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Resumen: OBJETIVO: Comparar la tasa de recién nacido vivo con la de embarazo clínico-transferencia embrionaria, las características clínicas y concentraciones hormonales entre dos esquemas de preparación endometrial para transferencia de embriones desvitrificados: con un agonista de GnRH versus su sustitución con dosis altas de estrógenos. MATERIALES Y MÉTODOS: Estudio observacional, de cohorte histórica, efectuado en pacientes atendidas en el Instituto Nacional de Perinatología en protocolo FIV-ICSI entre enero 2017-marzo 2019. Se compararon dos esquemas de preparación endometrial: grupo A con agonista de GnRH y grupo B con estradiol a dosis de 8 mg al día sin agonista de GnRH. A todas las pacientes se les tomaron muestras de sangre para determinación de FSH, LH, estradiol y progesterona y se dio seguimiento ultrasonográfico durante la preparación endometrial. RESULTADOS: En 99 pacientes entre 23 y 42 años, con embriones congelados, la tasa de recién nacido vivo-transferencia embrionaria fue, respectivamente, de 17.2 y 8.6% (OR 1.98; IC95%: 077-1.53) y la de embarazo clínico de 26.5 y 22.8% (OR1.09; IC95%: 0.77-1.53) en los grupos A y B, respectivamente. La duración total del ciclo, los días con estrógenos y la concentración sérica de estradiol al inicio de la progesterona alcanzaron diferencia significativa entre los grupos. No se detectaron datos clínicos ni de laboratorio sugerentes de ovulación. CONCLUSIONES: La tasa de recién nacido vivo fue mayor con agonistas de GnRH sin alcanzar significación; sin embargo, la preparación endometrial solo con estrógenos es un esquema seguro, de menor costo y más amigable para la paciente y el médico.
Abstract: OBJECTIVE: To compare the rate of live newborn with clinical pregnancy-embryo transfer, clinical characteristics and hormonal concentrations between two endometrial preparation schemes for devitrified embryo transfer: with a GnRH agonist (aGnRH) versus its replacement with high doses of estrogens. MATERIALS AND METHODS: Historical cohort observational study conducted in patients treated at the National Institute of Perinatology under IVF-ICSI protocol between January 2017-March 2019. Two endometrial preparation schemes were compared: group A with GnRH agonist and group B with estradiol at 8 mg per day without aGnRH. All patients had blood samples taken for FSH, LH, estradiol and progesterone determination and ultrasonographic follow-up during endometrial preparation. RESULTS: in 99 patients between 23 and 42 years of age, with frozen embryos, the live birth-embryo transfer rate was 17.2 and 8.6%, (OR 1.98; CI95%: 077-1.53) and the clinical pregnancy rate was 26.5 and 22.8% (OR1.09; CI95%: 0.77-1.53) in groups a and b, respectively. total cycle length, estrogen days and serum estradiol concentration at the beginning of progesterone reached significant difference between groups. no clinical or laboratory data suggesting ovulation were detected. CONCLUSIONS: The rate of live newborn was higher with GnRH agonists without reaching significance; however, endometrial preparation with estrogens alone is a safe, lower cost and more patient- and physician-friendLy scheme.
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Along with the application and development of the assisted reproductive technology in vitro fertilization and embryo transfer,the emergence of frozen embryos in the law,medicine,and ethics area are gradually increased.Two-child policy makes more older couples choose assisted reproductive technology,which will cause more disputes about frozen embryos.There is no unified conclusion of the legal status of human embryos,and there exists three main views of embryos namely property,person and intermediate state.Defined the legal status of frozen embryos as ethical substance,this paper analyzed the main position and possible legal and ethical issues involved in the disposal of frozen embryos through three typical cases.
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Objective To verify the feasibility of Cas9 microinjection in frozen-thawed pronuclear embryos, based on the model of pronuclear embryos of C57BL/6J mice by in vitro fertilization.Methods After fertilized mouse pronuclear embryos cultured in vitro, one-cell and 2-cell embryos were frozen using EFS20/40 cryopreservation tube.The next day recovered and then cultured.The recovery rate and survival rate of the one-cell and 2-cell embryos were compared.The frozen-thawed and fresh pronuclear embryos were injected with Cas9 mixture and injection buffer into the cytoplasm, and then cultivated to 2-cell embryos,and the survival rate and development rate of the 2-cell embryos were compared.Results The recovery rate of frozen-thawed one-cell embryos was 92.5%, the survival rate was 92.8%, the recovery rate of 2-cell embryos was 90.5% and the survival rate was 95.8%, showing no significant difference.Furthermore, the survival rate of fresh one-cell embryos after Cas9 injection was 92.7%, the survival rate of one-cell embryos of the blank group was 97.5%.While the survival rate of Cas9 injected frozen-thawed one-cell embryos was 82.6%, and that of the blank group was 92%,showing a significant difference between the frozen-thawed injected group and other groups(P < 0.05).The development rate of 2-cell embryos after Cas9 injection was not significantly different.Conclusions Frozen-thawed pronuclear embryos can be used for Cas9 microinjection.
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Objective To establish a rapid SNP( single-nucleotide polymorphism) genetic identification method for the frozen samples, such as frozen embryos and sperm of inbred mice.Methods In this study, the frozen embryos and sperm of inbred mice were provided by Shanghai Lab.Animal Research Center.Whole genome amplification and PCR-LDR genotyping system were used to get the rich DNA sample.Forty-five SNP were genotyped by multiple polymerase chain re-action and ligase detection reaction( PCR-LDR) .Results The electrophoresis results showed that the whole genome am-plification technique could highly increase the total DNA of frozen embryos.PCR-LDR typing method was suitable for the mouse genome typing of 45 SNPs.Ten strains of inbred frozen embryos and sperms of C57BL/6, BALB/c, FVB/NJ mice were genotyping identified, and their SNP loci data obtained by PCR-LDR were as the same as those of database.The num-ber of frozen mouse embryos was proportional to the number of SNPs detected, and when the embryo number reached more than 12, the detection rate of SNP was 100%.Conclusions This method can be used to the genetic quality identification, and rapidly identify the inbreed frozen mouse embryos and sperms.
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By analyzing the physiological and psychological state of the children conceived by different assisted reproduction techniques,studies confirm that the current assisted reproductive technology is safe,and there is no adverse effect on the physiological and psychological state of offspring.However,the high multiple pregnancy rate caused by assisted reproductive technology can affect the growth and psychological state of the children conceived by different assisted reproduction techniques,which is to be resolved.
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O objetivo do artigo é abordar aquilo que as novas tecnologias reprodutivas - com a separação por elas operada entre sexo e reprodução - trazem de inédito para o campo da filiação. Para isso, em primeiro lugar, serão diferenciadas, as montagens de filiação propostas por essas tecnologias das soluções encontradas em algumas sociedades tradicionais para contornar o problema da esterilidade. Será sustentado que, diferentemente das últimas, que se baseiam em uniões legitimadas pelo social, as primeiras se fundamentam na ficção da existência do ato sexual fecundo. Em seguida, serão analisados alguns aspectos da relação entre mercado, sexualidade e reprodução no contexto das chamadas "reproduções artificiais", e mais particularmente naquele das questões referentes ao congelamento dos chamados "embriões excedentes". Para isso, será, em primeiro lugar, apresentado o elo entre as evoluções sociais no campo da família e da sexualidade e os avanços científicos no campo da reprodução, e, em segundo lugar, descrito o processo pelo qual passa um casal durante o tratamento para infertilidade. Enfim, se buscará compreender a circulação destes embriões à luz da noção de "potlatch" analisada por Marcel Mauss, Georges Bataille e Jacques Lacan. Aqui, se destacará a presença, no próprio seio da lógica mercantil e do domínio/controle daquilo que se produz, de uma outra lógica: aquela que gira em torno do desperdício de um excedente.
The aim of this article is to approach what the new reproductive technologies - along with the separation operated by them between sex and reproduction - are bringing as novelty to the field of filiation. To this purpose, the filiation assemblies proposed by these technologies will be firstly distinguished from the solutions found in certain traditional societies to resolve the problem of sterility. It will be maintained that while the latter are based on legitimate unions from the social, the former ones are based on the fiction of the fecund sexual intercourse. Next, some aspects of the relationships between the market, sexuality and reproduction in the context of the so called "artificial reproductions" will be analyzed, more specifically in that aspect of the issues related to the freezing of the called "exceeding embryos". So, in first place, the link among the social evolutions in the field of family and sexuality and the scientific advances in the field of reproduction will be presented, and secondly, the process by which a couple goes through during the treatment for infertility will be described. Finally, we will try to understand the circulation of these embryos in the light of the notion of "potlatch" analyzed by Marcel Mauss, Georges Bataille and Jacques Lacan. Here, the presence of another logic, in the midst of the commercial logic and of the domain/control of that which is produced, will be highlighted: the logic that circles around the waste of an excess.