To test if this effect was caused by a direct influence on the oocyte, we supplemented bovine cumulus oocyte complexes during in vitro maturation with either omega-3 alpha-linolenic acid (ALA), omega-6 linoleic acid (LA) or trans-10, cis-12 conjugated linoleic acid (CLA). Sex ratio of the produced transferable embryos was determined using PCR of SRY gene. Similar to the in vivo results, sex ratio was skewed to the male side in the embryos derived from LA- and CLA-treated oocytes (79% and 71%) compared to control and ALA-treated oocytes (44% and 54%, respectively). These results indicate that both dietary and in vitro supplementation of omega-6 PUFAs can skew the sex ratio towards the male side in cattle. Further experiments are required to confirm this effect on a larger scale and to study the mechanisms of action that might be involved.
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Affiliation(s)
- Waleed F A Marei
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt
| | - Wael A Khalil
- Department of Animal Production, Faculty of Agriculture, Mansoura University, Mansoura 35516, Egypt
| | - Anil P G Pushpakumara
- Department of Farm Animal Production and Health, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Sri Lanka
| | - Mostafa A El-Harairy
- Department of Animal Production, Faculty of Agriculture, Mansoura University, Mansoura 35516, Egypt
| | - Ahmed M A Abo El-Atta
- Department of Animal Production, Faculty of Agriculture, Mansoura University, Mansoura 35516, Egypt
| | - D Claire Wathes
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield AL9 7TA, UK
| | - Ali Fouladi-Nashta
- Department of Comparative Biomedical Sciences, Royal Veterinary College, Hatfield AL9 7TA, UK
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Pérez-Cerezales S, Ramos-Ibeas P, Rizos D, Lonergan P, Bermejo-Alvarez P, Gutiérrez-Adán A. Early sex-dependent differences in response to environmental stress. Reproduction 2017; 155:R39-R51. [PMID: 29030490 DOI: 10.1530/rep-17-0466] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 12/14/2022]
Abstract
Developmental plasticity enables the appearance of long-term effects in offspring caused by exposure to environmental stressors during embryonic and foetal life. These long-term effects can be traced to pre- and post-implantation development, and in both cases, the effects are usually sex specific. During preimplantation development, male and female embryos exhibit an extensive transcriptional dimorphism mainly driven by incomplete X chromosome inactivation. These early developmental stages are crucial for the establishment of epigenetic marks that will be conserved throughout development, making it a particularly susceptible period for the appearance of long-term epigenetic-based phenotypes. Later in development, gonadal formation generates hormonal differences between the sexes, and male and female placentae exhibit different responses to environmental stressors. The maternal environment, including hormones and environmental insults during pregnancy, contributes to sex-specific placental development that controls genetic and epigenetic programming during foetal development, regulating sex-specific differences, including sex-specific epigenetic responses to environmental hazards, leading to long-term effects. This review summarizes several human and animal studies examining sex-specific responses to environmental stressors during both the periconception period (caused by differences in sex chromosome dosage) and placental development (caused by both sex chromosomes and hormones). The identification of relevant sex-dependent trajectories caused by sex chromosomes and/or sex hormones is essential to define diagnostic markers and prevention/intervention protocols.
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Affiliation(s)
| | | | | | - Pat Lonergan
- School of Agriculture and Food ScienceUniversity College Dublin, Dublin, Ireland
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Chen M, Du J, Zhao J, Lv H, Wang Y, Chen X, Zhang J, Hu L, Jin G, Shen H, Hu Z, Xiong F, Chen L, Ling X. The sex ratio of singleton and twin delivery offspring in assisted reproductive technology in China. Sci Rep 2017; 7:7754. [PMID: 28839144 PMCID: PMC5570918 DOI: 10.1038/s41598-017-06152-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 06/09/2017] [Indexed: 12/28/2022] Open
Abstract
In order to evaluate the impact of assisted reproductive technology (ART) procedure and individual factors on the sex ratio of singletons and twins at birth after in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) treatment in China. We conducted a retrospective cohort study including patients undergoing their first cycle of IVF or ICSI with autologous oocytes from 2001 to 2015. A total of 7410 babies were born from 5832 women with 7410 live birth. The secondary sex ratio (SSR) in singletons was significantly higher than twins (53.97% vs. 50.89%, P = 0.009). The largest disparity was observed in ‘thawed blastocyst embryos ICSI’ subgroup that SSR was 59.84% in singletons and 42.45% in twins (P = 0.013). Blastocyst transfer was positively associated with elevated SSR when compared to cleavage stage embryos in singletons (Odds Ratio [OR] = 1.17, P < 0.001). In addition, paternal age was significantly associated with SSR (OR = 0.75, P = 0.014). While the decrease of SSR was significantly associated with ICSI when compared to IVF (OR = 0.61, P = 0.046) in twins. Blastocyst transfer increases SSR in comparing with cleavage stage embryos in singletons, while the use of ICSI reduces SSR in twins. Our findings offered important complement for better understanding the underlying determinant of SSR in ART offspring.
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Affiliation(s)
- Mengxi Chen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Jing Zhao
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Reproduction, the Affiliated Nanjing Maternity and Child Health Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yifeng Wang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - XiaoJiao Chen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Reproduction, the Affiliated Nanjing Maternity and Child Health Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Junqiang Zhang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Reproduction, the Affiliated Nanjing Maternity and Child Health Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Lingmin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Reproduction, the Affiliated Changzhou Maternity and Child Health Hospital of Nanjing Medical University, Changzhou, 213003, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Hongbing Shen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Fang Xiong
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China. .,Department of Reproduction, the Affiliated Wuxi Maternity and Child Health Hospital of Nanjing Medical University, Wuxi, 214002, China.
| | - Li Chen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China. .,Department of Reproduction, the Affiliated Changzhou Maternity and Child Health Hospital of Nanjing Medical University, Changzhou, 213003, China.
| | - Xiufeng Ling
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, China. .,Department of Reproduction, the Affiliated Nanjing Maternity and Child Health Hospital of Nanjing Medical University, Nanjing, 210004, China.
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Abstract
The human sex ratio (proportion male) at birth (SRB) varies with many variables. Some of this variation has an established proximate cause. For instance, low SRB (more females) at birth are associated with various forms of stressful events or circumstances during or prior to pregnancy. These low SRB are almost certainly mainly caused by maternal-stress-induced male foetal loss. Other types of SRB variation are thought to be caused by hormonal variation in either or both parents around the time of conception. One or other of these two types of proximate cause seems to be responsible for most of the established variation of SRB. This will be illustrated here in respect of some selected forms of SRB variation. It seems likely that a clarification of the hormonal causes of SRB variation will also help explain the striking (apparent) inconsistencies in the results of reported tests of the influential Trivers-Willard hypothesis. It is further proposed that an appreciation of the evidence that parental hormones influence SRB may enhance understanding of several important pathologies (hepatitis B, toxoplasmosis, testicular cancer, prostate cancer and autism).
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Affiliation(s)
- William H James
- The Galton Laboratory, Department of Genetics, Evolution and Environment, University College London, United Kingdom.
| | - Victor Grech
- Department of Paediatrics, Mater Dei Hospital Medical School, Malta.
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Sotiroska V, Petanovski Z, Dimitrov G, Hadji-Lega M, Shushleski D, Saltirovski S, Matevski V, Shenbakar S, Panov S, Johansson L. The day of embryo transfer affects delivery rate, birth weights, female-to-male ratio, and monozygotic twin rate. Taiwan J Obstet Gynecol 2016; 54:716-21. [PMID: 26700991 DOI: 10.1016/j.tjog.2015.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To compare the reproductive outcomes between the transfer of cleavage-stage embryos and blastocysts in two different age groups of patients. The reproductive capacity of women decreases by age. This decrease in capacity is directly related to a lower ovarian reserve and errors in the meiotic spindle of the oocyte, which increase chromosomal abnormalities and the formation of aneuploidy embryos with lower chances of implantation. MATERIALS AND METHODS A total of 1400 intracytoplasmic sperm injection cycles were analyzed. The study patients were divided into two age groups [aged < 36 years (Group I) and aged ≧ 36 years (Group II)]. The groups were subdivided according to the day of embryo transfer (ET)-Day 3 (ET3) and Day 5 (ET5). RESULTS In both age groups, transfer of blastocysts resulted in a higher clinical pregnancy rate and deliveries. An increased twin birth rate was observed in patients who were younger than 36 years on both transfer days compared with those who were older than 36 years of age. There was an elevated percentage of newborn males on ET5 in both age groups. Monozygotic twinning (MZT) rate was observed only among younger patients (<36 years of age), specifically on ET5 compared with ET3. There was no significant difference in the mean birth weight of singleton and twins between the ET3 and ET5 subgroups in the younger group of patients except for the triplets who were significantly heavier in the ET5 group compared with the older group (≧36 years of age) where significant difference was found only on the mean birth weight of singleton. CONCLUSION The study suggests that if a blastocyst can be obtained in patients of advanced age (≧36 years), it improves their baby take-home rates. Younger patients (aged < 36 years) should undergo elective single blastocyst transfers to reduce multiple pregnancy rates.
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Affiliation(s)
- Valentina Sotiroska
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia.
| | - Zorancho Petanovski
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia
| | - Gligor Dimitrov
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia
| | - Makjuli Hadji-Lega
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia
| | - Damjan Shushleski
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia
| | - Stefan Saltirovski
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia
| | - Vladimir Matevski
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia
| | - Simona Shenbakar
- Center for Assisted Reproduction and IVF Fertilization, General Private Hospital-Remedika, Skopje, Macedonia
| | - Sasho Panov
- Institute for Biology, Faculty for Natural Science and Mathematics, Saints Cyril and Methodius University, Skopje, Macedonia
| | - Lars Johansson
- Reproductive Centre, Women's Clinic, Academic Hospital, Uppsala, Sweden
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Nasr Esfahani MH, Deemeh MR, Tavalaee M, Sekhavati MH, Gourabi H. Zeta Sperm Selection Improves Pregnancy Rate and Alters Sex Ratio in Male Factor Infertility Patients: A Double-Blind, Randomized Clinical Trial. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:253-60. [PMID: 27441060 PMCID: PMC4948079 DOI: 10.22074/ijfs.2016.4917] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 01/24/2016] [Indexed: 11/21/2022]
Abstract
Background Selection of sperm for intra-cytoplasmic sperm injection (ICSI) is usually
considered as the ultimate technique to alleviate male-factor infertility. In routine ICSI,
selection is based on morphology and viability which does not necessarily preclude the
chance injection of DNA-damaged or apoptotic sperm into the oocyte. Sperm with high
negative surface electrical charge, named “Zeta potential”, are mature and more likely to
have intact chromatin. In addition, X-bearing spermatozoa carry more negative charge.
Therefore, we aimed to compare the clinical outcomes of Zeta procedure with routine
sperm selection in infertile men candidate for ICSI. Materials and Methods From a total of 203 ICSI cycles studied, 101 cycles were
allocated to density gradient centrifugation (DGC)/Zeta group and the remaining 102
were included in the DGC group in this prospective study. Clinical outcomes were com-
pared between the two groups. The ratios of Xand Y bearing sperm were assessed
by fluorescence in situ hybridization (FISH) and quantitative polymerase chain reaction
(qPCR) methods in 17 independent semen samples. Results In the present double-blind randomized clinical trial, a significant increase in
top quality embryos and pregnancy rate were observed in DGC/Zeta group compared
to DGC group. Moreover, sex ratio (XY/XX) at birth significantly was lower in the
DGC/Zeta group compared to DGC group despite similar ratio of X/Y bearings sper-
matozoa following Zeta selection. Conclusion Zeta method not only improves the percentage of top embryo quality and
pregnancy outcome but also alters the sex ratio compared to the conventional DGC
method, despite no significant change in the ratio of Xand Ybearing sperm population
(Registration number: IRCT201108047223N1).
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Affiliation(s)
- Mohammad Hossein Nasr Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran; Isfahan Fertility and Infertility Center, Isfahan, Iran
| | | | - Marziyeh Tavalaee
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mohammad Hadi Sekhavati
- Department of Animal Science, Ferdowsi University of Mashhad, Mashhad, Iran; Embryonic and Stem Cell Biotechnology Research Group, Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Hamid Gourabi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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PARTIALLY CONSTRAINED SEX ALLOCATION AND THE INDIRECT EFFECTS OF ASSISTED REPRODUCTIVE TECHNOLOGIES ON THE HUMAN SEX RATIO. J Biosoc Sci 2016; 49:281-291. [PMID: 27090908 DOI: 10.1017/s0021932016000146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Infertility affects around 15% of human couples and in many countries approximately 1-4% of babies are born following Assisted Reproductive Technologies (ART). Several ART techniques are used and these differentially affect the sex ratio of offspring successfully produced. These direct effects on sex ratio also have the potential to influence, indirectly, the sex ratios of offspring born to untreated couples. This is of concern because human sex ratio bias may adversely affect public health. Here the extent of indirect effects of ART that could operate, via Fisherian frequency-dependent natural selection, on the progeny sex ratio of unassisted members of a population is heuristically modelled. Given the degrees to which ART techniques bias sex ratios directly, it is predicted that well over 20% of couples would have to reproduce via ART for there to be any discernible effect on the sex ratios produced, in response, by the remainder of the population. This value is greater than the estimated prevalence of infertility problems among human couples. It is concluded that providing ART to couples with fertility problems does not currently generate significant ethical issues or public health concern in terms of indirect effects on the offspring sex ratios of untreated couples.
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Tan K, Wang Z, Zhang Z, An L, Tian J. IVF affects embryonic development in a sex-biased manner in mice. Reproduction 2016; 151:443-53. [DOI: 10.1530/rep-15-0588] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/28/2016] [Indexed: 11/08/2022]
Abstract
Increasing evidence indicates that IVF (IVF includes in vitro fertilization and culture) embryos and babies are associated with a series of health complications, and some of them show sex-dimorphic patterns. Therefore, we hypothesized that IVF procedures have sex-biased or even sex-specific effects on embryonic and fetal development. Here, we demonstrate that IVF-induced side effects show significant sexual dimorphic patterns from the pre-implantation to the prenatal stage. During the pre-implantation stage, female IVF embryos appear to be more vulnerable to IVF-induced effects, including an increased percentage of apoptosis (7.22±1.94 vs 0.71±0.76, P<0.01), and dysregulated expression of representative sex-dimorphic genes (Xist, Hprt, Pgk1 and Hsp70). During the mid-gestation stage, IVF males had a higher survival rate than IVF females at E13.5 (male:female=1.33:1), accompanied with a female-biased pregnancy loss. In addition, while both IVF males and females had reduced placental vasculogenesis/angiogenesis, the compensatory placental overgrowth was more evident in IVF males. During the late-gestation period, IVF fetuses had a higher sex ratio (male:female=1.48:1) at E19.5, and both male and female IVF placentas showed overgrowth. After birth, IVF males grew faster than their in vivo (IVO) counterparts, while IVF females showed a similar growth pattern with IVO females. The present study provides a new insight into understanding IVF-induced health complications during embryonic and fetal development. By understanding and minimizing these sex-biased effects of the IVF process, the health of IVF-conceived babies may be improved in the future.
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Arikawa M, Jwa SC, Kuwahara A, Irahara M, Saito H. Effect of semen quality on human sex ratio in in vitro fertilization and intracytoplasmic sperm injection: an analysis of 27,158 singleton infants born after fresh single-embryo transfer. Fertil Steril 2015; 105:897-904. [PMID: 26738748 DOI: 10.1016/j.fertnstert.2015.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/18/2015] [Accepted: 12/03/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the effect of semen quality on human sex ratio in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). DESIGN Retrospective cohort study. SETTING Not applicable. PATIENT(S) A total of 27,158 singleton infants born between 2007 and 2012 after fresh single-embryo transfer. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Proportion of male infants among liveborn infants. RESULT(S) There were 14,996 infants born after IVF, 12,164 infants born after ICSI with ejaculated sperm, and 646 infants born after ICSI with nonejaculated sperm. The sex ratio of IVF was 53.1% (95% confidence interval [CI], 52.3-53.9); the sex ratio of ICSI with ejaculated and nonejaculated sperm demonstrated as statistically significant reduction (48.2%; 95% CI, 47.3-49.1 and 47.7%; 95% CI, 43.8-51.6, respectively). In IVF, lower sperm motility, including asthenozoospermia (sperm motility <40%), was associated with a statistically significantly lower sex ratio compared with normal sperm (51.0%; 95% CI, 48.6-53.3 vs. 53.4%; 95% CI, 52.5-54.3). In ICSI with ejaculated sperm, there was no association between sperm motility and sex ratio. Sperm concentration was not associated with sex ratio in both IVF and ICSI. CONCLUSION(S) In IVF, lower sperm motility was associated with a statistically significant reduction in sex ratio; ICSI with either ejaculated or nonejaculated sperm was associated with a statistically significant reduction in sex ratio regardless of semen quality.
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Affiliation(s)
- Mikiko Arikawa
- Division of Reproductive Medicine, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Seung Chik Jwa
- Division of Reproductive Medicine, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan; SORA no MORI Clinic, Okinawa, Japan.
| | - Akira Kuwahara
- Department of Obstetrics and Gynecology, School of Medicine, University of Tokushima, Tokushima, Japan
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, School of Medicine, University of Tokushima, Tokushima, Japan
| | - Hidekazu Saito
- Division of Reproductive Medicine, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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Ebner T, Tritscher K, Mayer RB, Oppelt P, Duba HC, Maurer M, Schappacher-Tilp G, Petek E, Shebl O. Quantitative and qualitative trophectoderm grading allows for prediction of live birth and gender. J Assist Reprod Genet 2015; 33:49-57. [PMID: 26572782 DOI: 10.1007/s10815-015-0609-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/28/2015] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Prolonged in vitro culture is thought to affect pre- and postnatal development of the embryo. This prospective study was set up to determine whether quality/size of inner cell mass (ICM) (from which the fetus ultimately develops) and trophectoderm (TE) (from which the placenta ultimately develops) is reflected in birth and placental weight, healthy live-birth rate, and gender after fresh and frozen single blastocyst transfer. METHODS In 225 patients, qualitative scoring of blastocysts was done according to the criteria expansion, ICM, and TE appearance. In parallel, all three parameters were quantified semi-automatically. RESULTS TE quality and cell number were the only parameters that predicted treatment outcome. In detail, pregnancies that continued on to a live birth could be distinguished from those pregnancies that aborted on the basis of TE grade and cell number. Male blastocysts had a 2.53 higher chance of showing TE of quality A compared to female ones. There was no correlation between the appearance of both cell lineages and birth or placental weight, respectively. CONCLUSIONS The presented correlation of TE with outcome indicates that TE scoring could replace ICM scoring in terms of priority. This would automatically require a rethinking process in terms of blastocyst selection and cryopreservation strategy.
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Affiliation(s)
- Thomas Ebner
- Department of Gynecological Endocrinology and Kinderwunsch Zentrum, Landes- Frauen- und Kinderklinik, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria. .,Department of Gynecology and Obstetrics, Kepler University Hospital, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria.
| | - Katja Tritscher
- Institute of Human Genetics, Medical University, Harrachgasse 21/8, 8010, Graz, Styria, Austria
| | - Richard B Mayer
- Department of Gynecological Endocrinology and Kinderwunsch Zentrum, Landes- Frauen- und Kinderklinik, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria.,Department of Gynecology and Obstetrics, Kepler University Hospital, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria.,Institute of Human Genetics, Medical University, Harrachgasse 21/8, 8010, Graz, Styria, Austria.,Department of Human Genetics, Landes- Frauen- und Kinderklinik, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria.,Department for Mathematics and Scientific Computing, Karl-Franzens-University Graz, Universitätsstr. 15, 8010, Graz, Styria, Austria
| | - Peter Oppelt
- Department of Gynecological Endocrinology and Kinderwunsch Zentrum, Landes- Frauen- und Kinderklinik, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria.,Department of Gynecology and Obstetrics, Kepler University Hospital, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria
| | - Hans-Christoph Duba
- Department of Human Genetics, Landes- Frauen- und Kinderklinik, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria
| | - Maria Maurer
- Department of Human Genetics, Landes- Frauen- und Kinderklinik, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria
| | - Gudrun Schappacher-Tilp
- Department for Mathematics and Scientific Computing, Karl-Franzens-University Graz, Universitätsstr. 15, 8010, Graz, Styria, Austria
| | - Erwin Petek
- Institute of Human Genetics, Medical University, Harrachgasse 21/8, 8010, Graz, Styria, Austria
| | - Omar Shebl
- Department of Gynecological Endocrinology and Kinderwunsch Zentrum, Landes- Frauen- und Kinderklinik, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria.,Department of Gynecology and Obstetrics, Kepler University Hospital, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria
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Würfel W. Der frühe Embryo. GYNAKOLOGISCHE ENDOKRINOLOGIE 2015. [DOI: 10.1007/s10304-015-0002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mekonen HK, Nigatu B, Lamers WH. Birth weight by gestational age and congenital malformations in Northern Ethiopia. BMC Pregnancy Childbirth 2015; 15:76. [PMID: 25886401 PMCID: PMC4381366 DOI: 10.1186/s12884-015-0507-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/19/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Studies on birth weight and congenital anomalies in sub-Saharan regions are scarce. METHODS Data on child variables (gestational age, birth weight, sex, and congenital malformations) and maternal variables (gravidity, parity, antenatal care, previous abortions, maternal illness, age, medication, and malformation history) were collected for all neonates delivered at Ayder referral and Mekelle hospitals (Northern Ehthiopia) in a prospective study between 01-12-2011 and 01-05-2012. RESULTS The total number of deliveries was 1516. More female (54%) than male neonates were born. Birth weights were 700-1,000 grams between 26 and 36 weeks of pregnancy and then increased linearly to 3,500-4,000 grams at 40 weeks. Thirty-five and 54% of neonates were very-low and low birth weight, respectively, without sex difference. Very-low birth-weight prevalence was not affected by parity. Male and female neonates from parity-2 and parity-2-4 mothers, respectively, were least frequently under weight. Sixty percent of newborns to parity -3 mothers weighed less than 2,500 grams, without sex difference. The percentage male neonates dropped from ~50% in parity-1-3 mothers to ~20% in parity-6 mothers. Diagnosed congenital malformations (~2%) were 2-fold more frequent in boys than girls. The commonest malformations were in the central nervous system (CNS; ~1.5% of newborns). Parity, low birth weight, gestational age less than 35 weeks, male sex, and lack of antenatal care were the most significant risk factors for congenital anomalies. CONCLUSION The high prevalence of neonates with low birth weight and CNS anomalies in Northern Ethiopia was very high. The findings may reflect the harsh conditions in the past 2 decades and suggest environmental and/or nutritional causes. Male sex and parity affected the outcome of pregnancy negatively.
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Affiliation(s)
- Hayelom K Mekonen
- Department of Anatomy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. .,Department of Anatomy & Embryology, Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Balkachew Nigatu
- Department of Gynaecology and Obstetrics, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | - Wouter H Lamers
- Department of Anatomy & Embryology, Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands.
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Zhu J, Zhuang X, Chen L, Liu P, Qiao J. Effect of embryo culture media on percentage of males at birth. Hum Reprod 2015; 30:1039-45. [DOI: 10.1093/humrep/dev049] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 02/11/2015] [Indexed: 11/13/2022] Open
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