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Dueñas JA, Cobo A, Galtarossa F, Goasduff A, Mengoni D, Sánchez-Benítez AM. Energy Resolution from a Silicon Detector's Interstrip Regions. Sensors (Basel) 2024; 24:2622. [PMID: 38676237 PMCID: PMC11053534 DOI: 10.3390/s24082622] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/26/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
In this work, we present a novel approach for improving the energy resolution from particles impinging on the interstrip regions of silicon strip detectors. We employed three double-sided strip detectors from the GRIT array and a triple α-source under laboratory conditions. The results showed that the interstrip resolution depends not only on the impinging side but also on whether it is a P- or an N-interstrip. We obtained the interstrip energy resolution down to 0.4%, and, depending on the scenario, the resolution was enhanced by a factor of 2. We believe that this new rotation method allows for the possibility of applying particle identification methods on interstrip events, which in most cases are dismissed during data recording.
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Affiliation(s)
- J. A. Dueñas
- Departamento de Ingeniería Eléctrica y Centro de Estudios Avanzados en Física, Matemáticas y Computación, Universidad de Huelva, 21007 Huelva, Spain
| | - A. Cobo
- Grand Accélérateur National d’Ions Lourds (GANIL), Boulevard Henri Becquerel, F-14076 Caen, France;
| | - F. Galtarossa
- INFN, Sezione di Padova, 35131 Padova, Italy; (F.G.); (D.M.)
| | - A. Goasduff
- INFN Laboratori Nazionali di Legnaro, 35131 Padova, Italy;
| | - D. Mengoni
- INFN, Sezione di Padova, 35131 Padova, Italy; (F.G.); (D.M.)
| | - A. M. Sánchez-Benítez
- Departamento de Ciencias Integradas y Centro de Estudios Avanzados en Física, Matemáticas y Computación, Universidad de Huelva, 21007 Huelva, Spain;
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Cobo A, Coello A, De Los Santos MJ, Remohi J, Bellver J. Embryo long-term storage does not affect assisted reproductive technologies outcome: analysis of 58,001 vitrified blastocysts over 11 years. Am J Obstet Gynecol 2024:S0002-9378(24)00469-1. [PMID: 38527601 DOI: 10.1016/j.ajog.2024.03.033] [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: 11/08/2023] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Recently, the potential detrimental effect that the duration of storage time may have on vitrified samples has raised some concerns, especially when some studies found an association between cryostorage length and decreased clinical results. OBJECTIVE This study aimed to evaluate the effects of the storage time length of day-5 vitrified blastocysts in 2 study groups: freeze-all cycles and nonelective frozen embryo transfers. STUDY DESIGN This was a retrospective study that included 58,001 vitrified/warmed day-5 blastocysts from 2 different populations, according to the reason for frozen embryo transfer. Elective frozen embryo transfer comprised freeze-all cycles (N=16,615 blastocysts and 16,615 patients) in which only single embryo transfers and only the first frozen embryo transfer were included. The nonelective frozen embryo transfer group included 41,386 embryos from 25,571 patients where frozen embryo transfer took place using supernumerary embryos after fresh embryo transfer. All the possible frozen embryo transfers were included. Both single embryo transfer and double embryo transfers were included. Donor and autologous oocytes were used. The period covered by this study was 11 years. The blastocyst sample was clustered into deciles, which provided specific storage duration categories. The main outcome was the live birth rate, and secondary outcomes were embryo survival, miscarriage, and clinical and ongoing pregnancy rates according to storage duration. The impact of storage time was assessed by univariable analyses in both groups. The comparison was made between each decile and the last one. A multivariable logistic regression analysis was conducted, including the variables with significant association found in the univariate analysis. Student t test and chi-square tests, or an analysis of variance, were used wherever appropriate. P<.05 was considered statistically significant. RESULTS There were statistical differences in baseline characteristics of patients included in the study groups. Storage durations ranged from ≤0.67 to ≥4.34 and from ≤1.8 to ≥34.81 months in freeze-all and nonelective frozen embryo transfer, respectively. Embryo survival did not show statistical differences across the categories of storage time in freeze-all and nonelective frozen embryo transfer groups. Statistical differences were found for the live birth rate across some, but not all, the subgroups of storage duration. The multivariable analysis showed no association between storage time and the live birth rate in both groups (nonsignificant). Blastocyst quality, body mass index, number of retrieved oocytes, endometrial preparation, male factor, and uterine factor were related to the drop in the live birth rate in the freeze-all group (P<.05). In the nonelective frozen embryo transfer group, the variables that showed significant association with the live birth rate were age at retrieval and frozen embryo transfer, type of frozen embryo transfer (single embryo transfer or double embryo transfers), number of retrieved oocytes, body mass index, endometrial preparation, origin of sperm sample, and female factor. CONCLUSION This large study demonstrated no association between storage time and clinical outcome. Other variables, such as the patient's age, embryo quality, body mass index, and etiology, are somewhat responsible for impacting the outcome. This provides evidence for the safety of embryo vitrification, even after long storage periods. This is reassuring for both in vitro fertilization practitioners and patients undergoing frozen embryo transfer of either elective or nonelective embryos.
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Affiliation(s)
- Ana Cobo
- IVIRMA Global Research Alliance, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain.
| | - Aila Coello
- IVIRMA Global Research Alliance, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
| | - María J De Los Santos
- IVIRMA Global Research Alliance, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
| | - Jose Remohi
- IVIRMA Global Research Alliance, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
| | - Jose Bellver
- IVIRMA Global Research Alliance, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain; IVI Foundation, Health Research Institute La Fe, Valencia, Spain
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Giles J, Cruz M, Cobo A, Vidal C, Requena A, Remohi J, Bosch E. Corrigendum to 'Medroxyprogesterone acetate: an alternative to GnRH-antagonist in oocyte vitrification for social fertility preservation and preimplantation genetic testing for aneuploidy' Reproductive Biomedicine Online. 2023 Aug;47(2):103222. Reprod Biomed Online 2024; 48:103841. [PMID: 38262210 DOI: 10.1016/j.rbmo.2024.103841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Affiliation(s)
- J Giles
- IVIRMA Valencia; IVI Foundation.
| | - M Cruz
- IVIRMA Valencia; IVI Foundation
| | - A Cobo
- IVIRMA Valencia; IVI Foundation
| | - C Vidal
- IVIRMA Valencia; IVI Foundation
| | | | | | - E Bosch
- IVIRMA Valencia; IVI Foundation
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Cimadomo D, Cobo A, Galliano D, Fiorentino G, Marconetto A, Zuccotti M, Rienzi L. Oocyte vitrification for fertility preservation is an evolving practice requiring a new mindset: societal, technical, clinical, and basic science-driven evolutions. Fertil Steril 2024:S0015-0282(24)00004-9. [PMID: 38185200 DOI: 10.1016/j.fertnstert.2024.01.003] [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: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
Infertility is a condition with profound social implications. Indeed, it is not surprising that evolutions in both medicine and society affect the way in vitro fertilization is practiced. The keywords in modern medicine are the four principles, which implicitly involve a constant update of our knowledge and our technologies to fulfill the "prediction" and "personalization" tasks, and a continuous reshaping of our mindset in view of all relevant societal changes to fulfill the "prevention" and "participation" tasks. A worldwide aging population whose life priorities are changing requires that we invest in fertility education, spreading actionable information to allow women and men to make meaningful reproductive choices. Fertility preservation for both medical and nonmedical reasons is still very much overlooked in many countries worldwide, demanding a comprehensive update of our approach, starting from academia and in vitro fertilization laboratories, passing through medical offices, and reaching out to social media. Reproduction medicine should evolve from being a clinical practice to treat a condition to being a holistic approach to guarantee patients' reproductive health and well-being. Oocyte vitrification for fertility preservation is the perfect use case for this transition. This tool is acquiring a new identity to comply with novel indications and social needs, persisting technical challenges, brand-new clinical technologies, and novel revolutions coming from academia. This "views and reviews" piece aims at outlining the advancement of oocyte vitrification from all these tightly connected perspectives.
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Affiliation(s)
- Danilo Cimadomo
- Clinica Valle Giulia, IVIRMA Global Research Alliance, Genera, Rome, Italy
| | - Ana Cobo
- IVI, IVIRMA Global Research Alliance, Valencia, Spain
| | | | - Giulia Fiorentino
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Anabella Marconetto
- University Institute of Reproductive Medicine, National University of Córdoba, Córdoba, Argentina
| | - Maurizio Zuccotti
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Laura Rienzi
- Clinica Valle Giulia, IVIRMA Global Research Alliance, Genera, Rome, Italy; Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy.
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Pérez-Sánchez M, Pardiñas ML, Díez-Juan A, Quiñonero A, Domínguez F, Martin A, Vidal C, Beltrán D, Mifsud A, Mercader A, Pellicer A, Cobo A, de Los Santos MJ. The effect of vitrification on blastocyst mitochondrial DNA dynamics and gene expression profiles. J Assist Reprod Genet 2023; 40:2577-2589. [PMID: 37801195 PMCID: PMC10643482 DOI: 10.1007/s10815-023-02952-3] [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: 01/09/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
PURPOSE Does vitrification/warming affect the mitochondrial DNA (mtDNA) content and the gene expression profile of blastocysts? METHODS Prospective cohort study in which 89 blastocysts were obtained from 50 patients between July 2017 and August 2018. mtDNA was measured in a total of 71 aneuploid blastocysts by means of real-time polymerase chain reaction (RT-PCR). Transcriptomic analysis was performed by RNA sequencing (RNA-seq) in an additional 8 aneuploid blastocysts cultured for 0 h after warming, and 10 aneuploid blastocysts cultured for 4-5 h after warming. RESULTS A significant decrease in mtDNA content just during the first hour after the warming process in blastocysts was found (P < 0.05). However, mtDNA content experimented a significantly increased along the later culture hours achieving the original mtDNA levels before vitrification after 4-5 h of culture (P < 0.05). Gene expression analysis and functional enrichment analysis revealed that such recovery was accompanied by upregulation of pathways associated with embryo developmental capacity and uterine embryo development. Interestingly, the significant increase in mtDNA content observed in blastocysts just after warming also coincided with the differential expression of several cellular stress response-related pathways, such as apoptosis, DNA damage, humoral immune responses, and cancer. CONCLUSION To our knowledge, this is the first study demonstrating in humans, a modulation in blastocysts mtDNA content in response to vitrification and warming. These results will be useful in understanding which pathways and mechanisms may be activated in human blastocysts following vitrification and warming before a transfer.
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Affiliation(s)
- Marta Pérez-Sánchez
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106 - Torre A, Planta 1ª, 46026, Valencia, Spain
| | - Maria Luisa Pardiñas
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106 - Torre A, Planta 1ª, 46026, Valencia, Spain
| | - Antonio Díez-Juan
- Department of Research, Igenomix, Parque Tecnológico, Rda. de Narcís Monturiol, nº11, B, 46980, Paterna, Valencia, Spain
| | - Alicia Quiñonero
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106 - Torre A, Planta 1ª, 46026, Valencia, Spain
| | - Francisco Domínguez
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106 - Torre A, Planta 1ª, 46026, Valencia, Spain
| | - Angel Martin
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106 - Torre A, Planta 1ª, 46026, Valencia, Spain
| | - Carmina Vidal
- Department of Gynaecology, IVIRMA Global, Plaça de La Policía Local, 3, Valencia, 46015, Spain
| | - Diana Beltrán
- IVF Laboratory, IVIRMA Global, Plaça de La Policía Local, 3, 46015, Valencia, Spain
| | - Amparo Mifsud
- IVF Laboratory, IVIRMA Global, Plaça de La Policía Local, 3, 46015, Valencia, Spain
| | - Amparo Mercader
- IVF Laboratory, IVIRMA Global, Plaça de La Policía Local, 3, 46015, Valencia, Spain
| | - Antonio Pellicer
- Department of Gynaecology, IVIRMA Global, Largo Ildebrando Pizzetti, 1, Rome, 00197, Italy
| | - Ana Cobo
- IVF Laboratory, IVIRMA Global, Plaça de La Policía Local, 3, 46015, Valencia, Spain
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Giles J, Cruz M, Cobo A, Vidal C, Requena A, Remohi J, Bosch E. Medroxyprogesterone acetate: an alternative to GnRH-antagonist in oocyte vitrification for social fertility preservation and preimplantation genetic testing for aneuploidy. Reprod Biomed Online 2023; 47:103222. [PMID: 37290978 DOI: 10.1016/j.rbmo.2023.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 01/23/2023] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 06/10/2023]
Abstract
RESEARCH QUESTION Can medroxyprogesterone acetate (MPA) be used as a pituitary suppressor instead of a gonadotrophin releasing hormone (GnRH) antagonist during ovarian stimulation in elective fertility preservation and preimplantation genetic testing for aneuploidy (PGT-A) cycles? DESIGN A multicentre, retrospective, observational, cohort study conducted in 11 IVIRMA centres affiliated to private universities. Of a total of 1652 cycles of social fertility preservation, 267 patients were stimulated using a progestin-primed ovarian stimulation protocol (PPOS), and 1385 patients received a GnRH antagonist. In the PGT-A cycles, 5661 treatments were analysed: 635 patients received MPA and 5026 patients received GnRH antagonist. A further 66 fertility preservation and 1299 PGT-A cycles were cancelled. All cycles took place between June 2019 and December 2021. RESULTS In the social fertility preservation cycles, the number of mature oocytes vitrified in MPA was similar to the number of those treated with an antagonist, a trend that was seen regardless of age (≤35 or >35 years). In the PGT-A cycles, no differences were found in number of metaphase II, two pronuclei, number of biopsied embryos (4.4 ± 3.1 versus 4.5 ± 3.1), rate of euploidy (57.9% versus 56.4%) or ongoing pregnancy rate (50.4% versus 47.1%, P = 0.119) between the group receiving MPA versus a GnRH antagonist, whereas the clinical miscarriage rate was higher in the antagonist group (10.4% versus 14.8%, P = 0.019). CONCLUSIONS Administration of PPOS yields similar results to GnRH antagonists in oocytes retrieved, rate of euploid embryos and clinical outcome. Hence, PPOS can be recommended for ovarian stimulation in social fertility preservation and PGT-A cycles, as it allows greater patient comfort.
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Affiliation(s)
- Juan Giles
- Human Reproduction Department, IVI-RMA, Plaza de la Policia Local, 3, PC, Valencia 46015, Spain; IVI Foundation - IIS La Fe. Avenida Fernando Abril Martorell, Torre 106 A, 7(a) planta, 46026, Valencia, Spain
| | - Maria Cruz
- IVI Foundation - IIS La Fe. Avenida Fernando Abril Martorell, Torre 106 A, 7(a) planta, 46026, Valencia, Spain; IVIRMA Global, Avenida del Talgo 68, Madrid 28023, Spain
| | - Ana Cobo
- IVI Foundation - IIS La Fe. Avenida Fernando Abril Martorell, Torre 106 A, 7(a) planta, 46026, Valencia, Spain; Cryopreservation Department, IVI-RMA, Plaza de la Policia Local, 3, PC, Valencia 46015, Spain
| | - Carmen Vidal
- Human Reproduction Department, IVI-RMA, Plaza de la Policia Local, 3, PC, Valencia 46015, Spain; IVI Foundation - IIS La Fe. Avenida Fernando Abril Martorell, Torre 106 A, 7(a) planta, 46026, Valencia, Spain
| | - Antonio Requena
- IVI Foundation - IIS La Fe. Avenida Fernando Abril Martorell, Torre 106 A, 7(a) planta, 46026, Valencia, Spain; IVIRMA Global, Avenida del Talgo 68, Madrid 28023, Spain
| | - Jose Remohi
- Human Reproduction Department, IVI-RMA, Plaza de la Policia Local, 3, PC, Valencia 46015, Spain; IVI Foundation - IIS La Fe. Avenida Fernando Abril Martorell, Torre 106 A, 7(a) planta, 46026, Valencia, Spain
| | - Ernesto Bosch
- Human Reproduction Department, IVI-RMA, Plaza de la Policia Local, 3, PC, Valencia 46015, Spain; IVI Foundation - IIS La Fe. Avenida Fernando Abril Martorell, Torre 106 A, 7(a) planta, 46026, Valencia, Spain
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Dueñas JA, Cobo A, López L, Galtarossa F, Goasduff A, Mengoni D, Sánchez-Benítez AM. Test Bench for Highly Segmented GRIT Double-Sided Silicon Strip Detectors: A Detector Quality Control Protocol. Sensors (Basel) 2023; 23:5384. [PMID: 37420550 DOI: 10.3390/s23125384] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 07/09/2023]
Abstract
This work deals with the characteristics of highly segmented double-sided silicon detectors. These are fundamental parts in many new state-of-the-art particle detection systems, and therefore they must perform optimally. We propose a test bench that can handle 256 electronic channels with off-the-shelf equipment, as well as a detector quality control protocol to ensure that the detectors meet the requirements. Detectors with a large number of strips bring new technological challenges and issues that need to be carefully monitored and understood. One of the standard 500 μm thick detectors of the GRIT array was investigated, undergoing studies that revealed its IV curve, charge collection efficiency, and energy resolution. From the data obtained, we calculated, among other things, the depletion voltage (110 V), the resistivity of the bulk material (9 kΩ·cm), and the electronic noise contribution (8 keV). We present, for the first time, a methodology called "the energy triangle'' to visualize the effect of charge sharing between two adjacent strips and to study the hit distribution with the interstrip-to-strip hit ratio (ISR).
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Affiliation(s)
- J A Dueñas
- Departamento de Ingeniería Eléctrica y Centro de Estudios Avanzados en Física, Matemáticas y Computación, Universidad de Huelva, 21007 Huelva, Spain
| | - A Cobo
- Dipartimento di Fisica Astronomia dell' Università di Padova, 35131 Padova, Italy
| | - L López
- Dipartimento di Elettronica Informazione e Bioingegneria dell' Politecnico di Milano, 20133 Milano, Italy
| | | | - A Goasduff
- INFN Laboratori Nazionali di Legnaro, 35131 Padova, Italy
| | - D Mengoni
- Dipartimento di Fisica Astronomia dell' Università di Padova, 35131 Padova, Italy
- INFN, Sezione di Padova, 35131 Padova, Italy
| | - A M Sánchez-Benítez
- Departamento de Ciencias Integradas y Centro de Estudios Avanzados en Física, Matemáticas y Computación, Universidad de Huelva, 21071 Huelva, Spain
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Novella SR, Cobo A, Montes A, Lopez JS, Rondan MA, Palanca SN, Tena I, Miguel J, Navarro B, Domingo I, Esteban SC, Díaz M, Andrade P, Rosello E, Santander JL, Estelles DL, Hernández AS. 70P Impact of TP53/KRAS mutations on overall survival of metastatic non-small cell lung cancer patients (pts) treated with systemic first-line therapy. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00324-6] [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: 04/03/2023]
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Pellicer N, Cozzolino M, Diaz-García C, Galliano D, Cobo A, Pellicer A, Herraiz S. Ovarian rescue in women with premature ovarian insufficiency: facts and fiction. Reprod Biomed Online 2023; 46:543-565. [PMID: 36710157 DOI: 10.1016/j.rbmo.2022.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 07/26/2022] [Revised: 11/16/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
The ovary has a comparatively short functional lifespan compared with other organs, and genetic and pathological injuries can further shorten its functional life. Thus, preserving ovarian function should be considered in the context of women with threats to ovarian reserve, such as ageing, premature ovarian insufficiency (POI) and diminished ovarian reserve (DOR). Indeed, one-third of women with POI retain resting follicles that can be reactivated to produce competent oocytes, as proved by the in-vitro activation of dormant follicles. This paper discusses mechanisms and clinical data relating to new therapeutic strategies using ovarian fragmentation, stem cells or platelet-rich plasma to regain ovarian function in women of older age (>38 years) or with POI or DOR. Follicle reactivation techniques show promising experimental outcomes and have been successful in some cases, when POI is established or DOR diagnosed; however, there is scarce clinical evidence to warrant their widespread clinical use. Beyond these contexts, also discussed is how new insights into the biological mechanisms governing follicular dynamics and oocyte competence may play a role in reversing ovarian damage, as no technique modifies oocyte quality. Additional studies should focus on increasing follicle number and quality. Finally, there is a small but important subgroup of women lacking residual follicles and requiring oocyte generation from stem cells.
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Affiliation(s)
| | | | - César Diaz-García
- IVI London, EGA Institute for Women's Health, UCL, London, UK; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | | | - Ana Cobo
- IVI RMA Valencia, Valencia, Spain
| | - Antonio Pellicer
- IVI RMA Rome, Rome, Italy; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Sonia Herraiz
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.
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Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Ruiz-Galiana J, Cantón R, De Lucas Ramos P, García-Botella A, García-Lledó A, Hernández-Sampelayo T, Gómez-Pavón J, González Del Castillo J, Muñoz P, Valerio M, Catalán P, Burillo A, Cobo A, Alcamí A, Bouza E. Monkeypox in humans: a new outbreak. Rev Esp Quimioter 2022; 35:509-518. [PMID: 35785957 PMCID: PMC9728594 DOI: 10.37201/req/059.2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 12/24/2022]
Abstract
Infection caused by Monkeypox Virus (MPVX) has small rodents as its natural reservoir and both monkeys and humans are occasional hosts. The causative agent is an Orthopoxvirus (MPVX) that was isolated in monkeys in 1958 and proved capable of passing to humans in 1970. It remained contained in Africa, causing isolated episodes of infection, until 2003 when an outbreak occurred in the United States following importation of animals from that continent. Since then, anecdotal cases have continued to be reported outside Africa, usually very clearly linked to travelers to those countries, but in May 2022, a broad outbreak of this disease has begun, now affecting several continents, with the emergence of human cases of MPVX (H-MPVX) infection mainly among Men that have Sex with Men (MSM). The disease has an incubation time ranging from 5 to 15 days and is characterized by the presence of pustules, fever, malaise and headache. The presence of significant regional lymphadenopathy is a differential feature with episodes of classical smallpox. Proctitis and pharyngitis, with minimal skin lesions, may be another form of presentation. Diagnosis can be confirmed by PCR testing of lesions or by demonstration of MPVX in other body fluids or tissues, although in the appropriate epidemiologic setting the clinical picture is highly suggestive of the disease. Effective drug treatment has been developed as part of programs to protect against potential bioterrorist agents and smallpox vaccinees are known to have high protection against monkeypox. New vaccines are available, but neither the drugs nor the vaccines are yet freely available on the market. The prognosis of the disease appears, at least in adults in developed countries, to be good, with very low mortality figures and much less aggressive behavior than that described in classical smallpox. Isolation measures, essential for the control of the outbreak, have been published by the health authorities.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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Coello A, MAR NOHALES Córcoles MDEL, Meseguer M, Gimenez JR, Vallejo, embryologist B, Cobo A. IMPACT OF FRESH-EMBRYO PARAMETERS ON ONGOING PREGNANCY IN VITRIFIED/WARMED EUPLOID BLASTOCYST CYCLES. Fertil Steril 2022. [DOI: 10.1016/j.fertnstert.2022.08.357] [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: 11/04/2022]
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Arnal LB, Rocha JC, Martínez LC, Garg A, Gouveia Nogueira MF, Coello A, Cobo A, Meseguer M. APPLICATION OF ARTIFICIAL INTELLIGENCE ON VITRIFIED/WARMED EMBRYOS: PREDICTION OF LIVE BIRTH FROM POST-WARMED BLASTOCYST DYNAMICS. Fertil Steril 2022. [DOI: 10.1016/j.fertnstert.2022.08.337] [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: 11/04/2022]
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Conversa L, Payá E, Bori L, Coello A, Cobo A, Meseguer M. Predicting implantation of vitrified-warmed blastocysts: Artificial Intelligence applied to post-warming dynamics. Reprod Biomed Online 2022. [DOI: 10.1016/j.rbmo.2022.08.022] [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: 11/28/2022]
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Coello A, MAR NOHALES Córcoles MDEL, Meseguer M, Campos, Embryologist P, Gimenez JR, Cobo A. DEGREE OF BLASTOCYST EXPANSION PREDICTS SURVIVAL IN EUPLOID VITRIFIED/WARMED EMBRYOS. Fertil Steril 2022. [DOI: 10.1016/j.fertnstert.2022.08.360] [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: 11/04/2022]
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Giles J, Cruz M, Cobo A, Vidal C, Alama P, Requena A, Bosch E. P-601 Is Medroxiprogesterone acetate (MPA) an adequate alternative to GnRH antagonist in oocyte vitrification for non oncological fertility preservation (FP) and preimplantation genetic test (PGT-A) cycles? Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Can we use MPA as a pituitary inhibitor instead of the GnRH antagonist in ovarian stimulation protocols in non-oncological fertility preservation and PGT-A cycles?
Summary answer
MPA can act as a substitute of GnRH antagonist for pituitary suppression in FP and PGT-A cycles, since the results are similar between both groups.
What is known already
Progestin-primed ovarian stimulation (PPOS) protocols using exogenous progesterone to replace GnRH analogs during the follicular phase of OS have emerged as an efficient alternative to prevent LH from peaking and have been used successfully in different types of patients.
Fertility preservation (FP) and preimplantation genetic testing (PGT-A) have become new emerging areas of assisted reproduction. FP gives women the ability to have children using their own gametes after age-related fertility decline, while PGT-A appears to improve reproductive outcomes in advanced maternal age at increased risk of aneuploid embryos. However, few data are available for both indications regarding PPOS cycle outcomes.
Study design, size, duration
Multicenter, retrospective, observational, cohort study conducted in eleven IVIRMA centers attached to private universities.
We included a total of 4,961 cycles of non-oncological fertility preservation that were distributed as follows: n = 494 were stimulated under a PPOS protocol while n = 4,467 received a GnRH antagonist. Regarding PGT-A cycles, we analyzed 12,461 treatments, of which n = 686 and n = 11,775 received MPA and GnRH antagonist, respectively. Cycles were performed from January 2017 to December 2021.
Participants/materials, setting, methods
Patients were divided according to the protocol used for preventing premature luteinization during follicular phase of OS. In the MPA group, participants received 10 mg daily administered orally, while in the control group, women received an antagonist once the main follicle reached 13 mm.
In FP cycles, ovarian response specific parameters were evaluated, such as endocrine profile and mature oocytes; in PGT-A treatments, main variables were number of biopsied and aneuploid embryos and reproductive outcomes.
Main results and the role of chance
Regarding FP's baseline characteristics, age was statistically but not clinically significant between the two groups. Length of ovarian stimulation and total dose of hMG administered were similar in both groups, despite the significantly higher total dose of FSH administered in MPA compared to the GnRH antagonist group (p = 0.008) . Number of mature oocytes retrieved (10.2 [95% CI 9.6-10.8] vs 9 [95% CI 8.8-9.2]) was significantly higher in MPA compared to antagonist group; this trend continued regardless of age (≤ 35 or > 35 years).
PGT-A cycles followed the same tendency in terms of demographic characteristics. Length of OS was comparable between groups, whilst the total dose of rFSH and hp-HMG administered in the MPA were significantly higher than that in the GnRH antagonist group. Although the number of MII was comparable and despite the lower number of embryos biopsied in the MPA group (4.5±0.2 vs 4.7±0.06, p = 0.031) the number of aneuploid embryos was similar between the two groups (2.3±0.1 vs 2.4±0.04, p = 0.474), as well as implantation (56% vs. 54% p = 0.359) and clinical pregnancy rate (64.1% vs. 62.1, p = 0.316). The miscarriage rate was significantly lower in the group treated with MPA compared to GnRH antagonists (4.7% vs. 8.2%, p = 0.001).
Limitations, reasons for caution
The retrospective nature of this study may be a reason for caution and only association, not causation, can be inferred from the results. Despite being the largest sample size ever reported with PPOS in no oncological FP and PGT-A, the number of patients included is still low.
Wider implications of the findings
The administration of PPOS yielded similar or even better results than those observed with GnRH antagonists in terms of oocytes retrieved, rate of aneuploid embryos or clinical results. Therefore, PPOS could be recommended for ovarian stimulation in non-oncological FP and PGT-A cycles as it allows for a more patient-friendly approach.
Trial registration number
Not applicable
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Affiliation(s)
- J Giles
- IVIRMA Valencia, Reproductive Medicine , Valencia, Spain
| | - M Cruz
- IVIRMA Madrid, Reproductive Medicine , Madrid, Spain
| | - A Cobo
- IVIRMA Valencia, Cryopreservation , Valencia, Spain
| | - C Vidal
- IVIRMA Valencia, Reproductive Medicine , Valencia, Spain
| | - P Alama
- IVIRMA Valencia, Reproductive Medicine , Valencia, Spain
| | - A Requena
- IVIRMA Madrid, Reproductive Medicine , Madrid, Spain
| | - E Bosch
- IVIRMA Valencia, Reproductive Medicine , Valencia, Spain
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Erazo-Torricelli R, Urtizberea A, Cobo A, Richard P, Schultz M. CONGENITAL MUSCULAR DYSTROPHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.092] [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: 10/20/2022]
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Pérez-Sánchez M, Martin A, De los Santos JM, Nohales M, Cobo A, Santos MJDL. MITOCHONDRIAL DNA CONTENT BEFORE VITRIFICATION (Mitoscore®) IS NOT A RELIABLE MARKER OF MITOCHONDRIAL MASS AND ACTIVITY IN THE HUMAN BLASTOCYST: A CONFOCAL AND ELECTRON MICROSCOPY APPROACH. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.460] [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: 11/29/2022]
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Pérez-Sánchez M, Martin A, Quiñonero A, Dominguez F, Vidal C, Pellicer A, Cobo A, Santos MJDL. MITOCHONDRIAL DNA REPLICATION AFTER BLASTOCYST VITRIFICATION: A HEROIC ACT OF SURVIVAL OR AN ALERT FOR THE FUTURE? Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.522] [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: 11/16/2022]
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Martínez A, Infante JR, Quirós J, Rayo JI, Serrano J, Moreno M, Jiménez P, Cobo A, Baena A. Baseline 18F-FDG PET/CT quantitative parameters as prognostic factors in esophageal squamous cell cancer. Rev Esp Med Nucl Imagen Mol 2021; 41:164-170. [PMID: 34452867 DOI: 10.1016/j.remnie.2021.07.006] [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: 01/14/2021] [Accepted: 03/18/2021] [Indexed: 11/19/2022]
Abstract
AIM To determine the utility of [18F]FDG PET/CT quantitative parameters as prognostic factors for the response to neoadjuvant treatment, progression-free survival (PFS) and cancer-specific survival (CSS) in patients with esophageal squamous cell carcinoma (SCC). MATERIAL AND METHODS Thirty patients (29 men) diagnosed with SCC were retrospectively evaluated over a 6-year interval. Metabolic parameters were determined: maximum SUV (SUVmax), mean SUV (SUVmed), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from baseline PET/CT study. After treatment with chemotherapy and/or radiotherapy, response to treatment and patient survival were assessed. The comparison of parameters between groups of responders and non-responders was carried out using a Mann-Whitney U test ROC curves and the Kaplan-Meier method were used for analysis of prognostic factors and survival curves. RESULTS The average follow-up was 22.4 months, with 22 recurrence-progressions and 25 deaths. Significant differences were demonstrated between responders and non-responders with respect to tumor size, MTV and TLG. Survival analysis found significant differences for SCE and CSS depending on these three parameters. CONCLUSION Metabolic parameters MTV and TLG, and tumor size were prognostic factors for neoadjuvant treatment response, PFS, and CSS in patients diagnosed with SCC. Neither SUVmax nor SUVmed were predictive for any of the evaluation criteria. Results could help to personalize patient treatment.
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Affiliation(s)
- A Martínez
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain.
| | - J R Infante
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
| | - J Quirós
- Servicio de Oncología Radioterápica, Hospital Universitario de Badajoz, Badajoz, Spain
| | - J I Rayo
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
| | - J Serrano
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
| | - M Moreno
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
| | - P Jiménez
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
| | - A Cobo
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
| | - A Baena
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
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Cobo A. O-014 How effective is oocyte cryopreservation? Hum Reprod 2021. [DOI: 10.1093/humrep/deab125.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract text
The challenge of cryopreserve, store for prolonged period, and successfully implant the female gamete is nowadays feasible thanks to vitrification. The technology that was initially validated in oocyte recipients is currently applied to a vast population, including women at risk of losing their ovarian function due either to iatrogenic causes as occurs in cancer patients, or due to the natural depletion of the ovarian reserve as a result of age related fertility decline. That is the case of a growing population of women who wish to postpone childbearing and decide on oocyte vitrification as a means of fertility preservation (FP). At present, there is a growing body of evidence regarding the use of vitrified oocytes by many women under different indications, which makes it possible to evaluate the approach from different scenarios. So that vitrification can be evaluated in terms on survival rates, embryo development and the rate at which vitrified oocytes develop into live-born children in IVF cycles using vitrified oocytes which were initially stored due to different reasons. The effects of vitrification at the subcellular level and its impact on oocyte competence is of interest in the evaluation of the efficacy of the technology. Some studies have indicated that vitrification may affect ultrastructure, reactive oxygen species (ROS) generation, gene expression, and epigenetic status. However, it is still controversial whether oocyte vitrification could induce DNA damage in the oocytes and the resulting early embryos. Recent studies show that oocytes survival and clinical outcome after vitrification can be impaired by patients’ age and the clinical indication or the reason for vitrification. These studies show that age at oocyte retrieval strongly affects the survival and reproductive prognosis. In our experience, oocyte survival, pregnancy and cumulative live birth rates are significantly higher when patients are aged 35 years or younger versus patients older than 35 years at oocyte retrieval. Therefore, elective-FP patients should be encouraged to decide at young ages to significantly increase their chances of success. There is also evidence that the reason for vitrification is associated to the success rates. Poorer reproductive outcome was reported in cancer patients, low responders and endometriosis patients when compared to healthy women in age matching groups. Moreover, there are certain individualities linked to specific populations, as occurs when endometriosis patients had cystectomy earlier than the oocyte retrieval for FP. These women achieved lower success rates as compared to non-operated age matching counterparts. In this case, the lower cumulative live birth rates observed in operated women are, most probably, due to the smaller number of oocytes available, as a consequence of the detrimental effect of the surgery on the ovarian reserve. In this regard, several reports show that the number of oocytes available per patient is another variable closely related to the outcome in all populations using vitrified oocytes after FP. Thus, a significant improvement in the cumulative live birth rates can be achieved by adding a few oocytes, especially in healthy young patients. Different populations using vitrified oocytes under several indications achieve differential results in terms of pregnancy rates, when calculated in overall. Nonetheless, when the calculations for the cumulative probability of achieving a baby are made according the number of oocytes used per patient belonging to the same group of age, the results become comparable between different populations, as shown by the comparison between elective freezers versus endometriosis patients. Undoubtedly, vitrification can be recognized as one of the latest brakethrough in the ART field, but certainly the next step forward would be the successfull automatization of the vitrification and warming processes to achieve fully consistency among different laboratories.
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Affiliation(s)
- A Cobo
- IVIRMA-Valencia, IVF Laboratory-Cryopreservation Unit, Valencia, Spain
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Alegre L, Bori L, Coello A, Ferreira AS, Rocha JC, Cobo A, Meseguer M. P–135 Artificial neural networks (ANNs) for live birth prediction in frozen embryo transfers: the strength of post-warmed blastocyst dynamics. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does the post-warmed blastocyst dynamics have an impact over the likelihood of achieving a live birth?
Summary answer
Variables related to dynamics of vitrified/warmed blastocysts have shown a greater effect on the live birth prediction than only embryo morphological quality through artificial intelligence.
What is known already
Morphological dynamics of vitrified/warmed blastocysts were described by Coello et al., in 2017. The investigated markers were the thickness of zona pellucida (µm) and blastocysts area (µm2) after warming and before transfer, the area of the inner cell mass (µm2), time of initiation of reexpansion (in minutes), and presence of collapse or contraction. They found a correlation between blastocyst reexpansion and implantation rate and developed a hierarchical model for implantation prediction. In our study, we evaluated the post-warmed blastocyst dynamics for live birth prediction by using novel artificial intelligence techniques.
Study design, size, duration
This retrospective analysis included 415 vitrified/warmed blastocysts with known live birth data. Blastocysts after warming were placed in EmbryoScope (Vitrolife) immediately until embryo transfer. Embryo evaluation and selection were performed by senior embryologists according to fresh blastocyst morphology (before vitrification). Then, parameters related to post-warmed blastocyst dynamics were calculated. Finally, these variables and the embryo morphological grade before the vitrification were used as input data for ANNs optimized with genetic algorithm for live birth prediction.
Participants/materials, setting, methods
Blastocysts were vitrified and warmed by the Cryotop method (Kitazato,Biopharma). During the period between the warming procedure and the embryo transfer, the following variables were measured with the drawing tools provided by the EmbryoViewer workstation: zona pellucida thinning (µm), blastocyst expansion (um) and the speed of these two events (µm/h). Finally, multilayer perceptron neural networks were trained with data of 331 embryos by using the backpropagation learning algorithm and tested with data of 84 embryos.
Main results and the role of chance
We trained and tested three architectures of ANNs with different input variables as follows: post-warmed variables (thinning of the zona pellucida, blastocyst expansion, thinning speed and expansion speed) and morphological grade (A, B or C) for ANN1, only post-warmed variables for ANN2 and only morphological grade for ANN3. The highest success rate when ANNs classified embryos as positive and negative live birth (LB+ and LB-) was achieved by combining post-warmed variables and morphological grade before embryo vitrification. The general accuracies for the blind tests were: 73.8% for ANN1, 66.7% for ANN2 and 71.4% for ANN3. Likewise, this combination achieved the highest AUC on test dataset to predict LB- (0.76 for ANN1, 0.74 for ANN2 and 0.67 for ANN3). However, the ANN2 trained with only post-warmed variables showed the best capacity to predict LB+ with an AUC of 0.73 (versus 0.46 for ANN1 and 0.5 for ANN3).
Limitations, reasons for caution
The main limitation is the subjectivity of manual annotations, although only one embryologist participated in this task.
Wider implications of the findings: The dynamics of vitrified/warmed blastocysts prior to embryo transfer could be more relevant variables than the morphological quality on day 5 before the cryopreservation. The analysis of embryo behavior after warming could improve clinical outcomes in frozen embryo transfers.
Trial registration number
none
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Affiliation(s)
- L Alegre
- Instituto Valenciano de Infertilidad IVI, In Vitro Fertilization, Valencia, Spain
| | - L Bori
- Instituto Valenciano de Infertilidad IVI, In Vitro Fertilization, Valencia, Spain
| | - A Coello
- Instituto Valenciano de Infertilidad IVI, In Vitro Fertilization, Valencia, Spain
| | - A S Ferreira
- Universidade Estadual Paulista, Research department, Sao Paulo, Brazil
| | - J C Rocha
- Universidade Estadual Paulista, Research department, Sao Paulo, Brazil
| | - A Cobo
- Instituto Valenciano de Infertilidad IVI, In Vitro Fertilization, Valencia, Spain
| | - M Meseguer
- Instituto Valenciano de Infertilidad IVI, In Vitro Fertilization, Valencia, Spain
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Martínez A, Infante JR, Quirós J, Rayo JI, Serrano J, Moreno M, Jiménez P, Cobo A, Baena A. Baseline 18F-FDG PET/CT quantitative parameters as prognostic factors in esophageal squamous cell cancer. Rev Esp Med Nucl Imagen Mol 2021; 41:S2253-654X(21)00107-4. [PMID: 34088649 DOI: 10.1016/j.remn.2021.03.016] [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: 01/14/2021] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 11/20/2022]
Abstract
AIM To determine the utility of 18F-FDG PET/CT quantitative parameters as prognostic factors for the response to neoadjuvant treatment, progression-free survival (PFS) and cancer-specific survival (CSS) in patients with esophageal squamous cell carcinoma (SCC). MATERIAL AND METHODS Thirty patients (29 men) diagnosed with SCC were retrospectively evaluated over a 6-year interval. Metabolic parameters were determined: maximum SUV (SUVmax), mean SUV (SUVmed), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from baseline PET/CT study. After treatment with chemotherapy and/or radiotherapy, response to treatment and patient survival were assessed. The comparison of parameters between groups of responders and non-responders was carried out using a Mann-Whitney U test. ROC curves and the Kaplan-Meier method were used for analysis of prognostic factors and survival curves. RESULTS The average follow-up was 22.4months, with 22 recurrence-progressions and 25 deads. Significant differences were demonstrated between responders and non-responders with respect to tumor size, MTV and TLG. Survival analysis found significant differences for SCE and CSS depending on these three parameters. CONCLUSION Metabolic parameters MTV and TLG, and tumor size were prognostic factors for neoadjuvant treatment response, PFS, and CSS in patients diagnosed with SCC. Neither SUVmax nor SUVmed were predictive for any of the evaluation criteria. Results could help to personalize patient treatment.
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Affiliation(s)
- A Martínez
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España.
| | - J R Infante
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España
| | - J Quirós
- Servicio de Oncología Radioterápica, Hospital Universitario de Badajoz, Badajoz, España
| | - J I Rayo
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España
| | - J Serrano
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España
| | - M Moreno
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España
| | - P Jiménez
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España
| | - A Cobo
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España
| | - A Baena
- Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, España
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Cobo A, García-Velasco JA, Remohí J, Pellicer A. Oocyte vitrification for fertility preservation for both medical and nonmedical reasons. Fertil Steril 2021; 115:1091-1101. [DOI: 10.1016/j.fertnstert.2021.02.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
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Coello A, Nohales M, Meseguer M, de Los Santos MJ, Remohí J, Cobo A. Prediction of embryo survival and live birth rates after cryotransfers of vitrified blastocysts. Reprod Biomed Online 2021; 42:881-891. [PMID: 33785304 DOI: 10.1016/j.rbmo.2021.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/27/2020] [Revised: 01/17/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
RESEARCH QUESTION Which pre-vitrification parameters are the most predictive of survival and live birth in vitrified-warmed blastocyst transfer cycles? DESIGN A retrospective study including 11,936 warmed blastocysts. Pre-vitrification morphological parameters analysed for blastocysts included day of vitrification; blastocyst expansion degree; trophoectoderm grade (A, B and C); and inner cell mass grade (A, B and C). Univariate and multivariate generalized estimating equations models were used to analyse survival, clinical pregnancy and live birth rate. A stepwise regression analysis was conducted to select and classify by order which outcomes were the most predictive. RESULTS The odds of survival increased almost twice for blastocysts with lower expansion degree (OR 1.92; 95% CI 1.37 to 2.69; P < 0.001) and by about 50% for blastocysts vitrified on day 5 (OR 1.56; 95% CI 1.27 to 1.89; P < 0.001). Multivariate generalized estimating equations model showed that trophectoderm grade followed by the day of vitrification were the most significant predictors of live birth. The odds of live birth increased nearly three times for blastocysts with trophectoderm graded as A compared with those with trophectoderm graded as C (OR 2.85; 95% CI 2.48 to 3.27; P < 0.001), and double for blastocysts vitrified on day 5 compared with those vitrified on day 6 (OR 2.22; 95% CI 1.97 to 2.49; P < 0.001). The odds of live birth also increased in higher expansion degree blastocysts. CONCLUSIONS Blastocysts vitrified on day 5 and those with higher trophoectoderm grade should be given priority when warming.
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Affiliation(s)
- Aila Coello
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain.
| | - Mar Nohales
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Marcos Meseguer
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - M José de Los Santos
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - José Remohí
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Ana Cobo
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
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Cobo A, Coello A, de Los Santos MJ, Giles J, Pellicer A, Remohí J, García-Velasco JA. Number needed to freeze: cumulative live birth rate after fertility preservation in women with endometriosis. Reprod Biomed Online 2021; 42:725-732. [PMID: 33573907 DOI: 10.1016/j.rbmo.2020.12.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 10/15/2020] [Revised: 12/15/2020] [Accepted: 12/29/2020] [Indexed: 11/16/2022]
Abstract
RESEARCH QUESTION How does the number of oocytes used affect the cumulative live birth rate (CLBR) in endometriosis patients who had their oocytes vitrified for fertility preservation? DESIGN Retrospective observational study including data from 485 women with endometriosis who underwent fertility preservation from January 2007 to July 2018. Survival curves and Kaplan-Meier plots were used to analyse the CLBR according to the number of vitrified oocytes used. Endometriosis curves were compared with plots developed using elective fertility preservation (EFP) patients as control group. Log-rank, Breslow and Tarone-Ware tests were used to compare the survival curves. RESULTS The CLBR increased as the number of oocytes used per patient rose, reaching 89.5% (95% confidence interval [CI] 80.0-99.1%) using 22 oocytes. Higher outcomes were observed in young women (≤35 years old versus >35 years old). In the younger group, the CLBR was 95.4% (95% CI 87.2-103.6%) using approximately 20 oocytes versus 79.6% (95% CI 58.1-101.1%) in older women (log-rank [Mantel-Cox] P = 0.002). The mean age was higher in EFP patients (37.2 ± 4.9 versus 35.7 ± 3.7; P < 0.001). The outcome was better in the endometriosis group as compared with EFP: a CLBR of 89.5% (95% CI 80.0-99.1%) versus 59.9% (95% CI 51.4-68.6%) when 22 oocytes were used (log-rank [Mantel-Cox] P < 0.00001). CONCLUSION The probability of live birth increases as the number of oocytes used increases in patients with endometriosis, but better outcomes were observed among young women. The information provided here may be of interest to both patients and treating physicians for counselling purposes.
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Affiliation(s)
- Ana Cobo
- IVIRMA Valencia, Plaza de la Policía Local 3, Valencia 46015, Spain.
| | - Aila Coello
- IVIRMA Valencia, Plaza de la Policía Local 3, Valencia 46015, Spain
| | | | - Juan Giles
- IVIRMA Valencia, Plaza de la Policía Local 3, Valencia 46015, Spain
| | - Antonio Pellicer
- IVIRMA Valencia, Plaza de la Policía Local 3, Valencia 46015, Spain
| | - José Remohí
- IVIRMA Valencia, Plaza de la Policía Local 3, Valencia 46015, Spain
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Infante J, Cabrera J, Rayo J, Cruz C, Serrano J, Moreno M, Martínez A, Jiménez P, Cobo A. 18F-FDG PET/CT quantitative parameters as prognostic factors in localized and inoperable lung cancer. Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2020.09.001] [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: 11/24/2022]
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Infante JR, Cabrera J, Rayo JI, Cruz C, Serrano J, Moreno M, Martínez A, Jiménez P, Cobo A. 18F-FDG PET/CT quantitative parameters as prognostic factor in localized and inoperable lung cancer. Rev Esp Med Nucl Imagen Mol 2020; 39:353-359. [PMID: 32605894 DOI: 10.1016/j.remn.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/25/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022]
Abstract
AIM To assess the utility of 18F-FDG PET/CT quantitative parameters as prognostic factor in patients diagnosed with localized and inoperable lung cancer treated by stereotactic body radiotherapy (SBRT). MATERIAL AND METHODS Fifty patients (42 men) diagnosed in the last 7years with early-stage lung cancer and treated with SBRT alone were assessed by a prospective study. After PET/CT study, metabolic parameters maximum SUV (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were determined at different thresholds. The prognostic factors for overall survival (OS), cause-specific survival (CS) and disease-free survival (DFS) were analysed by Cox proportional hazards model and the survival analysis by Kaplan-Meier method. RESULTS The average follow-up was 39.6months, with 21 recurrences and 24 dead. Univariate analysis determined MTV30 and MTV40 as predictors for OS; MTV30, MTV40, TLG30 and TLG40 for CS, and MTV2, MTV30, MTV40, TLG2, TLG30 and TLG40 for DFS. Survival analysis found statistically significant differences for CS and DFS depending on tumor size and for DFS considering the cut-off values of MTV2 and TLG2 (threshold SUVmax=2). SUVmax, age and sex were not shown to be significant factors. CONCLUSION Pre-treatment quantitative assessment using metabolic parameters MTV2 and TLG2 as well as tumor size proved to be prognostic factors in patients diagnosed with localized and inoperable lung cancer treated by SBRT. Results could help to personalize treatment.
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Affiliation(s)
- J R Infante
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España.
| | - J Cabrera
- Servicio de Oncología Radioterápica, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
| | - J I Rayo
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
| | - C Cruz
- Servicio de Oncología Radioterápica, Hospital Punta de Europa, Algeciras, Cádiz, España
| | - J Serrano
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
| | - M Moreno
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
| | - A Martínez
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
| | - P Jiménez
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
| | - A Cobo
- Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
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Cobo A, Giles J, Paolelli S, Pellicer A, Remohí J, García-Velasco JA. Oocyte vitrification for fertility preservation in women with endometriosis: an observational study. Fertil Steril 2020; 113:836-844. [PMID: 32145929 DOI: 10.1016/j.fertnstert.2019.11.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [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: 09/04/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To describe the outcome of fertility preservation (FP) using vitrified oocytes in patients with endometriosis and to determine the impact of ovarian surgery. DESIGN Retrospective observational study. SETTING University-affiliated private in vitro fertilization (IVF) center. PATIENT(S) Four hundred and eighty-five women with endometriosis who underwent FP from January 2007 to July 2018. INTERVENTION(S) Vitrification of metaphase II (MII) oocytes for future use. MAIN OUTCOME MEASURE(S) Oocyte survival rate and cumulative live-birth rate (CLBR). RESULT(S) Mean age at vitrification was 35.7 ± 3.7 years. The women undergoing operations were younger than the nonsurgical patients (33.4 ± 3.6 years vs. 36.7 ± 3.7 years). The survival rate and CLBR were 83.2% and 46.4%, respectively. The number of vitrified oocytes per cycle (6.2 ± 5.8) was higher for the nonsurgical patients compared with the unilateral (5.0 ± 4.5) or bilateral (4.5 ± 4.4) surgery groups, but was comparable among the surgical patients. The effect of age (adjusted odds ratio [OR] 0.904; 95% CI, 0.858-0.952), number of oocytes (adjusted OR 1.050; 95% CI, 1.025-1.091), and survival (adjusted OR 1.011; 95% CI, 1.001-1.020) on the CLBR was confirmed. However, the effect of surgery was not observed (adjusted OR 1.142; 95% CI, 0.778-1.677). Nonetheless, the ovarian response (vitrified oocytes = 8.6 ± 6.9 vs. 5.1 ± 4.8) and CLBR (72.5% vs. 52.8%) were higher in young (≤35 years) nonsurgical patient versus the surgical patients; older women showed similar outcomes. CONCLUSION(S) Fertility preservation gives patients with endometriosis a valid treatment option to help them increase their reproductive chances. We suggest performing surgery after ovarian stimulation for FP in young women. In older women, an individualized treatment should be considered.
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Affiliation(s)
- Ana Cobo
- IVIRMA Valencia, Valencia, Spain.
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Niederberger C, Pellicer A, Simon C, Kathrins M, Goldstein M, Sigman M, Schlegel PN, Munné S, Gardner DK, Cobo A, Coutifaris C, Donnez J, Taylor HS, Giudice LC, Fauser BC, Lindheim SR, Rosenwaks Z, Casper RF, de Ziegler D, Gibbons WE, Paulson RJ, Laufer N, Klock SC, Mendola P, Sauer MV. 25 historic papers: an ASRM 75th birthday gift from Fertility and Sterility. Fertil Steril 2019; 112:e2-e27. [DOI: 10.1016/j.fertnstert.2019.08.099] [Citation(s) in RCA: 3] [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: 02/07/2023]
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Cobo A, Kuwayama M, Pérez S, Ruiz A, Pellicer A, Remohí J. Reprint of: Comparison of concomitant outcome achieved with fresh and cryopreserved donor oocytes vitrified by the Cryotop method. Fertil Steril 2019; 112:e85-e92. [DOI: 10.1016/j.fertnstert.2019.08.078] [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: 10/25/2022]
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Coello A, Santos MJDL, Nohales M, Meseguer M, Remohi JA, Cobo A. Impact of fresh-embryo parameters on survival and implantation in vitrified blastocyst cycles: analysis of 11936 warmed blastocysts. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.510] [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: 10/26/2022]
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Cobo A, García-Velasco J, Domingo J, Pellicer A, Remohí J. Elective and Onco-fertility preservation: factors related to IVF outcomes. Hum Reprod 2019; 33:2222-2231. [PMID: 30383235 DOI: 10.1093/humrep/dey321] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/22/2018] [Indexed: 12/25/2022] Open
Abstract
STUDY QUESTION Is the indication for fertility preservation (FP) related to success in IVF cycles after elective-FP (EFP) for age-related fertility decline and FP before cancer treatment (Onco-FP)? SUMMARY ANSWER Although success rates were lower in cancer patients, there was no statistically significant association between malignant disease and reproductive outcome after correction for age and controlled-ovarian stimulation (COS) regime. WHAT IS KNOWN ALREADY FP is increasingly applied in assisted reproduction, but little is known about the outcome of IVF cycles with vitrified oocytes in FP patients. STUDY DESIGN, SIZE, DURATION Retrospective, observational multicenter study of vitrification cycles for FP and of the warming cycles of women who returned to attempt pregnancy from January 2007 to May 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 6362 women (EFP = 5289 patients; 7044 cycles + Onco-FP = 1073 patients; 1172 cycles) had their oocytes vitrified for FP. A logistic regression analysis was performed to examine the impact of indication for FP corrected for age at vitrification. The protocol used for COS was also included as a possible confounder. The main outcome measures were oocyte survival and live birth. A detailed description of the baseline and clinical data is provided, with comparisons between EFP and Onco-FP. The cumulative live birth rate (CLBR) per utilized oocyte according to age at vitrification was analyzed in those patients returning to use their oocytes. MAIN RESULTS AND ROLE OF CHANCE Age at vitrification was significantly older in EFP patients (37.2 ± 4.9 vs. 32.3 ± 3.5 year; P < 0.0001). Fewer oocytes were retrieved and vitrified per cycle in EFP (9.6 ± 8.4 vs. 11.4 ± 3.5 and 7.3 ± 11.3 vs. 8.7 ± 2.1, respectively; P < 0.05), but numbers became comparable when analyzed per patient (12.8 ± 7.4 vs. 12.5 ± 3.2 and 9.8 ± 6.4 vs. 9.5 ± 2.6). Storage time was shorter in EFP (2.1 ± 1.6 vs. 4.1 ± 0.9 years; P < 0.0001). In all, 641 (12.1%) EFP and 80 (7.4%) Onco-FP patients returned to attempt pregnancy (P < 0.05). Overall oocyte survival was comparable (83.9% vs. 81.8%; NS), but lower for onco-FP patients among younger (≤35 year) subjects (81.2% vs. 91.4%; P > 0.05). Fewer EFP cycles finished in embryo transfer (50.2% vs. 72.5%) (P < 0.05). The implantation rate was 42.6% and 32.5% in EFP versus Onco-FP (P < 0.05). Ongoing pregnancy (57.7% vs. 35.7%) and live birth rates (68.8% vs. 41.1%) were higher in EFP patients aged ≤35 than the Onco-FP matching age patients (P < 0.05). The reason for FP per se had no effect on oocyte survival (OR = 1.484 [95%CI = 0.876-2.252]; P = 0.202) or the CLBR (OR = 1.275 [95%CI = 0.711-2.284]; P = 0.414). Conversely, age (<36 vs. ≥36 y) impacted oocyte survival (adj.OR = 1.922 [95%CI = 1.274-2.900]; P = 0.025) and the CLBR (adj.OR= 3.106 [95%CI = 2.039-4.733]; P < 0.0001). The Kaplan-Meier analysis showed a significantly higher cumulative probability of live birth in patients <36 versus >36 in EFP (P < 0.0001), with improved outcomes when more oocytes were available for IVF. LIMITATIONS, REASONS FOR CAUTION Statistical power to compare IVF outcomes is limited by the few women who came to use their oocytes in the Onco-FP group. The patients' ages and the COS protocols used were significantly different between the EFP and ONCO-PP groups. WIDER IMPLICATIONS OF THE FINDINGS Although the implantation rate was significantly lower in the Onco-FP patients the impact of cancer disease per se was not proven'. EFP patients should be counseled according to their age and number of available oocytes. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- A Cobo
- IVIRMA-Valencia, Plaza de la Policía Local 3, Valencia, Spain
| | | | - J Domingo
- IVIRMA-Las Palmas, Av. Juan Carlos I, 17, Edificio Corona, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - A Pellicer
- IVIRMA-Valencia, Plaza de la Policía Local 3, Valencia, Spain
| | - J Remohí
- IVIRMA-Valencia, Plaza de la Policía Local 3, Valencia, Spain
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Pabón D, Meseguer M, Sevillano G, Cobo A, Romero JL, Remohí J, de Los Santos MJ. A new system of sperm cryopreservation: evaluation of survival, motility, DNA oxidation, and mitochondrial activity. Andrology 2019; 7:293-301. [PMID: 30916488 DOI: 10.1111/andr.12607] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 06/11/2018] [Revised: 02/08/2019] [Accepted: 02/18/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Sperm vitrification (V) is a method for cryopreservation, without the use of conventional cryoprotectants, by plunging the sperm suspension directly into liquid nitrogen (LN25). OBJECTIVE This study aimed to compare the new system of V with conventional freezing (CF) protocol using fresh spermatozoa as reference (C). MATERIAL AND METHODS Prospective cohort study. A total of 47 sperm samples from men attending the infertility clinic at Instituto Valenciano de Infertilidad Valencia. The sperm V solution was 0.3 M trehalose-sucrose and plunged directly in liquid nitrogen in microdroplets of 5-10 lL, using a new system collector of V. Sperm viability indicators such as sperm motility, vitality rates, mitochondrial function, and sperm DNA oxidation were assessed before and after cryopreservation. Sperm motility and vitality analysis were performed according to published guidelines of the World Health Organization (WHO, 2010). Mitochondrial function was evaluated using JC-1 (fluorescent cationic dye, 5,50,6,60-tetrachloro-1-10,3,30-tetraethyl-benzamidazolocarbocyanin iodide). Sperm DNA oxidation was determined using a fluorescent assay (Oxy-DNA test) for the detection of 8-oxoguanine. The evaluation was carried out before and after cryopreservation using flow cytometry. Statistical analysis was performed using ANOVA and chi-square test, and p < 0.05 was considered statistically significant. RESULT(S) Sperm parameters, including progressive motility, total motility, and viability, observed after cryopreservation were as follows: C = 74.9% [1] 12.3, CF = 27.2% [1] 8.4, V = 42.3% [1] 9.3, p < 0.001; C = 90.1 [1] 6.8, CF = 42.0 [1] 12.9, V = 61.4 [1] 11.8, p < 0.001; C = 90.0% [1] 7.4, CF = 42.5% [1] 14.6, V = 70.9% [1] 6.5, p < 0.001, respectively. Regarding Oxy-DNA and mitochondrial activity, they were significantly affected in both groups (V and CF) when compared to the control group. DISCUSSION The sperm V and CF have negative impact on sperm parameters as well as DNA integrity and mitochondrial activity. However, sperm V presented improved sperm motility recovery, similar levels of DNA oxidation, and, moreover, a slightly increase in mitochondrial activity when compared to the conventional method. CONCLUSION(S) V as an optimal protocol for sperm cryopreservation.
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Affiliation(s)
- D Pabón
- IVI VALENCIA, Valencia, Spain
| | | | | | - A Cobo
- IVI VALENCIA, Valencia, Spain
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Coello A, Sanchez E, Vallejo B, Meseguer M, Remohí J, Cobo A. Effect of oocyte morphology on post-warming survival and embryo development in vitrified autologous oocytes. Reprod Biomed Online 2019; 38:313-320. [DOI: 10.1016/j.rbmo.2018.11.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
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Sitthideatphaiboon P, Cobo A, Poteete A, Zhang F, Lui D, Rinsurongkawong W, Heymach J. P3.03-28 LKB1 Mutation Status is Associated with Poor Radiation Outcome in Patients with Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1705] [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: 10/28/2022]
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Coello A, Cobo A, Galan A, Nohales M, Beltrán D, Meseguer M. The ability of warmed blastocysts to re-expand and the pre-vitrification trophoectoderm grade significantly correlated with implantation. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.665] [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: 10/28/2022]
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Abstract
In recent years, growing evidence for the safety and efficiency of oocyte vitrification has made this technique be increasingly proposed for fertility preservation (FP). The populations who could benefit from FP include oncological patients who need the option to preserve their gametes before undergoing potential sterilizing treatment, patients with non-oncologic conditions requiring gonadotoxic chemotherapy and women who wish to delay their motherhood for a variety of reasons. By vitrifying oocytes, women have the chance to conceive in the future, have their own genetic offspring and maintain their reproductive autonomy. This review focuses on describing current knowledge on oocyte vitrification as a means to preserve female fertility. We present the general experience of our group and others in FP for both oncological and non-oncological reasons.
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Affiliation(s)
- Aila Coello
- Instituto Valenciano de Infertilidad, University of Valencia, Valencia, Spain
| | - Antonio Pellicer
- Instituto Valenciano de Infertilidad, University of Valencia, Valencia, Spain
| | - Ana Cobo
- Instituto Valenciano de Infertilidad, University of Valencia, Valencia, Spain -
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Cobo A, Coello A, Remohí J, Serrano J, de Los Santos JM, Meseguer M. Effect of oocyte vitrification on embryo quality: time-lapse analysis and morphokinetic evaluation. Fertil Steril 2017; 108:491-497.e3. [PMID: 28865549 DOI: 10.1016/j.fertnstert.2017.06.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 03/06/2017] [Revised: 06/16/2017] [Accepted: 06/20/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To analyze whether oocyte vitrification may affect subsequent embryo development from a morphokinetic standpoint by means of time-lapse imaging. DESIGN Observational cohort study. SETTING University-affiliated private IVF center. PATIENT(S) Ovum donation cycles conducted with the use of vitrified (n = 631 cycles; n = 3,794 embryos) or fresh oocytes (n = 1,359 cycles; n = 9,935 embryos) over 2 years. INTERVENTIONS(S) None. MAIN OUTCOME MEASURE(S) Embryo development was analyzed in a time-lapse imaging incubator. The studied variables included time to 2 cells (t2), 3 cells (t3), 4 cells (t4), 5 cells (t5), morula (tM), and cavitated, early, and hatching blastocyst (tB, tEB, tHB) as well as 2nd cell cycle duration (cc2 = t3 - t2). All of the embryos were classified according to the hierarchic tree model currently used for embryo selection. The analyzed variables were compared with the use of analysis of variance or chi-square and included 95% confidence intervals (CIs). RESULT(S) The embryos that originated from vitrified oocytes showed a delay of ∼1 hour from the first division to 2 cells (t2) to the time of blastulation (tB). The embryos that originated from vitrified oocytes showed a delay of ∼1 hour from the 1st division to 2 cells (t2) to the time of blastulation (tB) (P<.05). The proportions of embryos allocated to categories A-E in the hierarchical tree were similar between groups. No differences in implantation rates between the fresh (51.3% [95% CI 47.1%-55.7%]) and vitrified (46.4% [95% CI 38.4%-54.4%]) groups were found. CONCLUSION(S) The embryo quality of vitrified oocytes was not impaired: cc2, quality according to our hierarchic morphokinetic model, and implantation rates were similar between fresh and vitrified oocytes. However, morphokinetic differences were observed from t2 to tB. Our main study limitation was the retrospective nature of the analysis, although a large database was studied.
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Affiliation(s)
- Ana Cobo
- Instituto Valenciano de Infertilidad Valencia, INCLIVA-University of Valencia, Valencia, Spain.
| | - Aila Coello
- Instituto Valenciano de Infertilidad Valencia, INCLIVA-University of Valencia, Valencia, Spain
| | - Jose Remohí
- Instituto Valenciano de Infertilidad Valencia, INCLIVA-University of Valencia, Valencia, Spain
| | - Jose Serrano
- Instituto Valenciano de Infertilidad Valencia, INCLIVA-University of Valencia, Valencia, Spain
| | | | - Marcos Meseguer
- Instituto Valenciano de Infertilidad Valencia, INCLIVA-University of Valencia, Valencia, Spain
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Nohales M, Almerich GS, Coello A, Tatone C, Di Emidio G, Cobo A, Santos MDL. Vitrification causes a redox imbalance in MII human in vitro aged and “good” oocytes but apparently can be counteracted by the antioxidant crocin. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.517] [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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Basile N, Insua M, Cobo A, Tejera A, Pellicer A, Meseguer M. The difference in delivery rates and number of neonates between time-lapse systems and standard incubators changes depending on the number and the stage of the embryos being transferred. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.478] [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: 11/30/2022]
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Coello A, Sanchez E, Campos P, Vallejo B, Meseguer M, Cobo A. Oocyte dysmorphisms are not associated with post warming survival, fertilization and embryo development in own oocytes vitrification cycles. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.520] [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: 10/18/2022]
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Rienzi L, Cobo A, Ubaldi FM. Chapter 10 Human Oocyte Vitrification. Methods Mol Biol 2017; 1568:131-139. [PMID: 28421494 DOI: 10.1007/978-1-4939-6828-2_10] [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] [Indexed: 06/07/2023]
Abstract
Discovery and widespread application of successful cryopreservation methods for MII-phase oocytes was one of the greatest successes in human reproduction during the past decade. Although considerable improvements in traditional slow-rate freezing were also achieved, the real breakthrough was the result of introduction of vitrification. Here we describe the method that is most commonly applied for this purpose, provides consistent survival and in vitro developmental rates, results in pregnancy and birth rates comparable to those achievable with fresh oocytes, and does not result in higher incidence of gynecological or postnatal complications.
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Affiliation(s)
- Laura Rienzi
- Genera Centre for Reproductive Medicine, Clinica Valle Giulia, via Barnaba Tortolini, 13, 00 197, Rome, Italy.
| | - Ana Cobo
- Cryo Preservation Laboratory, IVI Valencia, Plaza Policia Local 3, Valencia, Espana, 46015, Spain
| | - Filippo Maria Ubaldi
- Genera Centre for Reproductive Medicine, Clinica Valle Giulia, via Barnaba Tortolini, 13, 00 197, Rome, Italy
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Romany L, Garrido N, Cobo A, Aparicio-Ruiz B, Serra V, Meseguer M. Obstetric and perinatal outcome of babies born from sperm selected by MACS from a randomized controlled trial. J Assist Reprod Genet 2016; 34:201-207. [PMID: 27882439 DOI: 10.1007/s10815-016-0838-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 03/14/2016] [Accepted: 10/27/2016] [Indexed: 01/24/2023] Open
Abstract
PURPOSE The purpose of this study is to assess outcomes after magnetic-activated cell sorting (MACS) technology on obstetric and perinatal outcomes compared with those achieved after swim up from randomized controlled trial. METHODS This is a two-arm, unicentric, prospective, randomized, and triple-blinded trial and has a total of 237 infertile couples, between October 2010 and January 2013. A total of 65 and 66 newborns from MACS and control group, respectively, were described. RESULTS MACS had no clinically relevant adverse effects on obstetric and perinatal outcomes. No differences were found for obstetric problems including premature rupture of membranes 6.1% (CI95% 0-12.8) vs. 5.9% (CI95% 0-12.4), 1st trimester bleeding 28.6% (CI95% 15.9-41.2) vs. 23.5% (CI95% 11.9-35.1), invasive procedures as amniocentesis 2.0% (CI95% 0-5.9) vs. 3.9% (CI95% 0-9.2), diabetes 14.3% (CI95% 4.5-24.1) vs. 9.8% (CI95% 1.6-17.9), anemia 6.1% (CI95% 0-12.8) vs. 5.9%(CI95% 0-12.4), 2nd and 3rd trimesters 10.2% (CI95% 1.7-18.7) vs. 5.9% (CI95% 0-12.4), urinary tract infection 8.2% (CI95% 0.5-15.9) vs. 3.9% (CI95% 0-9.2), pregnancy-induced hypertension 6.1% (CI95% 0-12.8) vs. 15.7% (CI95% 5.7-25.7), birth weight (g) 2684.10 (CI95% 2499.48-2868.72) vs. 2676.12 (CI95% 2499.02-2852.21), neonatal height (cm) 48.3 (CI95% 47.1-49.4) vs. 46.5 (CI95% 44.6-48.4), and gestational cholestasis 0%(CI95% 0-0) vs. 3.9% (CI95% 0-9.2), respectively, in MACS group compared with control group. CONCLUSIONS Our data suggest that MACS technology does not increase or decrease Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation adverse obstetric and perinatal outcomes in children conceived when this technology was performed, being the largest randomized control trial with live birth reported results with MACS.
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Affiliation(s)
- Laura Romany
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
| | - Nicolas Garrido
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
| | - Ana Cobo
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
| | - Belen Aparicio-Ruiz
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
| | - Vicente Serra
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
| | - Marcos Meseguer
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain. .,Instituto Valenciano de Infertilidad, Plaza de la Policía Local, 3, Valencia, 46015, Spain.
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García-Talavera P, Díaz-Soto G, Montes A, Villanueva J, Cobo A, Gamazo C, Ruiz M, González-Selma M. Contribution of early SPECT/CT to 99mTc-MIBI double phase scintigraphy in primary hyperparathyroidism: Diagnostic value and correlation between uptake and biological parameters. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.03.004] [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: 10/20/2022]
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Coello A, Cobo A, Galan A, Alegre L, Nohales M, Meseguer M. A novel hierarchical classification method based on morphology dynamics of vitrified-warmed blastocysts to forecast implantation potential. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.413] [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: 10/21/2022]
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García-Talavera P, Díaz-Soto G, Montes AA, Villanueva JG, Cobo A, Gamazo C, Ruiz MÁ, González-Selma ML. Contribution of early SPECT/CT to 99mTc-MIBI double phase scintigraphy in primary hyperparathyroidism: Diagnostic value and correlation between uptake and biological parameters. Rev Esp Med Nucl Imagen Mol 2016; 35:351-357. [PMID: 27132216 DOI: 10.1016/j.remn.2016.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 01/10/2016] [Revised: 02/11/2016] [Accepted: 03/01/2016] [Indexed: 11/17/2022]
Abstract
AIM To evaluate the value of 99mTc-MIBI double-phase scintigraphy (DPS) and early SPECT/CT in the pre-surgical assessment of patients with primary hyperparathyroidism (PHPT). Also, to calculate the correlation between uptake and some biological parameters. MATERIAL AND METHODS Forty patients with PHPT were included: 37 solitary adenomas, 1 hyperplasia, and 2 double adenomas. Fifteen patients had ectopic glands. DPS and early SPECT/CT were acquired in all patients. Ultrasound was performed in 31/40. All patients underwent surgery, intra-operative iPTH measurements, and histopathological examinations. Qualitative DPS uptake was assessed and correlated to pre-surgical calcium, iPTH levels, gland weight, and maximum diameter. RESULTS In the planar study, there were 23 positive cases, 8 doubtful, and 9 negatives. With the SPECT/CT, 8/9 negatives cases were located. All doubtful cases were confirmed as positives. Gland location improved in 16 cases (12 ectopic). DPS+SPECT/CT failed to detect a solitary adenoma and at least one gland in three cases of multiglandular disease (MGD). The sensitivity by patient was: DPS 72.5%, DPS+SPECT/CT 90%, and ultrasound 42%. Ultrasound and scintigraphy (DPS+SPECT/CT) were concordant in 16/31 patients. For the rest of them, scintigraphy proved correct in 14/15, and both techniques failed in one case. There was a significant correlation between level of uptake and iPTH level, gland weight, and maximum diameter. CONCLUSION Early SPECT/CT improves sensitivity and the locating of parathyroid pathological glands and increases diagnostic confidence. iPTH level, glandular size, and weight are related to the qualitative assessment of 99mTc-MIBI uptake in early DPS.
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Affiliation(s)
- P García-Talavera
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Salamanca, Salamanca, Spain.
| | - G Díaz-Soto
- Servicio de Endocrinología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A A Montes
- Servicio de Radiodiagnóstico, Hospital Universitario Río Hortega, Valladolid, Spain
| | - J G Villanueva
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Cobo
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - C Gamazo
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M Á Ruiz
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M L González-Selma
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Gamiz P, Pérez S, Viloria T, Cobo A, De Los Santos MJ. PP-028 - Implantation rates of blastocyst following transfer on day 6 versus day 5 in hormonal replacement therapy cycles: does it really matter? Reprod Biomed Online 2016. [DOI: 10.1016/s1472-6483(16)30163-8] [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: 11/28/2022]
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Swain JE, Carrell D, Cobo A, Meseguer M, Rubio C, Smith GD. Optimizing the culture environment and embryo manipulation to help maintain embryo developmental potential. Fertil Steril 2016; 105:571-587. [PMID: 26851765 DOI: 10.1016/j.fertnstert.2016.01.035] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [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: 11/27/2015] [Revised: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 12/30/2022]
Abstract
With increased use of comprehensive chromosome screening (CCS), the question remains as to why some practices do not experience the same high levels of clinical success after implementation of the approach. Indeed, the debate surrounding the efficacy and usefulness of blastocyst biopsy and CCS continues. Importantly, several variables impact the success of an assisted reproductive technology cycle. Transfer of a euploid embryo is but one factor in an intricate system that requires numerous steps to occur successfully. Certainly, the culture environment and the manipulations of the embryo during its time in the laboratory can impact its reproductive potential. Environmental stressors ranging from culture media to culture conditions and even culture platform can impact biochemical, metabolic, and epigenetic patterns that can affect the developing cell independent of chromosome number. Furthermore, accompanying procedures, such as biopsy and vitrification, are complex and, when performed improperly, can negatively impact embryo quality. These are areas that likely still carry room for improvement within the IVF laboratory.
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Affiliation(s)
| | - Doug Carrell
- Department of Surgery (Urology) and Human Genetics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Ana Cobo
- Instituto Valenciano de Infertilidad, Valencia, Spain
| | | | | | - Gary D Smith
- Department of Molecular and Integrative Physiology, Ob/Gyn, Urology, University of Michigan, Ann Arbor, Michigan
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Coello A, Campos P, Remohí J, Meseguer M, Cobo A. A combination of hydroxypropyl cellulose and trehalose as supplementation for vitrification of human oocytes: a retrospective cohort study. J Assist Reprod Genet 2016; 33:413-421. [PMID: 26754749 DOI: 10.1007/s10815-015-0633-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 10/13/2015] [Accepted: 12/02/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE This study aimed to determine whether the new formulation of vitrification solutions containing a combination of hydroxypropyl cellulose (HPC) and trehalose does not affect outcomes in comparison with using conventional solutions made of serum substitute supplement (SSS) and sucrose. METHODS Ovum donation cycles were retrospectively compared regarding the solution used for vitrification and warming of human oocytes. The analysis included 218 cycles (N = 2532 oocytes) in the study group (HPC + trehalose) and 214 cycles (N = 2353 oocytes) in the control group (SSS + sucrose). RESULTS No statistical differences were found in ovarian stimulation parameters and baseline characteristics of donors and recipients. The survival rate was 91.3% (95% confidence interval (CI) = 89.8-92.9) in the HPC + trehalose group vs. 92.1% (95% CI = 90.4-93.7) in the SSS + sucrose group (NS). The implantation rate (42.8%, 95% CI = 37.7-47.9 vs. 41.2%, 95% CI = 36.0-46.4), clinical pregnancy rate (CPR) per transfer (60.7%, 95% CI = 53.9-67.5 vs. 56.4%, 95% CI = 49.3-63.5), and ongoing pregnancy rate (OPR) per transfer (48.5%, 95% CI = 41.5-55.5 vs. 46.3%, 95% CI = 39.2-53.4) were similar for patients who received either HPC + trehalose-vitrified oocytes or SSS + sucrose-vitrified oocytes. Statistical differences were found when analyzing blastocyst rate both per injected oocyte (30.2%, 95% CI = 28.3-32.1 vs. 24.1%, 95% CI = 22.3-25.9) and per fertilized oocyte (40.8%, 95%CI = 38.5-43.1 vs. 33.2%, 95% CI = 30.8-35.5) (P < 0.0001). Delivery rate was comparable between groups (37.2%, 95% CI = 30.8-46.6 vs. 36.9%, 95% CI = 30.4-43.4; NS). CONCLUSIONS Our data demonstrate that HPC and trehalose are suitable and safe substitutes for serum and sucrose. Therefore, the new commercial media can be used efficiently in the vitrification of human oocytes avoiding viral and endotoxin contamination risk.
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Affiliation(s)
- Aila Coello
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Pilar Campos
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - José Remohí
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Marcos Meseguer
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Ana Cobo
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain.
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Cobo A, García-Velasco JA, Coello A, Domingo J, Pellicer A, Remohí J. Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril 2015; 105:755-764.e8. [PMID: 26688429 DOI: 10.1016/j.fertnstert.2015.11.027] [Citation(s) in RCA: 304] [Impact Index Per Article: 33.8] [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: 09/21/2015] [Revised: 11/03/2015] [Accepted: 11/17/2015] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To provide a detailed description of the current oocyte vitrification status as a means of elective fertility preservation (EFP). DESIGN Retrospective observational multicenter study. SETTING Private university-affiliated center. PATIENT(S) A total of 1,468 women who underwent EFP because of age or having associated a medical condition other than cancer (January 2007 to April 2015). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Survival and cumulative live birth rate (CLBR) per consumed oocyte. RESULT(S) Mean age was higher with EFP due to age versus having an associated medical reason (37.7 y [95% confidence interval (CI) 36.5-37.9] vs. 35.7 y [95% CI 34.9-36.3]). In total, 137 patients (9.3%) returned to use their oocytes. Overall survival rate was 85.2% (95% CI 83.2-87.2). Live birth rate per patient was higher in women ≤35 years old than ≥36 years old (50% [95% CI 32.7-67.3] vs. 22.9% [95% CI 14.9-30.9]). CLBR was higher and increased faster in younger women. The gain in CLBR was sharp from 5 (15.4%, 95% CI -4.2 to 35.0) to 8 oocytes (40.8%, 95% CI 13.2-68.4), with an 8.4% gain per additional oocyte, in the ≤35-year-old group. The increase was slower with 10-15 oocytes, reaching a plateau CLBR of 85.2%. A milder increase (4.9% gain) was observed in the ≥36-year-old group (from 5.1% [95% CI -0.6 to 10.7] to 19.9% [95% CI 8.7-31.1] when 5-8 oocytes were consumed), reaching the plateau with 11 oocytes (CLBR 35.6%). Forty babies were born. CONCLUSION(S) At least 8-10 metaphase II oocytes are necessary to achieve reasonable success. Numbers should be individualized in women >36 years old. We suggest encouraging women who are motivated exclusively by a desire to postpone childbearing because of age, to come at younger ages to increase success possibilities.
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Affiliation(s)
- Ana Cobo
- IVI-Valencia, Institut Universitari IVI, Valencia, Spain.
| | | | - Aila Coello
- IVI-Valencia, Institut Universitari IVI, Valencia, Spain
| | | | - Antonio Pellicer
- IVI Foundation, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - José Remohí
- IVI-Valencia, Institut Universitari IVI, Valencia, Spain
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