[Effects of patient age, number and quality of embryo transferred on the outcome of in vitro fertilization-embryo transfer].

OBJECTIVE: To study the effect of patient age, the number and quality of embryo transferred on pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ETs). METHODS: A retrospective study was performed in infertile women who underwent a total of 1800 cycles of IVF-ET and intracytoplasmic sperm injection (ICSI). The patients were divided into three age groups, namely<30 years group, 30-35 years group, and>or=35 years group. The clinical pregnancy rate and the multiple pregnancy rate were compared when 1, 2 or 3 embryos and 0, 1, 2 or 3 good-quality embryos were transferred. RESULTS: In patients<30 years, no significant differences was found in the clinical pregnancy rate between 1, 2 and 3 embryos transfer groups; 2 and 3 good-quality embryos transfer resulted in similar pregnancy rate, which was significantly higher than that resulted from 0 and 1 good-quality embryo transfer. Multiple pregnancy was not found in 1 embryo transfer group. In patients aged 30-35 years, the pregnancy rate showed no significant differences not only between 1 and 2 embryos transfer groups, but also between 2 and 3 good-quality embryos transfer groups; multiple embryo transfer led to significantly increased multiple pregnancy rate. In patients aged>or=35 years, the transfer of 1, 2 and 3 embryos resulted in similar pregnancy rate; transfer of 3 good-quality embryos had obviously higher pregnancy rate than 0, 1 and 2 good-quality embryos transfer groups. Increased numbers of embryos and good-quality embryos transferred were both associated with increased multiple pregnancy rate. CONCLUSION: One good-quality embryo transfer in patients<30 years and 2 good-quality embryos transfer in patients>or=30 years can obtain ideal pregnancy rate and reduce the incidence of multiple pregnancy. For patients aged>or=35 years, transfer of only good-quality embryo is recommended.

[Development and genetic polymorphism of abnormal pronuclear zygotes after intracytoplasmic sperm injection].

OBJECTIVE: To compare the development of abnormal pronuclear zygotes after intracytoplasmic sperm injection (ICSI) and analyze their genetic polymorphism. METHODS: Four hundred and ninety three abnormal pronuclear zygotes after ICSI were divided into three groups based on the number of pronuclei: 347 nonpronuclear oocytes, 71 monopronuclear zygotes and 75 multipronuclear zygotes. All of them were cultured in the medium of Vitrolife G5 series(TM). Sixteen short tandem repeats (STR) of seven blastocysts were then analyzed by ABI3100. RESULTS: The cleavage rate of nonpronuclear group (25.4%) was lower than that of the others (P<0.01), the proportion of blocked embryos in nonpronuclear group (48.9%) was significantly higher than that of the others (P<0.05), but the blastocyst rate showed no significant difference in three groups (P>0.05). The genetic polymorphism of the 16 STRs showed that the blastocysts from the nonpronuclear and multipronuclear were diploid, and one of the blastocysts from nonpronuclear oocyte was Y-bearing. CONCLUSION: The zygotes with abnormal pronuclei after ICSI might have development potential, and the blastocysts from nonpronuclear oocytes and multipronuclear zygotes could be diploid.

[In vitro maturation of human oocytes from pregnant late term: a new source of oocytes].

OBJECTIVE: To investigate the in vitro maturation of human oocytes (IVM) from pregnant late term, natural cycles and Gn stimulating cycles and the effect of granulose cells on IVM from pregnant late term. METHODS: A total of 1086 immature oocytes were obtained including 633 oocyte-cumulus complexes (OCCs) and 453 denuded oocytes (DOs). OCCs were divided into pregnant late term group, natural cycle group and IVM group, and DOs were divided into pregnant late term group, natural cycle group and controlled ovarian hyperstimulation (COH) group. All the oocytes were matured in IVM culture system and fertilized by ICSI. The embryos were cultured to blastocyst stage except that those in IVM group were transferred into the uterus. The main outcomes were assessed including maturation rate (MR), fertilization rate (FR), cleavage rate (CR), and blastulation rate (BR) (natural cycle group, pregnant late term group and COH group) and pregnancy rate per transfer cycle (PR) of IVM group. RESULTS: MR of OCCs in pregnant late term group, natural cycle group and COH group was 74.3%, 76.9% and 82.2%, respectively, showing statistical difference between pregnant late term cycle group and IVM group. No statistical difference was observed in FR, CR or BR between the three groups. For IVM cycle group, clinical pregnancy rate of 20% per aspiration was achieved. For DOs, MR of COH group (86.0%) was significantly higher than that of the natural cycle group (72.5%) and pregnant late term group (72.7%) (P<0.01). FR, CR and BR showed no statistical difference among the 3 groups. No difference was found in MR, FR, CR and BR between OCCs group and DOs group from pregnant late term. CONCLUSIONS: The oocytes from pregnant late term have the same development potential as those from natural cycles or Gn stimulating cycles in vitro, and provide a new source of donor oocytes. Granulose cells do not affect the IVM from pregnant late term.

[Sperm acrosin activity helps predict IVF-ET outcome].

OBJECTIVE: To investigate the effect of sperm acrosin activity on the IVF-ET outcome. METHODS: We analyzed sperm parameters, morphology and acrosin activity for 909 infertile husbands by computer-assisted self-assessment (CASA), modified Papanicolaou staining and N-alpha-benzoyl-DL-arginine-p-nitroanilide (BAPNA), respectively, and detected the rates of fertilization, cleavage, quality embryos, embryo cryopreservation, implantation, clinical pregnancy and abortion. The wives were identified as normal or with mere oviduct problems. RESULTS: The rate of normal sperm morphology and sperm motility, vitality, rapid progressive velocity and concentration were significantly lower in the abnormal acrosin activity group than in the normal one (P < 0.01). Significant positive correlations were observed between acrosin activity and the above-mentioned semen parameters (P < 0.01). There were no significant differences in the number of retrieved eggs, the rates of cleavage, quality embryos, embryo cryopreservation, non-embryo transfer cycles and miscarriages, and the number of transferred embryos between the two groups (P > 0.05). The fertilization rate, the percentage of transfer cycles with only 1 embryo and the rate of implantation and clinical pregnancy were notably higher in the normal acrosin activity group than in the abnormal one (P < 0.01). CONCLUSION: Sperm acrosin activity is closely related with semen parameters, and it helps to predict the sperm fertilizing capacity and IVF-ET outcome.