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Li S, Nong Y, Wang F, Li Z, Liu W, Xie Y, Peng T, Zhang X, Liu F. Clinical efficacy analysis of oocyte cryopreservation: A propensity score matched study. J Obstet Gynaecol Res 2022; 48:3152-3159. [PMID: 36098236 PMCID: PMC10088013 DOI: 10.1111/jog.15412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/21/2022] [Accepted: 08/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the effectiveness of oocyte thawing cycles in the clinical application of assisted reproductive technology (ART). STUDY DESIGN The clinical data of 78 cases who underwent oocyte thawing cycles in our center were retrospectively analyzed. All patients in this study received oocyte cryopreservation for the husband reason. According to patient age at egg freezing, patients were divided into three observation groups (Group A, <30 years old; Group B, 30-34 years old; Group C, ≥35 years old), and the control groups were selected by propensity score matching with fresh cycles. The clinical outcomes of each group were compared, and the clinical efficacy of oocyte thawing cycles was analyzed. RESULTS Clinical pregnancy outcomes of oocyte thawing cycles were not significantly different from that of fresh oocytes, but vitrification affected the number of two pronuclei zygotes developing to cleavage stage and the number of high-quality embryos, and the normal fertilization rate after thawing. The cycle cumulative live birth rate in Group C was significantly lower than those in Groups A and B. The live birth rates per egg of Groups A, B, C were 5.03%, 5.61%, and 3.57%, respectively, and the numbers of eggs per live birth were 13.72, 14.43, and 21.0, respectively. CONCLUSIONS The overall clinical outcomes of oocyte vitrification were similar to that of fresh oocytes, but the cleavage rate and embryo quality of frozen oocytes were slightly reduced. Freezing of oocytes in women over 35 years of age affects the clinical efficacy of ART.
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Affiliation(s)
- Shifen Li
- Reproductive Medicine Center, Affiliated Shenzhen City Maternity and Child Healthcare Hospital of Southern Medical University, Shenzhen, China
| | - Yingqi Nong
- Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Fang Wang
- Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Zitao Li
- Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Wenjuan Liu
- Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Yanni Xie
- Graduate School of Guangzhou Medical University, Guangzhou, China
| | - Tong Peng
- Graduate School of Guangzhou Medical University, Guangzhou, China
| | - Xiqian Zhang
- Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Fenghua Liu
- Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
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2
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Morita A, Satouh Y, Sato K, Iwase A. Significance of the association between early embryonic development and endocytosis. Med Mol Morphol 2022; 55:167-173. [PMID: 35833996 DOI: 10.1007/s00795-022-00331-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
Fertilization triggers a process called maternal-to-zygotic transition, in which the oocyte undergoes oocyte-to-embryo transition, leading to massive intracellular remodeling toward early embryogenesis. This transition requires the degradation of oocyte-derived components; however, the significance and mechanism of degradation of cell surface components remain unknown. In this review, we focused on the dynamics of plasma membrane proteins and investigated the relationship between embryonic development and endocytosis. Our survey of the extant literature on the topic led to the conclusion that clathrin-mediated endocytosis is essential for the progression of early embryogenesis and selective degradation of oocyte-derived plasma membrane proteins in mouse embryos, as reported by studies analyzing maternal cellular surface proteins, including a glycine transporter, GlyT1a. Evaluation of such endocytic activity in individual embryos may allow the selection of embryos with higher viability in assisted reproductive technologies, and it is important to select viable embryos to increase the rates of successful pregnancy and live birth. Although the early embryonic developmental abnormalities are mainly accompanied with chromosomal aneuploidy, other causes and mechanisms remain unclear. This review summarizes molecular biological approaches to early embryonic developmental abnormalities and their future prospects.
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Affiliation(s)
- Akihito Morita
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, 3-39-15 Showamachi, Maebashi, Gunma, 371-8511, Japan.
- Laboratory of Molecular Traffic, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan.
| | - Yuhkoh Satouh
- Laboratory of Molecular Traffic, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Ken Sato
- Laboratory of Molecular Traffic, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Akira Iwase
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, 3-39-15 Showamachi, Maebashi, Gunma, 371-8511, Japan
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3
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Chang CC, Shapiro DB, Nagy ZP. The effects of vitrification on oocyte quality. Biol Reprod 2021; 106:316-327. [PMID: 34962575 DOI: 10.1093/biolre/ioab239] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Vitrification, is an ultra-rapid, manual cooling process that produces glass-like (ice crystal free) solidification. Water is prevented from forming intercellular and intracellular ice crystals during cooling as a result of oocyte dehydration and the use of highly concentrated cryoprotectant. Though oocytes can be cryopreserved without ice crystal formation through vitrification, it is still not clear whether the process of vitrification causes any negative impact (temperature change/chilling effect, osmotic stress, cryoprotectant toxicity, and/or phase transitions) on oocyte quality that translate to diminished embryo developmental potential or subsequent clinical outcomes. In this review, we attempt to assess the technique's potential effects and the consequence of these effects on outcomes.
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Affiliation(s)
- Ching-Chien Chang
- Reproductive Biology Associates, 1100 Johnson Ferry Rd., Ste200, Atlanta, GA 30342, USA
| | - Daniel B Shapiro
- Reproductive Biology Associates, 1100 Johnson Ferry Rd., Ste200, Atlanta, GA 30342, USA
| | - Zsolt Peter Nagy
- Reproductive Biology Associates, 1100 Johnson Ferry Rd., Ste200, Atlanta, GA 30342, USA
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4
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Davoodian N, Kadivar A, Ahmadi E, Nazari H, Mehrban H. Quercetin effect on the efficiency of ovine oocyte vitrification at GV stage. Theriogenology 2021; 174:53-9. [PMID: 34418772 DOI: 10.1016/j.theriogenology.2021.07.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023]
Abstract
The widely adopted method of vitrification is known to induce some negative effects on oocytes. In order to enhance the efficiency of this process performed on ovine oocytes at germinal vesicle stage, vitrification and warming (VW) solutions, and maturation media were supplemented with 5 μM Quercetin (Q). Four groups of vitrified and fresh immature oocytes were subjected to IVM, IVF and IVC, and their survival rate, apoptosis, nuclear status and developmental competence were assessed. Non-vitrified oocytes treated with Quercetin experienced higher cleavage rate relative to those matured without Quercetin (p < 0.05). Supplementation of VW and maturation media with Quercetin resulted in increased survival, cleavage and total blastocyst rates relative to the untreated oocytes. The post-IVM survival rate of non-vitrified oocytes showed no difference among those matured with and without Quercetin, but was higher for oocytes vitrified, warmed and matured with Quercetin relative to VW group lacking Quercetin. The proportion of early-apoptotic (AV+) oocytes was affected by Quercetin supplementation in both control and VW groups (p < 0.05). The number of AV positive oocytes was lower and the proportion of oocytes reaching MII stage was greater in non-vitrified and VW groups matured with Quercetin, in comparison with their untreated respective controls (p < 0.05). There was no difference in the number of late-stage apoptotic oocytes among different groups. It is concluded that supplementing vitrification and warming solutions with Quercetin endows vitrified ovine oocytes with protective potential against early apoptotic damage, and improves viability, maturation rate and developmental competence at GV stage.
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Abstract
Societal changes and the increasing desire and opportunity to preserve fertility have increased the demand for effective assisted reproductive technologies (ART) and have increased the range of scenarios in which ART is now used. In recent years, the "freeze-all" strategy of cryopreserving all oocytes or good quality embryos produced in an IVF cycle to transfer later-at a time that is more appropriate for reasons of medical need, efficacy, or desirability-has emerged as an accepted and valuable alternative to fresh embryo transfer. Indeed, improvements in cryopreservation techniques (vitrification) and the development of more efficient ovarian stimulation protocols have facilitated a dramatic increase in the practice of elective frozen embryo transfer (eFET). Alongside these advances, debate continues about whether eFET should be a standard treatment option available to the whole IVF population or if it is important to identify patient subgroups who are most likely to benefit from such an approach. Achieving successful outcomes in ART, whether by fresh or frozen embryo transfer, is influenced by a wide range of factors. As well as the efficiency of IVF and embryo transfer protocols and techniques, factors affecting implantation include maternal aging, sperm quality, the vaginal and endometrial microbiome, and peri-implantation levels of serum progesterone. The safety of eFET, both during ART cycles and on longer-term obstetric and neonatal outcomes, is also an important consideration. In this review, we explore the benefits and risks of freeze-all strategies in different scenarios. We review available evidence on the outcomes achieved with elective cryopreservation strategies and practices and how these compare with more traditional IVF cycles with fresh embryo transfers, both in the general IVF population and in subgroups of special interest. In addition, we consider how to optimize and individualize "freeze-all" procedures to achieve successful reproductive outcomes.
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Affiliation(s)
- Ernesto Bosch
- Instituto Valenciano de Infertilidad, Valencia, Spain
- *Correspondence: Ernesto Bosch
| | - Michel De Vos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark
- Faculty of Health, Aarhus University, Aarhus, Denmark
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6
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Scaravelli G, Levi-Setti PE, Livi C, La Sala G, Ubaldi FM, Greco E, Coccia ME, Borini A, Revelli A, Ricci G, Vigiliano V, De Luca R, Bolli S, Rienzi L. Contribution of cryopreservation to the cumulative live birth rate: a large multicentric cycle-based data analysis from the Italian National Registry. J Assist Reprod Genet 2019; 36:2287-2295. [PMID: 31463873 PMCID: PMC6885470 DOI: 10.1007/s10815-019-01566-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/13/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To estimate the contribution of cryopreservation to the cumulative live birth rate (CLBR) after law modification in Italy in the era of vitrification and freeze-all. METHODS The Italian National Registry performed a cycle-based data collection. Nine Italian IVF clinics were involved incorporating a total of 10,260 fresh cycles performed between January 2015 and April 2016 resulting in 9273 oocyte retrievals and 3266 subsequent warming cycles from the same oocyte retrievals performed up to December 2016. Mean female age was 37 ± 4.3 years. Primary outcome measure was CLBR per oocyte retrieval. Confounding factors were tested in multivariate regression analysis, and the relative impact of cryopreservation to the CLBR in different patient categories was calculated. RESULTS CLBR per oocyte retrieval was 32.6%, 26.5%, 18.7%, 13.0%, and 5.5% for women younger than 36, aged 36-39, 40-41, and older than 41 years, respectively. The total relative contribution of oocyte/embryo cryopreservation was 40.6% (95% CI 38.41-42.75). An association between maternal age, number of oocytes retrieved, fertilization rate, cryopreservation, and cumulative live birth was shown. When adjusted for confounders, a 2.3-fold increase was observed in the chance of live birth when cryopreservation was performed (OR 2.3; 95% CI 1.99-2.56). In high responder patients (> 15 oocytes retrieved) where freeze-all was applied in 67.6% of cycles to avoid the risk of hyper stimulation syndrome, the relative contribution of vitrification to the CLBR was 80.6%. CONCLUSIONS Cryopreservation is essential in IVF and should always be available to patients to optimize success rates. Multicentric, cycle-based data analyses are crucial to provide infertile couples, clinicians, and regulatory bodies with accurate information on IVF effectiveness including fresh and cryopreserved cycles.
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Affiliation(s)
- G Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy.
| | - P E Levi-Setti
- IRCCS, Division of Gynecology and Reproductive Medicine, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy.,Department of Obstetrics, Gynecology and Reproductive Science, School of Medicine, Yale University, New Haven, CT, USA
| | - C Livi
- ART Center DEMETRA, Florence, Italy
| | - G La Sala
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Modena, Italy
| | - F M Ubaldi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via de Notaris 2B, Rome, Italy
| | - E Greco
- Center for Reproductive Medicine, European Hospital, Via Portuense 700, 00149, Rome, Italy
| | - M E Coccia
- DAI-MI -AOU, Careggi-University of Florence, Florence, Italy
| | - A Borini
- 9.baby, Family and Fertility Center, Tecnobios Procreazione, Bologna, Italy
| | - A Revelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Torino, Torino, Italy
| | - G Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - V Vigiliano
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - R De Luca
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - S Bolli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - L Rienzi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via de Notaris 2B, Rome, Italy
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7
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Iussig B, Maggiulli R, Fabozzi G, Bertelle S, Vaiarelli A, Cimadomo D, Ubaldi FM, Rienzi L. A brief history of oocyte cryopreservation: Arguments and facts. Acta Obstet Gynecol Scand 2019; 98:550-558. [PMID: 30739329 DOI: 10.1111/aogs.13569] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/02/2019] [Accepted: 02/04/2019] [Indexed: 12/11/2022]
Abstract
The term "cryopreservation" refers to the process of cooling cells and tissues and storing them at subzero temperatures in order to stop all biological activity and preserve their viability and physiological competences for future use. Cooling to subzero temperatures is not a physiological condition for human cells; this is probably due to the high content of water in the living matter, whose conversion to ice crystals may be associated with severe and irreversible damage. Among reproductive cells and tissues, metaphase II oocytes are notably vulnerable to cryopreservation, mainly because of their large size, low surface area to volume ratio, relatively high water content and presence of the meiotic spindle. As human biological systems lack efficient internal defense mechanisms against chilling injuries, it is of the utmost importance to supply adequate external support, in terms of cryoprotectant additives, appropriate cooling/warming rates, and suitable long-term storage. Over the years, scientists have proposed different cryopreservation strategies in the effort to achieve an optimized recipe ensuring cell survival and, at the same time, maintenance of the physiological functions and abilities necessary to continue life. However, despite the first success obtained in the 1980s with frozen oocytes, it was not until recently that notable improvements in the cryopreservation technique, thanks to the advent of vitrification, allowed a breakthrough of this fine procedure.
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Affiliation(s)
- Benedetta Iussig
- G.EN.E.R.A. Center for Reproductive Medicine, G.EN.E.R.A. Veneto, Marostica, Italy
| | - Roberta Maggiulli
- G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy
| | - Gemma Fabozzi
- G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy
| | - Sara Bertelle
- G.EN.E.R.A. Center for Reproductive Medicine, G.EN.E.R.A. Veneto, Marostica, Italy
| | - Alberto Vaiarelli
- G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy
| | - Danilo Cimadomo
- G.EN.E.R.A. Center for Reproductive Medicine, G.EN.E.R.A. Veneto, Marostica, Italy.,G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy
| | - Filippo M Ubaldi
- G.EN.E.R.A. Center for Reproductive Medicine, G.EN.E.R.A. Veneto, Marostica, Italy.,G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy
| | - Laura Rienzi
- G.EN.E.R.A. Center for Reproductive Medicine, G.EN.E.R.A. Veneto, Marostica, Italy.,G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy
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8
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Wang Y, Zhang M, Chen ZJ, Du Y. Resveratrol promotes the embryonic development of vitrified mouse oocytes after in vitro fertilization. In Vitro Cell Dev Biol Anim 2018; 54:430-438. [DOI: 10.1007/s11626-018-0262-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/02/2018] [Indexed: 11/30/2022]
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9
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Abstract
PURPOSE OF REVIEW Oocyte cryopreservation is no longer experimental and one of its rapidly growing indications is elective fertility preservation. Currently there is no sufficient evidence to support its practice and therefore its place in IVF remains uncertain. RECENT FINDINGS Vitrification has superior post-thaw survival and fertilization outcomes compared with oocytes that were frozen with the slow-freeze technique. Oocyte vitrification produces similar IVF outcomes compared with fresh oocytes and is not associated with further obstetrical or perinatal morbidity. Undergoing elective oocyte cryopreservation between ages 35 and 37 will optimize live birth rates as well as cost effectiveness from mathematical models. SUMMARY In women who delay child bearing, elective oocyte cryopreservation in the mid 30s may be beneficial in terms of live birth rates and cost effectiveness. Prospective studies of women who have undergone oocyte cryopreservation and are now attempting conception are needed before official recommendations can be made regarding elective egg freezing.
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10
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Massarotti C, Scaruffi P, Lambertini M, Remorgida V, Del Mastro L, Anserini P. State of the art on oocyte cryopreservation in female cancer patients: A critical review of the literature. Cancer Treat Rev 2017; 57:50-7. [PMID: 28550713 DOI: 10.1016/j.ctrv.2017.04.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/11/2022]
Abstract
During the last decades, important advances in therapeutic options have led to increased survival rates in cancer patients; however, cancer treatments are associated with several potential adverse effects including infertility in those diagnosed during their reproductive years. A proper discussion about fertility preservation options before the use of therapies with potential gonadotoxicity (i.e. oncofertility counseling) is standard of care and should be offered to all patients of childbearing age. Temporary ovarian suppression with LH-RH analogs, oocyte and embryo cryopreservation are standard strategies for fertility preservation in female cancer patients. Oocyte cryopreservation should be preferred to embryo cryopreservation when this latter is prohibited by law, avoided for ethical or religious issues and in single women refusing sperm donation. Despite the increasing use of this strategy, data are still lacking about the efficacy and safety of the procedure in female cancer patients, with most of the evidence on this regard deriving from infertile non-oncologic women. This article aims at critically review the available evidence about the success of oocyte cryopreservation in female cancer patients with the final goal to further improve the oncofertility counseling of these women.
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11
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Grifo J, Adler A, Lee HL, Morin SJ, Smith M, Lu L, Hodes-Wertz B, McCaffrey C, Berkeley A, Munné S. Deliveries from trophectoderm biopsied, fresh and vitrified blastocysts derived from polar body biopsied, vitrified oocytes. Reprod Biomed Online 2015; 31:210-6. [PMID: 26096028 DOI: 10.1016/j.rbmo.2015.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 04/23/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
Abstract
This longitudinal study reports preliminary findings of six patients who underwent first polar body biopsy followed by oocyte vitrification. All oocytes were warmed, inseminated by intracytoplasmic sperm injection and cultured to blastocyst. All suitable blastocysts underwent trophectoderm biopsy for aneuploidy screening, and supernumerary blastocysts were vitrified. Euploid blastocysts were transferred either fresh or in a subsequent programmed cycle. Of the 91 metaphase II oocytes, 30 had euploid first polar bodies. Development to blastocyst was more likely in oocytes with a euploid first polar body (66.7% versus 24.6%; P < 0.001). Nineteen euploid blastocysts were produced: 10 from oocytes with a euploid first polar body and nine from oocytes with an aneuploid first polar body. Five out of six patients (83%) had a live birth or ongoing pregnancy at the time of analysis. Eleven euploid blastocysts have been transferred and seven implanted (64%). Although the chromosomal status of the first polar body was poorly predictive of embryonic ploidy, an association was found between chromosomal status of the first polar body and development to blastocyst. Further study is required to characterize these relationships, but proof of concept is provided that twice biopsied, twice cryopreserved oocytes and embryos can lead to viable pregnancies.
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Affiliation(s)
- Jamie Grifo
- New York University Langone Medical Center Fertility Center, 660 1st Ave. 5th Floor, New York, NY 10016, USA
| | - Alexis Adler
- New York University Langone Medical Center Fertility Center, 660 1st Ave. 5th Floor, New York, NY 10016, USA
| | - Hsiao Ling Lee
- New York University Langone Medical Center Fertility Center, 660 1st Ave. 5th Floor, New York, NY 10016, USA
| | - Scott J Morin
- Department of Obstetrics and Gynecology, New York University Langone Medical Center, 530 1st Ave. NBV 9E2, New York, NY 10016, USA.
| | - Meghan Smith
- Department of Obstetrics and Gynecology, New York University Langone Medical Center, 530 1st Ave. NBV 9E2, New York, NY 10016, USA
| | - Lucy Lu
- New York University Langone Medical Center Fertility Center, 660 1st Ave. 5th Floor, New York, NY 10016, USA
| | - Brooke Hodes-Wertz
- New York University Langone Medical Center Fertility Center, 660 1st Ave. 5th Floor, New York, NY 10016, USA
| | - Caroline McCaffrey
- New York University Langone Medical Center Fertility Center, 660 1st Ave. 5th Floor, New York, NY 10016, USA
| | - Alan Berkeley
- New York University Langone Medical Center Fertility Center, 660 1st Ave. 5th Floor, New York, NY 10016, USA
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12
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Abstract
Cancer may be detected at any age and could affect children, and reproductive age women as well. In recent years, cancer treatment has become less destructive and more specific. As a result, survival rates and quality of life following successful treatment have continuously improved. Cancer treatment typically involves surgery, chemo- or radiation therapy, or the combinations of these. These interventions often adversely affect the function of the reproductive organs. Chemo- and radiation therapy are known to be gonadotoxic. Survivors of oncologic therapy are typically rendered infertile primarily due to the loss of ovarian function. There are, however, several medical, surgical, and assisted reproductive technology options that could be and should be offered to those diagnosed with cancer and wish to maintain their fertility. Embryo cryopreservation has been available for decades and has been successfully applied for fertility preservation in women diagnosed with cancer. Recent advances in cryobiology have increased the efficacy of not just embryo but even oocyte and ovarian tissue freezing-thawing. Oocyte vitrification just like embryo cryopreservation requires the use of stimulation but does not require the patient to be in a stable relationship or accept the use of donor sperm. Ovarian tissue cryopreservation does not require stimulation and, following successful transplantation, provides the patient with the most eggs but is currently still considered experimental. This paper summarizes the various fertility-sparing medical, surgical and assisted reproductive technology options. It reviews the current status of embryo, oocyte, and ovarian tissue cryopreservation and discusses their risks and benefits.
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Affiliation(s)
- Peter Kovacs
- Kaali Institute, IVF Center, Istenhegyi ut 54/a, Budapest, 1125 Hungary
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13
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Potdar N, Gelbaya TA, Nardo LG. Oocyte vitrification in the 21st century and post-warming fertility outcomes: a systematic review and meta-analysis. Reprod Biomed Online 2014; 29:159-76. [DOI: 10.1016/j.rbmo.2014.03.024] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 03/20/2014] [Accepted: 03/25/2014] [Indexed: 11/20/2022]
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14
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Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril 2013; 100:1214-23. [PMID: 24011612 DOI: 10.1016/j.fertnstert.2013.08.012] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 08/05/2013] [Indexed: 11/16/2022]
Abstract
Patients preparing to undergo gonadotoxic medical therapy or radiation therapy or gonadectomy should be provided with prompt counseling regarding available options for fertility preservation. Fertility preservation can best be provided by comprehensive programs designed and equipped to confront the unique challenges facing these patients.
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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15
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Levi Setti PE, Albani E, Morenghi E, Morreale G, Delle Piane L, Scaravelli G, Patrizio P. Comparative analysis of fetal and neonatal outcomes of pregnancies from fresh and cryopreserved/thawed oocytes in the same group of patients. Fertil Steril 2013; 100:396-401. [DOI: 10.1016/j.fertnstert.2013.03.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/17/2013] [Accepted: 03/21/2013] [Indexed: 01/29/2023]
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16
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Abstract
PURPOSE OF REVIEW To delineate the current trends in the clinical application of oocyte cryopreservation. RECENT FINDINGS Although the first live birth from oocyte cryopreservation was reported approximately three decades ago, significant improvement in the clinical application of oocyte cryopreservation took place only over the past decade. On the basis of the available evidence suggesting that success rates with donor oocyte vitrification are similar to that of IVF with fresh donor oocytes, the American Society of Reproductive Medicine has recently stated that oocyte cryopreservation should no longer be considered experimental for medical indications, outlying elective oocyte cryopreservation. Meanwhile, a few surveys on the attitudes toward oocyte cryopreservation revealed that elective use for the postponement of fertility is currently the most common indication for oocyte cryopreservation. Most recently, a randomized controlled trial revealed important evidence on the safety of nondonor oocyte cryopreservation, and confirmed that the clinical success of vitrification is comparable to that of IVF with fresh oocytes. SUMMARY The evidence suggesting similar IVF success rates with both donor and nondonor cryopreserved oocytes compared with fresh oocytes will increase the utilization of elective oocyte cryopreservation. Appropriate counseling of women for oocyte cryopreservation requires the establishment of age-based clinical success rates with cryopreserved oocytes for various indications.
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Affiliation(s)
- Aylin P. Cil
- Department of Obstetrics and Gynecology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Emre Seli
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
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17
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Abstract
There is good evidence that fertilization and pregnancy rates are similar to IVF/ICSI with fresh oocytes when vitrified/warmed oocytes are used as part of IVF/ICSI for young women. Although data are limited, no increase in chromosomal abnormalities, birth defects, and developmental deficits has been reported in the offspring born from cryopreserved oocytes when compared to pregnancies from conventional IVF/ICSI and the general population. Evidence indicates that oocyte vitrification and warming should no longer be considered experimental. This document replaces the document last published in 2008 titled, "Ovarian Tissue and Oocyte Cryopreservation," Fertil Steril 2008;90:S241-6.
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Affiliation(s)
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- Society for Reproductive Medicine and Society for Assisted Reproductive Technology, Birmingham, Alabama
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18
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Abstract
Eggs can be 'forever'. A longstanding goal in assisted reproductive technology (ART) has been realized at last, namely, cryopreservation of oocytes by vitrification technology. This breakthrough heralds benefits for infertility treatment, fertility preservation, and even postponement of reproduction but, as so often with ARTs, new waves of technology draw ethical and societal concerns in their wake.
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19
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Dillon KE, Fiester AM. Sperm and oocyte cryopreservation: comprehensive consent and the protection of patient autonomy. Hum Reprod 2012; 27:2894-8. [DOI: 10.1093/humrep/des290] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Abstract
BACKGROUND Vitrification is now a commonly applied technique for cryopreservation in assisted reproductive technology (ART) replacing, in many cases, conventional slow cooling methodology. This review examines evidence relevant to comparison of the two approaches applied to human oocytes and embryos at different developmental stages. METHODS Critical review of the published literature using PubMed with particular emphasis on studies which include data on survival and implantation rates, data from fresh control groups and evaluation of the two approaches in a single setting. RESULTS Slow cooling is associated with lower survival rates and compromised development relative to vitrification when applied to metaphase II (MII) oocytes, although the vitrification results have predominantly been obtained using direct contact with liquid nitrogen and there is some evidence that optimal protocols for slow cooling of MII oocytes are yet to be established. There are no prospective randomized controlled trials (RCTs) which support the use of either technique with pronuclear oocytes although vitrification has become the method of choice. Optimal slow cooling, using modifications of traditional methodology, and vitrification can result in high survival rates of early embryos, which implant at the same rate as equivalent fresh counterparts. Many studies report high survival and implantation rates following vitrification of blastocysts. Although slow cooling of blastocysts has been reported to be inferior in some studies, others comparing the two approaches in the same clinical setting have demonstrated comparable results. The variation in the extent of embryo selection applied in studies can lead to apparent differences in clinical efficiency, which may not be significant if expressed on a 'per oocyte used' basis. CONCLUSIONS Available evidence suggests that vitrification is the current method of choice when cryopreserving MII oocytes. Early cleavage stage embryos can be cryopreserved with equal success using slow cooling and vitrification. Successful blastocyst cryopreservation may be more consistently achieved with vitrification but optimal slow cooling can produce similar results. There are key limitations associated with the available evidence base, including a paucity of RCTs, limited reporting of live birth outcomes and limited reporting of detail which would allow assessment of the impact of differences in female age. While vitrification has a clear role in ART, we support continued research to establish optimal slow cooling methods which may assist in alleviating concerns over safety issues, such as storage, transport and the use of very high cryoprotectant concentrations.
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Affiliation(s)
- David H Edgar
- Reproductive Services/Melbourne IVF, Royal Women's Hospital, Parkville, Victoria 3052, Australia
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21
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von Wolff M, Dian D. Fertility preservation in women with malignant tumors and gonadotoxic treatments. Dtsch Arztebl Int 2012; 109:220-6. [PMID: 22532814 DOI: 10.3238/arztebl.2012.0220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 11/08/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Because of improved survival rates and recent advances in reproductive medicine, fertility preservation methods in women of reproductive age with malignant or autoimmune diseases have risen in importance. METHODS Selective literature review based on the authors' clinical and scientific experience. RESULTS Fertility-preserving techniques are recommended for all girls and women up to age 40 who are at high risk of ovarian failure. As these techniques are complex, special expertise in counseling and treatment is needed; in the German-speaking countries, such expertise is available in centers belonging to the FertiPROTEKT network (www.fertiprotekt.eu). Most of these techniques carry a very low risk and can be performed in two weeks or less. Success rates depend on the patient's age, the experience of the center, and the particular technique used. The highest attainable likelihood of pregnancy after the use of a combination of cryopreservation techniques is estimated at 40% to 50%. Fertility preservation is generally not covered by health insurance; its cost ranges from several hundred to several thousand euros. CONCLUSION Girls and women up to age 40 who are about to undergo gonadotoxic treatment should be counseled about the availability of fertility-preserving techniques and, if appropriate, should be treated with such techniques in a specialized center.
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Affiliation(s)
- Michael von Wolff
- Department of Gynecological Endocrinology and Fertility Disorders, University Hospital of Bern, Switzerland
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22
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Current world literature. Curr Opin Obstet Gynecol 2011; 23:301-5. [PMID: 21734502 DOI: 10.1097/GCO.0b013e3283491e27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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