Subject(s)
Abortion, Spontaneous , Hydatidiform Mole , Artificial Intelligence , Female , Humans , Nucleotides , Polymorphism, Single Nucleotide , PregnancyABSTRACT
OBJECTIVE: To evaluate the impact of multinucleation of a sibling blastomere of day 2 embryos on the rate of aneuploidy detected by day 3 preimplantation genetic screening (PGS) biopsy and the effect on subsequent implantation and pregnancy rates. DESIGN: Retrospective cohort study. SETTING: University-based IVF center. PATIENT(S): A total of 141 couples undergoing their first IVF-PGS cycle for idiopathic recurrent pregnancy loss (RPL) or multiple failed IVF implantations. INTERVENTION(S): Biopsy of single-nucleated blastomeres for PGS analysis of chromosomes X, Y, 13, 15, 16, 17, 18, 21, and 22 by fluorescence in situ hybridization. MAIN OUTCOME MEASURE(S): Aneuploidy, implantation, and pregnancy rates. RESULT(S): PGS revealed an increased incidence of aneuploidy when comparing multinucleated day 2 embryos with single-nucleated embryos (85% vs. 78%; relative risk 0.92 (95% confidence interval 0.84-1.00). Transfer of single-nucleated euploid embryos resulted in clinical pregnancy and implantation rates of 28% and 24%. Transfer of multinucleated euploid embryos resulted in no implantations. CONCLUSION(S): The presence of multinucleated blastomeres on day 2 of embryo development, 1 day before biopsy, predicts an increase of aneuploidy and poor pregnancy outcomes in IVF-PGS cycles.
Subject(s)
Blastomeres/physiology , Embryo Transfer , Fertilization in Vitro , Genetic Testing , Preimplantation Diagnosis , Siblings , Adult , Aneuploidy , Blastomeres/chemistry , Cell Nucleus/physiology , Cohort Studies , Embryo Transfer/standards , Female , Fertilization in Vitro/standards , Genetic Testing/standards , Humans , Organ Culture Techniques , Pregnancy , Pregnancy Outcome/genetics , Preimplantation Diagnosis/standards , Retrospective StudiesABSTRACT
A retrospective review of 237 initial, fresh nondonor IVF cycles in which all embryos generated during the cycle were transferred on either day 2 (n = 109) or day 3 (n = 128) were evaluated with regards to reproductive outcomes. Patients who underwent a day 2 ET had similar conception (18% vs. 16%; relative risk [RR], 1.1; 95% confidence interval [CI], 0.64-1.95), clinical pregnancy (13% vs. 16%; RR, 0.8; 95% CI, 0.44-1.55), implantation (6% vs. 7%; RR, 0.9; 95% CI, 0.50-1.68), and live-birth (10% vs. 16%; RR, 0.7; 95% CI, 0.32-1.29) rates as those who underwent a day 3 ET.
Subject(s)
Embryo Transfer/methods , Fertilization in Vitro , Pregnancy Outcome , Pregnancy Rate , Adult , Cleavage Stage, Ovum , Embryo Transfer/statistics & numerical data , Female , Humans , Pregnancy , Pregnancy Outcome/epidemiology , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
Because spermatocyte meiotic error results in embryonic sex chromosomal aneuploidy, it is speculated that teratospermia correlates with increased embryonic sex chromosomal abnormalities. Our findings contradict this theory, suggesting that morphology does not correlate with sex chromosomal genotype.
Subject(s)
Aneuploidy , Chorionic Gonadotropin/therapeutic use , Fertilization in Vitro/statistics & numerical data , Preimplantation Diagnosis/methods , Sex Chromosome Aberrations/statistics & numerical data , Spermatozoa/abnormalities , Adolescent , Adult , Estradiol/blood , Female , Fertility Agents, Female/therapeutic use , Follicle Stimulating Hormone/blood , Genotype , Humans , Leuprolide/therapeutic use , Male , Maternal Age , Oocyte Retrieval/methods , Ovulation Induction/methods , Paternal Age , Pregnancy , Treatment FailureABSTRACT
In this prospective, randomized study, waiting for the lead follicle to reach 14 mm before initiating GnRH antagonist administration effectively prevents an LH surge and ovulation during an IVF cycle. Furthermore, delaying GnRH start until the dominant follicle reaches 14 mm neither impacts the clinical pregnancy, implantation, or live birth rates nor increases the incidence of severe ovarian hyperstimulation syndrome.
Subject(s)
Embryo Implantation , Fertilization in Vitro/methods , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Ovarian Follicle/anatomy & histology , Pregnancy Outcome , Adult , Birth Rate , Female , Humans , Infant, Newborn , Luteinizing Hormone/metabolism , Ovarian Hyperstimulation Syndrome/prevention & control , Ovulation/drug effects , Pregnancy , Prospective Studies , Time FactorsABSTRACT
OBJECTIVE: To evaluate the impact on the rates of clinical pregnancy and live birth of polyploidy after intracytoplasmic sperm injection (ICSI). DESIGN: Retrospective cohort study. SETTING: University-based IVF center. PATIENT(S): One hundred forty-three patients undergoing their first IVF-embryo transfer cycle requiring ICSI. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Patients were divided into two groups on the basis of the proportion of post-ICSI triploid fertilization that was observed at the time of fertilization assessment: group 1 included patients with
Subject(s)
Fertilization in Vitro/methods , Fertilization , Polyploidy , Sperm Injections, Intracytoplasmic/methods , Embryo Implantation/physiology , Embryonic Development/physiology , Female , Fertilization in Vitro/standards , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome , Pregnancy, Multiple/statistics & numerical data , Sperm Injections, Intracytoplasmic/standards , TwinsABSTRACT
OBJECTIVE: To evaluate the impact of abnormal sperm morphology on the rates of aneuploidy, implantation, and clinical pregnancy. DESIGN: Retrospective cohort study. SETTING: University-based IVF center. PATIENT(S): Fifty-two patients undergoing their first IVF-preimplantation genetic diagnosis (PGD) cycle. INTERVENTION(S): The PGD analysis of embryos. MAIN OUTCOME MEASURE(S): Patients were divided into two groups based on sperm morphology: teratospermic group (TSG) and normal sperm group (NSG). The primary outcome measures of rates of aneuploidy, implantation, clinical pregnancy rate (PR) per cycle, and clinical PR per embryo transfer were compared between TSG and NSG according to PGD analysis results. RESULTS: A higher percentage of normal embryos was seen in the NSG (32%) versus the TSG (20%). Overall, 30% of IVF-PGD cycles had no normal embryos for transfer. The clinical PR per cycle was 44% in the NSG compared to 14% in the TSG (relative risk [RR] = 3.19; 95% confidence interval [CI] 1.1-9.0). A similar trend was noted with the clinical PR per embryo transfer with 57% patients becoming pregnant in the NSG versus 20% patients in the TSG (RR = 2.76; 95% CI 1.2-7.2). Implantation was twice as likely to occur in the NSG as compared to TSG (RR = 2.5; 95% CI 1.1-7.2). CONCLUSION(S): Rates of euploidy, implantation, clinical PR per cycle, and clinical PR per embryo transfer were higher in the NSG compared to the TSG, suggesting that sperm morphology plays an important role in the outcome of IVF-PGD cycles.
Subject(s)
Preimplantation Diagnosis/methods , Spermatozoa/cytology , Adult , Aneuploidy , Blastocyst/pathology , Blastocyst/physiology , Embryo Implantation , Embryo Transfer/statistics & numerical data , Embryo, Mammalian/cytology , Embryo, Mammalian/physiology , Female , Fertilization in Vitro/methods , Humans , Male , Oocyte Retrieval , Oocytes/cytology , Pregnancy , Pregnancy Rate , Preimplantation Diagnosis/statistics & numerical data , Spermatozoa/abnormalities , Spermatozoa/physiologyABSTRACT
The objective of this study was to assess the impact of assisted hatching (AH) on pregnancy rate (PR), clinical pregnancy rate (CPR), and implantation rate (IR) after a single failed, fresh, nondonor IVF cycle. Accordingly, we report that patients with one prior implantation failure benefit from AH with improved PR, CPR, and IR in a subsequent cycle.
