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Lee CI, Wang TE, Chen CH, Huang CC, Tsao HM, Lee TH, Chang TA, Hsu CT, Lee MS. Personalized prediction model for miscarriage: in-depth sperm DNA fragmentation. J Assist Reprod Genet 2025:10.1007/s10815-025-03445-1. [PMID: 40131681 DOI: 10.1007/s10815-025-03445-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Accepted: 02/28/2025] [Indexed: 03/27/2025] Open
Abstract
PURPOSE We investigated how different types of sperm DNA fragmentation (SDF) in males, in conjunction with varying levels of female reproductive potential, jointly impact ICSI outcomes. METHODS We retrospectively analyzed 195 couples undergoing ICSI, categorizing them by normal or poor prognosis according to POSEIDON criteria. Female factors included age, anti-Müllerian hormone (AMH), and oocyte retrieval numbers. Male factors included semen parameters, total SDF, and specific double-strand breaks (DSBs). Reproductive outcomes were followed up at different gestational stages, including clinical pregnancy, early gestation failure, live birth, and miscarriage. Risk factors were identified using univariate and multivariable logistic regression, and their predictive power was assessed via the receiver operating characteristic (ROC) curve. RESULTS In the normal group, female factors were primarily associated with reproductive failures. Non-pregnancy cases had lower AMH (4 ng/mL vs. 3.2 ng/mL), and miscarriage cases had fewer oocytes retrieved (15 vs. 10.5). However, the risk factor profile was distinct in poor prognosis. Male factors, including reduced sperm motility (68% vs. 54.5%), lower normal sperm morphology (5.5% vs. 2.5%), and elevated DSBs (7.5% vs. 18.8%) were linked to miscarriage. DSBs presented as the independent predictor of miscarriage risk (odds ratio: 1.19, 95% CI: 1.04-1.36), with a DSB cutoff of 19% providing 81% accuracy in predicting miscarriage. CONCLUSION Paternal effect is pronounced in women with poor prognosis, where elevated DSBs are linked to an increased risk of miscarriage. We propose a refined pipeline in which DSB testing is considered as initial evaluation before assisted reproductive treatments, especially for infertile couples with poor prognosis.
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Affiliation(s)
- Chun-I Lee
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
| | - Tse-En Wang
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan
| | - Chien-Hong Chen
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hui-Mei Tsao
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
| | - Tiencheng Arthur Chang
- Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Cheng-Teng Hsu
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan.
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Yen DT, Son NK, Giang NTH, Quyen LT, Tho DN, Thuy TTD, Hoi NX. The Relationship Between Abnormal Morphokinetic Embryos, Genetic Testing Results, and Clinical Outcomes. Med Arch 2025; 79:4-8. [PMID: 40322304 PMCID: PMC12045586 DOI: 10.5455/medarh.2025.79.4-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Accepted: 04/02/2025] [Indexed: 05/08/2025] Open
Abstract
Background Embryo quality is a crucial factor in the success of in vitro fertilization (IVF). Morphokinetics, which refers to the timing and sequence of embryonic cell division and development, has gained attention as a potential indicator of embryo viability and genetic competence. Objective This study evaluates the relationship between abnormal embryonic morphokinetics and genetic analysis results, and their impact on clinical outcomes in assisted reproductive technology (ART). Methods Conducted at Duc Phuc Hospital with Hanoi Medical University from January to December 2023, the prospective study included 152 patients undergoing in-vitro fertilization (IVF). A total of 968 blastocysts were analyzed using preimplantation genetic testing for aneuploidy (PGT-A). Time-lapse monitoring assessed cell division milestones and abnormal morphokinetic patterns, including direct cleavage, reverse cleavage, multinucleation, and vacuole. Patients received a single euploid embryo transfer. Clinical outcomes were tracked to the live birth stage, analyzed using SPSS 20.0, with p-values < 0.05 considered significant. Results Of 583 blastocysts, 294 (50.4%) showed abnormal cleavage patterns. The aneuploidy rate was higher in embryos with reverse cleavage (56.1%) and multinucleation (50%), while direct cleavage and vacuolization showed no significant correlation. Early blastocyst formation (≥100 hours) was linked to a higher aneuploidy rate (60.8%). Nonetheless, clinical outcomes, such as β-hCG positivity and live birth rates, were similar between abnormal and normal cleavage groups when euploid embryos were transferred. Conclusion Abnormal morphokinetic patterns are linked to higher aneuploidy rates, but do not significantly affect clinical outcomes when euploid embryos are selected. Integrating genetic testing with morphokinetic assessment can optimize ART success rates.
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Affiliation(s)
- Diem Thi Yen
- Department of Histology and Embryology, Hanoi Medical University, Hanoi, Vietnam
- Assisted Reproductive Center, Duc Phuc Hospital, Hanoi, Vietnam
| | - Nguyen Khang Son
- Department of Histology and Embryology, Hanoi Medical University, Hanoi, Vietnam
| | | | - Le Thi Quyen
- Assisted Reproductive Center, Duc Phuc Hospital, Hanoi, Vietnam
| | - Doan Nhu Tho
- Assisted Reproductive Center, Duc Phuc Hospital, Hanoi, Vietnam
| | | | - Nguyen Xuan Hoi
- Center for Umbilical Cord Blood Stem Cell, National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam
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Si K, Ma B, Bai J, Wu L, He H, Jin L, Huang B. Preimplantation development analysis of aneuploid embryos with different chromosomal abnormalities. Heliyon 2024; 10:e40686. [PMID: 39687119 PMCID: PMC11647804 DOI: 10.1016/j.heliyon.2024.e40686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 10/27/2024] [Accepted: 11/22/2024] [Indexed: 12/18/2024] Open
Abstract
Background The change of morphokinetic pattern in aneuploid embryos will facilitate the non-invasive selection of euploid embryos. In this study, we investigated the impact of different chromosomal abnormalities on the morphokinetic patterns of embryonic development. Methods Our cohort includes 939 time-lapse preimplantation genetic testing cycles performed between January 2019 and July 2022 at a single academic fertility center, with a total of 2876 biopsied blastocysts. Intracytoplasmic sperm injection, blastocyst culture, trophectoderm biopsy, time-lapse monitoring, and next-generation sequencing were performed. Results After adjusting for patient- and cycle-related factors, six morphokinetic parameters (t5, P = 0.006; t8, P = 0.048; tSB, P < 0.001; tB,P < 0.001; t5-t2, P = 0.004; tB-tSB, P < 0.001) were significant in multilevel mixed-effects logistic regression model analysis for morphokinetic parameters to predict euploid or aneuploid embryos. None of the patient- or cycle-related factors systematically affected any morphokinetic parameter. Morphokinetic parameters of late cleavage and blastocyst stages in embryos with chromosome fragment deletion (t4 to t8, tB, t5-t2, tB-tSB, ECC2, ECC3, s2, P < 0.05) or duplication (t4, t5, tSB, tB, t5-t2, P < 0.05) were prolonged, and the morphokinetic parameters of the blastocyst stage in monosomic embryos (tSB, tB, tB-tSB, P < 0.01) were prolonged. Partial or complete chromosome 20 or 22 deletion can cause significant delays in multiple parameters of cleavage and blastocyst stages (from t4 to tB, P < 0.05). Conclusions Our study found that different chromosomal abnormalities have different effects on the morphokinetic parameters. Significant delays in morphokinetic parameters at different stages were found in fragment-mutated embryos and monosomic embryos. This can provide insights into the pre-implantation development pattern of aneuploid embryos and help non-invasive embryo selection.
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Affiliation(s)
- Keyi Si
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bingxin Ma
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jian Bai
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Li Wu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hui He
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bo Huang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Lee CI, Su CY, Chen HH, Huang CC, Cheng EH, Lee TH, Lin PY, Yu TN, Chen CI, Chen MJ, Lee MS, Chen CH. Investigating developmental characteristics of biopsied blastocysts stratified by mitochondrial copy numbers using time-lapse monitoring. Reprod Biol Endocrinol 2024; 22:89. [PMID: 39080754 PMCID: PMC11290074 DOI: 10.1186/s12958-024-01262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND For in vitro fertilization (IVF), mitochondrial DNA (mtDNA) levels in the trophectodermal (TE) cells of biopsied blastocysts have been suggested to be associated with the cells' developmental potential. However, scholars have reached differing opinions regarding the use of mtDNA levels as a reliable biomarker for predicting IVF outcomes. Therefore, this study aims to assess the association of mitochondrial copy number measured by mitoscore associated with embryonic developmental characteristics and ploidy. METHODS This retrospective study analyzed the developmental characteristics of embryos and mtDNA levels in biopsied trophectodermal cells. The analysis was carried out using time-lapse monitoring and next-generation sequencing from September 2021 to September 2022. Five hundred and fifteen blastocysts were biopsied from 88 patients undergoing IVF who met the inclusion criteria. Embryonic morphokinetics and morphology were evaluated at 118 h after insemination using all recorded images. Blastocysts with appropriate morphology on day 5 or 6 underwent TE biopsy and preimplantation genetic testing for aneuploidy (PGT-A). Statistical analysis involved generalized estimating equations, Pearson's chi-squared test, Fisher's exact test, and Kruskal-Wallis test, with a significance level set at P < 0.05. RESULTS To examine differences in embryonic characteristics between blastocysts with low versus high mitoscores, the blastocysts were divided into quartiles based on their mitoscore. Regarding morphokinetic characteristics, no significant differences in most developmental kinetics and observed cleavage dysmorphisms were discovered. However, blastocysts in mitoscore group 1 had a longer time for reaching 3-cell stage after tPNf (t3; median: 14.4 h) than did those in mitoscore group 2 (median: 13.8 h) and a longer second cell cycle (CC2; median: 11.7 h) than did blastocysts in mitoscore groups 2 (median: 11.3 h) and 4 (median: 11.4 h; P < 0.05). Moreover, blastocysts in mitoscore group 4 had a lower euploid rate (22.6%) and a higher aneuploid rate (59.1%) than did those in the other mitoscore groups (39.6-49.3% and 30.3-43.2%; P < 0.05). The rate of whole-chromosomal alterations in mitoscore group 4 (63.4%) was higher than that in mitoscore groups 1 (47.3%) and 2 (40.1%; P < 0.05). A multivariate logistic regression model was used to analyze associations between the mitoscore and euploidy of elective blastocysts. After accounting for factors that could potentially affect the outcome, the mitoscore still exhibited a negative association with the likelihood of euploidy (adjusted OR = 0.581, 95% CI: 0.396-0.854; P = 0.006). CONCLUSIONS Blastocysts with varying levels of mitochondrial DNA, identified through biopsies, displayed similar characteristics in their early preimplantation development as observed through time-lapse imaging. However, the mitochondrial DNA level determined by the mitoscore can be used as a standalone predictor of euploidy.
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Affiliation(s)
- Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ching-Ya Su
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tzu-Ning Yu
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Ming-Jer Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
| | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
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Lee CI, Huang CC, Lee TH, Chen HH, Cheng EH, Lin PY, Yu TN, Chen CI, Chen CH, Lee MS. Associations between the artificial intelligence scoring system and live birth outcomes in preimplantation genetic testing for aneuploidy cycles. Reprod Biol Endocrinol 2024; 22:12. [PMID: 38233926 PMCID: PMC10792866 DOI: 10.1186/s12958-024-01185-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/12/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Several studies have demonstrated that iDAScore is more accurate in predicting pregnancy outcomes in cycles without preimplantation genetic testing for aneuploidy (PGT-A) compared to KIDScore and the Gardner criteria. However, the effectiveness of iDAScore in cycles with PGT-A has not been thoroughly investigated. Therefore, this study aims to assess the association between artificial intelligence (AI)-based iDAScore (version 1.0) and pregnancy outcomes in single-embryo transfer (SET) cycles with PGT-A. METHODS This retrospective study was approved by the Institutional Review Board of Chung Sun Medical University, Taichung, Taiwan. Patients undergoing SET cycles (n = 482) following PGT-A at a single reproductive center between January 2017 and June 2021. The blastocyst morphology and morphokinetics of all embryos were evaluated using a time-lapse system. The blastocysts were ranked based on the scores generated by iDAScore, which were defined as AI scores, or by KIDScore D5 (version 3.2) following the manufacturer's protocols. A single blastocyst without aneuploidy was transferred after examining the embryonic ploidy status using a next-generation sequencing-based PGT-A platform. Logistic regression analysis with generalized estimating equations was conducted to assess whether AI scores are associated with the probability of live birth (LB) while considering confounding factors. RESULTS Logistic regression analysis revealed that AI score was significantly associated with LB probability (adjusted odds ratio [OR] = 2.037, 95% confidence interval [CI]: 1.632-2.542) when pulsatility index (PI) level and types of chromosomal abnormalities were controlled. Blastocysts were divided into quartiles in accordance with their AI score (group 1: 3.0-7.8; group 2: 7.9-8.6; group 3: 8.7-8.9; and group 4: 9.0-9.5). Group 1 had a lower LB rate (34.6% vs. 59.8-72.3%) and a higher rate of pregnancy loss (26% vs. 4.7-8.9%) compared with the other groups (p < 0.05). The receiver operating characteristic curve analysis verified that the iDAScore had a significant but limited ability to predict LB (area under the curve [AUC] = 0.64); this ability was significantly weaker than that of the combination of iDAScore, type of chromosomal abnormalities, and PI level (AUC = 0.67). In the comparison of the LB groups with the non-LB groups, the AI scores were significantly lower in the non-LB groups, both for euploid (median: 8.6 vs. 8.8) and mosaic (median: 8.0 vs. 8.6) SETs. CONCLUSIONS Although its predictive ability can be further enhanced, the AI score was significantly associated with LB probability in SET cycles. Euploid or mosaic blastocysts with low AI scores (≤ 7.8) were associated with a lower LB rate, indicating the potential of this annotation-free AI system as a decision-support tool for deselecting embryos with poor pregnancy outcomes following PGT-A.
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Affiliation(s)
- Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tzu-Ning Yu
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
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Wang TE, Lee CI, Huang CC, Tsao HM, Chang HC, Chang LS, Chang TA, Lee MS, Hsu CT. Innovative technology for evaluation of sperm DNA double-strand breaks diagnoses male factor infertility and prevents reproductive failures. Sci Rep 2023; 13:18996. [PMID: 37923811 PMCID: PMC10624885 DOI: 10.1038/s41598-023-46049-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
Neutral comet assay has been available for two decades to evaluate sperm double-strand breaks (DSBs). However, its clinical usability is limited due to its complex and time-consuming procedure, as well as the lack of a standardized scoring system. The aim of this study was to: develop a rapid diagnostic method for DSBs, Sperm DNA Fragmentation Releasing Assay (SDFR), and explore the association between DSBs and reproductive outcomes. We pioneered the use of polyacrylamide (PA) for embedding sperm chromatin and optimized the porosity of PA to be between 10 and 13%. The refined PA network allowed the trapping of DSBs, which dispersed halo on an immunological slide; in contrast, intact chromatin failed to develop a halo. A strong correlation was showed between reproducible values obtained from SDFR and neutral comet assay. SDFR were responsive to dose-/time-dependent simulated DSBs, indicating high sensitivity and specificity. Furthermore, we conducted a retrospective study of couples with embryonic aneuploidy screening, and recording DSB profiles of the male partners. Our findings revealed that DSB enabled to predict embryonic aneuploidy whereas basic semen parameters did not. In conclusion, SDFR offers a rapid and user-friendly approach for evaluating DSBs, with potential implications for predictive healthcare in reproductive medicine.
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Affiliation(s)
- Tse-En Wang
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC
| | - Chun-I Lee
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan, ROC
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Chun-Chia Huang
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Hui-Mei Tsao
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC
| | - Hui-Chen Chang
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC
| | - Li-Sheng Chang
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC
| | - T Arthur Chang
- Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Maw-Sheng Lee
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan, ROC.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan, ROC.
| | - Cheng-Teng Hsu
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC.
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Chen CH, Lee CI, Huang CC, Chen HH, Chang CY, Cheng EH, Lin PY, Chen CI, Lee TH, Lee MS. Increased incidence of live births in implanted day 5 versus day 6 blastocysts following single embryo transfers with PGT-A. Sci Rep 2023; 13:12725. [PMID: 37543691 PMCID: PMC10404267 DOI: 10.1038/s41598-023-40052-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
Elective single-embryo transfers of euploid or low-level mosaic blastocysts were analyzed in this retrospective study to determine the correlations of live birth (LB) probability with embryonic developmental features of implanted day 5 (D5, n = 245) or day 6 (D6, n = 73) blastocysts using time-lapse (TL) monitoring. According to the logistic regression analyses (adjusted odds ratio [OR] = 0.341, 95% confidence interval [CI] = 0.169-0.685, P < 0.05), the LB probability was negatively associated with the D6 group. The LB rate of the D5 group was higher than the D6 group (88.2% vs. 75.3%; P < 0.05). Compared with the D5 blastocysts, the D6 blastocysts exhibited comparable dysmorphisms except for the multinucleation at the 4-cell stage (10.9% vs. 2.9%, P < 0.05). Moreover, D6 blastocysts had considerably slower developmental kinetics and poorer blastocyst morphologies. Further analysis confirmed that the LB rate was not associated with developmental kinetics or dysmorphisms but rather with blastocyst morphology (inner cell mass [ICM] grade ≤ C vs. ICM grade A, adjusted OR = 0.155, 95% CI = 0.04-0.596, P < 0.05; trophectoderm [TE] grade ≤ C vs. TE grade A, adjusted OR = 0.157, 95% CI = 0.032-0.760, P < 0.05). In conclusion, D6 implanted blastocysts have a considerably lower LB rate than D5 implanted blastocysts. As determined by TL monitoring, the diminished blastocyst morphology can be one of the primary reasons underlying the decreased likelihood of LB.
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Affiliation(s)
- Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chih-Ying Chang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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8
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Gao J, Wei N, Zhu X, Li R, Yan L, Qiao J. The correlation between morphological parameters and the incidence of de novo chromosomal abnormalities in 3238 biopsied blastocysts. J Assist Reprod Genet 2023; 40:1089-1098. [PMID: 37058258 PMCID: PMC10239399 DOI: 10.1007/s10815-023-02780-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/17/2023] [Indexed: 04/15/2023] Open
Abstract
PURPOSE The aim of this study was to determine the relationship between morphological parameters and the incidence of de novo chromosomal abnormalities. METHODS This was a retrospective cohort study of 652 patients who underwent 921 cycles with 3238 blastocysts biopsied. The embryo grades were evaluated according to Gardner and Schoolcraft's system. The incidence of euploidy, whole chromosomal aneuploidy (W-aneuploidy), segmental chromosomal aneuploidy (S-aneuploidy), and mosaicism in trophectoderm (TE) cell biopsies was analyzed. RESULTS The euploidy decreased significantly with maternal age and was positively correlated biopsy day and morphological parameters. The W-aneuploidy increased significantly with maternal age and was negatively correlated biopsy day and morphological parameters. Parental age, TE biopsy day, and morphological parameters were not associated with S-aneuploidy and mosaicism, except that TE grade C blastocysts had significantly higher mosaicism than TE grade A blastocysts. Subanalysis in different female age groups showed that euploidy and W-aneuploidy had a significant correlation with TE biopsy day among women aged ≤ 30 y and 31-35 y, with expansion degree among women aged ≥ 36 y, with ICM grade among women aged ≥ 31 y, and with TE grade among all female age ranges. CONCLUSION Female age, embryo developmental speed and blastocyst morphological parameters are associated with euploidy and whole chromosomal aneuploidy. The predictive value of these factors varies across female age groups. Parental age, embryo developmental speed, expansion degree, and ICM grade are not associated with the incidence of segmental aneuploidy or mosaicism, but TE grade seemingly has a weak correlation with segmental aneuploidy and mosaicism in embryos.
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Affiliation(s)
- Jiangman Gao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191, China
| | - Nan Wei
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Xiaohui Zhu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, (Peking University Third Hospital), Beijing, 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
- National Clinical Research Center for Obstetrics and Gynecology, (Peking University Third Hospital), Beijing, 100191, China.
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China.
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191, China.
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
- National Clinical Research Center for Obstetrics and Gynecology, (Peking University Third Hospital), Beijing, 100191, China.
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, 100191, China.
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, 100191, China.
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9
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Heiser HC, Cagnin NF, de Souza MU, Ali TM, Estrada PRQ, de Souza CCWD, Coprerski B, Rubio C, Riboldi M. The embryo mosaicism profile of next-generation sequencing PGT-A in different clinical conditions and their associations. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1132662. [PMID: 37050939 PMCID: PMC10083245 DOI: 10.3389/frph.2023.1132662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionUniform chromosome abnormalities are commonly seen in early pregnancy loss, with analyses of the product of conception suggesting the presence of mosaic autosomal trisomy in ∼10% of cases. Although chromosomal mosaicism occurs in a minority of embryos, their relative commonality and uncertainty regarding associated transfer outcomes have created discussion at both the clinical and research levels, highlighting the need to understand the clinical conditions associated with the incidence of embryo mosaicism.MethodsWe took advantage of a preimplantation genetic testing for aneuploidy (PGT-A) database created from 2019 to 2022 in more than 160 in vitro fertilization (IVF) clinics in Brazil, the second-largest world market for IVF. We carried out descriptive statistical and associative analyses to assess the proportions of mosaicism associated with clinical conditions and reported incidence by chromosome, clinic origin, and biopsy operator.ResultsChromosomal analysis revealed that most mosaic aneuploidies occurred in the last three chromosomes, with 78.06% of cases having only one chromosome affected. Low mosaicism in trisomy represented the most ordinary form, followed by low mosaicism in monosomy. We identified associations between low (negatively-associated) and high mosaicism (positively-associated) and maternal age, indication (male factor and uterus/ovarian factor negatively associated with low and high mosaic, respectively), day of blastocyst development (day five has an overall better outcome), morphology grade (lower quality increased the chances of low and high mosaicism), origin (vitrified oocyte and embryo increased the rates of low and high mosaicism, respectively), and embryo sex (male embryos negatively associated with low mosaic).DiscussionWith these results, we hope to foster an improved understanding of the chromosomal mosaicism linked with distinct clinical conditions and their associations in Brazil.
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Affiliation(s)
| | | | | | | | | | | | - Bruno Coprerski
- Laboratory of Genetic Medicine, Igenomix Brasil, São Paulo, Brazil
| | | | - Marcia Riboldi
- Laboratory of Genetic Medicine, Igenomix Brasil, São Paulo, Brazil
- Correspondence: Marcia Riboldi
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10
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Yang Y, Tan W, Chen C, Jin L, Huang B. Correlation of the position and status of the polar body from the fertilized oocyte to the euploid status of blastocysts. Front Genet 2022; 13:1006870. [PMID: 36204310 PMCID: PMC9530936 DOI: 10.3389/fgene.2022.1006870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/02/2022] [Indexed: 11/20/2022] Open
Abstract
Polar bodies are tiny cells that are extruded during oocyte meiosis and are generally considered not essential for embryonic development. Therefore, polar bodies have been widely used as important materials for the preimplantation genetic diagnosis of human embryos. Recent studies have shown that polar bodies mediate embryonic development and that their morphology is related to embryo quality and developmental potential. However, the relationship between the emission of the polar body and embryonic euploidy remains unclear. In this study, a total of 1,360 blastocyst trophectoderm (TE) biopsies were performed, and blastocyst ploidy results were correlated with the state of polar bodies. The results showed that polar body angle size and polar body status are not directly related to whether the blastocysts are euploid, aneuploid, or mosaic (p > 0.05). Therefore, in the process of clinical embryo selection, embryologists should not predict the euploidy of blastocysts based on the state of polar bodies, thus affecting embryo selection.
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Affiliation(s)
- Yongle Yang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Tan
- Wuhan Huchuang Union Technology Co.,Ltd, Wuhan, Hebei, China
| | - Changsheng Chen
- Wuhan Huchuang Union Technology Co.,Ltd, Wuhan, Hebei, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Lei Jin, ; Bo Huang,
| | - Bo Huang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Lei Jin, ; Bo Huang,
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