A Holistic Approach To Oncofertility In A Patient With Rectal Cancer: A Case Report.

OBJECTIVE: Cryopreservation techniques are used to preserve fertility before cancer treatment with gonadotoxic agents. Herein, we report a case of fertility preservation involving a 29-year-old G0P0 woman, married for one year, who was referred to our hospital for fertility preservation before starting rectal cancer treatment. CASE DESCRIPTION: Ovarian tissue and embryo cryopreservation were performed. Before the procedure, ovarian reserve was evaluated, and antral follicle counts were determined. Laparoscopic ovarian tissue cryopreservation was performed from the left side with a lower antral follicle count. Thus, we were able to keep the number of oocytes obtained in the following controlled ovarian hyperstimulation cycle at the highest level. Subsequently, the right ovary was transposed into the lateral wall of the abdomen under the peritoneum. Conventionally controlled ovarian hyperstimulation was initiated on the first postoperative day, depending on the menstrual cycle phase. Intracytoplasmic sperm injection was performed on four mature oocytes obtained, and one embryo was cryopreserved. Controlled ovarian hyperstimulation was initiated on the first postoperative day, and the process was repeated on the seventh postoperative day, yielding a total of seven viable embryos for cryopreservation. CONCLUSIONS: There is usually only one chance of controlled ovarian hyperstimulation in patients requiring a fertility-sparing approach due to malignancy. In the combined technique, performing ovarian tissue resection from the ovary with a lower number of antral follicles can keep the number of oocytes at the highest level in the following controlled ovarian hyperstimulation cycle.

Delivering embryos following 10 years of cryopreservation, using unpaired freeze/thaw techniques: A case report.

Although frozen embryo transfer is a widely established route for assisted reproduction, successful frozen embryo transfer using embryos that have undergone long term cryopreservation remains relatively unexplored, and its efficacy remains a matter of some debate. This case report describes two successful frozen embryo transfer conceptions in the same patient, one after 3 months of cryopreservation and the second 10 years after cryopreservation. These embryos were cryopreserved using the slow freezing technique and were thawed using an unpaired technique (ultra-rapid warming) after 10 years of storage.

The fate of surplus embryos: ethical and emotional impacts on assisted reproduction.

OBJECTIVE: This paper looked into the findings of a survey on the ethical and emotional aspects encircling the fate of surplus embryos in Assisted Human Reproduction (AHR). METHODS: Five staff members of a fertility clinic in the Brazilian State of São Paulo answered a semi-structured qualitative interview. RESULTS: The answers alluded to the different meanings assigned to embryos by medical staff (genetic material) and couples undergoing fertility treatment (potential child). The meaning couples assigned to their embryos, along with inherent uncertainty and distress, affected the choice of what would be done to surplus embryos. CONCLUSION: Psychological support may be helpful to two key groups present in assisted human reproduction: clinic staff, for support in their interactions with couples; and couples in need of support and awareness on surplus embryo donation.

The Replacement of Fetal Bovine Serum with Bovine Serum Albumin During Oocyte Maturation and Embryo Culture Does Not Improve Blastocyst Quality After Slow Freezing Cryopreservation.

In the present study, four experimental groups were used: fresh embryos, cultured during in vitro maturation and in vitro culture in media supplemented with bovine serum albumin (BSA) (fresh BSA) or fetal bovine serum (FBS) (fresh FBS); and two groups of cryopreserved and thawed embryos, produced under the same conditions (frozen BSA and frozen FBS). Experiment 1 evaluated the protein source effect on embryo development and response to cryopreservation. At day 7, half of the expanded blastocysts (Bx) from each group were cryopreserved and warmed and the other half were used as controls. After warming, embryos were incubated under the same conditions for 48 hours, and the hatching rate was measured at 24 and 48 hours. The total and the apoptotic cell numbers were measured in a subset of Bx after 24 hours. Experiment 2 used the Bx of experiment 1 to compare the expression of KRT8, PLAC8, FOSL1, HSP1A1, and HSPA5 genes in hatched blastocysts at 24 and 48 hours for all groups. The FBS group showed a higher percentage (p < 0.05) of embryos (42.8% vs. 27.9%) and higher rates of Bx (75.0% vs. 63.8%) on day 7, compared with the BSA group. At 24 hours postwarming, the fresh FBS group showed the highest hatching rate (p < 0.05) in comparison with other treatments. However, at 48 hours, the hatching rate was similar (p > 0.05) among groups: fresh FBS (68.1% ± 23.3%), fresh BSA (70.0% ± 31.0%), frozen FBS (39.2 ± 27.1), and frozen BSA (38.2 ± 23.9). After 24 hours, frozen BSA showed a higher number of cells compared with frozen FBS (p < 0.05). The expression of the PLAC8 gene was higher (p < 0.05) in fresh BSA embryos compared with frozen FBS embryos at 24 hours. In the present study, BSA replacement reduced embryo development, but did not affect the response to cryopreservation. However, upregulation of the PLAC8 gene suggests that embryos cultured in BSA might have better quality to support further development.

Pregnancy rate after fixed-time transfer of cryopreserved embryos collected by non-surgical route in Lacaune sheep.

This study investigated the feasibility of applying fixed-time (cryopreserved) embryo transfer in ewes. Embryos (n = 106) were non-surgically recovered from superovulated donors (n = 39) on day 6-7 after oestrus. Straws containing one or two embryos (morulae and/or blastocysts) subjected to either slow freezing (SF, n = 62) or vitrification (VT, n = 44) were randomly used within fixed-time embryo transfer on Day 8.5. Recipient ewes were nulliparous (n = 58) bearing corpora lutea after synchronous oestrous induction protocol. The pregnancy rate was higher (p = .03) in SF (39.4%) than VT (16.9%) and survival rate tended (p = .08) to be higher in SF than in VT (25.8% vs. 15.9%). Lambing rates were similar (p = .13) between SF (20.9%) and VT (15.9%). Embryos recovered by non-surgical route after cervical dilation treatment and later cryopreserved by either slow freezing or vitrification produced reasonable pregnancy rates after FTET.

Motherhood after breast cancer: can we balance fertility preservation and cancer treatment? A narrative review of the literature.

Breast cancer may affect young women who have not yet completed childbearing. Assisted reproductive technology (ART) provides alternatives for fertility preservation such as oocyte, embryo or ovarian tissue cryopreservation. We reviewed the published literature on fertility-preserving management in breast cancer, aiming at finding evidence to answer the following questions: (1) What are the fertility sparing options available?; (2) How do these women respond to IVF? and (3) Can pregnancy influence breast cancer recurrence? There is a paucity of publications describing clinical experience and outcome data which limits accessibility to fertility preservation in this setting. Presently, oocyte or embryo cryopreservation are the main options for fertility preservation. IVF success rates are comparable to the ones of non-oncological populations according to the woman's age but current published studies lack data on definitive success rates following embryo banking for cancer patients. The perception that IVF and pregnancy may worsen cancer prognosis remains, despite the lack of scientific evidence to support this notion. Published studies show reassuring results for pregnancies occurring >2 years after breast cancer diagnosis. The best published evidence suggests pregnancy after breast cancer does not increase the risk of disease recurrence, thus pregnancy should not be forbidden once treatment is completed. Decision making for women diagnosed with cancer requires up-to-date knowledge of the efficacy and safety of available options. Providing consultation with a reproductive specialist and appropriate information on fertility preservation for these women should be an essential aspect of their supportive care.

Efeito da adição do ácido linoleico conjugado no cultivo in vitro de embriões F1 Holandês x Zebu na sobrevivência pós-vitrificação / Effect of conjugated linoleic acid addition in in vitro culture medium in F1 Holstein X Zebu embryo survival post vitrification

Avaliou-se o efeito da adição do ácido linoleico conjugado (CLA) ao meio de cultivo in vitro na viabilidade pós-vitrificação de embriões F1 Holandês x Zebu. Foram utilizados três meios de cultivo: controle (n=340 oócitos): meio SOF e soro fetal bovino (SFB), sem o CLA; SFB+CLA (n=359 oócitos): meio SOF, SFB e CLA; CLA (n=339 oócitos): meio SOF e CLA, sem o SFB. Todos os blastocistos produzidos foram submetidos à vitrificação, pelo método de Open Pulled Straw. Quinze blastocistos de cada tratamento foram fixados para quantificação lipídica por coloração com Sudan Black B. Para avaliar a viabilidade embrionária, foi observada a capacidade de reexpansão e eclosão pós-aquecimento dos embriões (controle=27; SFB+CLA=30; CLA=17). Foram realizadas transferências em um ou dois embriões por receptora para avaliação da sobrevivência in vivo: T1 [receptoras que receberam um blastocisto (n=17 embriões, sendo controle=5, SFB+CLA=6 e CLA=6)]; T2 [receptoras que receberam dois blastocistos, (n= 54 embriões, sendo controle=18, SFB+CLA=14 e CLA=22)]. Não houve diferença nas taxas de clivagem (62,1%; 74,0%; 74,0% para controle; SFB+CLA; CLA, respectivamente), produção de blastocistos em relação aos clivados (59,7%; 47,7%; 38,3% para controle; SFB+CLA; CLA, respectivamente) e produção de blastocistos em relação ao total de oócitos (37,1%; 35,4%; 28,3% para controle; SFB+CLA; CLA, respectivamente) (P>0,05). Houve diminuição de gotículas lipídicas nos embriões cultivados em meio suplementado com CLA em relação aos embriões cultivados na presença do SFB e na ausência do CLA (P<0,05). A taxa de reexpansão foi maior no grupo controle (70,4%) em relação ao CLA (47,1%) e menor no grupo SFB+CLA (43,3%) (P<0,05). O CLA foi eficaz em reduzir a deposição de lipídeos intracitoplasmáticos nas células embrionárias, porém não houve diferença de viabilidade após a desvitrificação dos embriões.(AU)

The effect of adding conjugated linoleic acid (CLA) to the culture media on the viability after cryopreservation of F1 Holstein X Zebu embryos was evaluated. Three different culture media were tested: control (n = 340 oocytes): SOF medium and fetal bovine serum (FBS) without the CLA; FBS + CLA (n = 359 oocytes): SOF, FBS and CLA; CLA (n = 339 oocytes): SOF and CLA without the FBS. The produced blastocysts were subjected to vitrification, by the Open Pulled Straw method. Fifteen blastocysts per treatment were fixed for lipid quantification by staining with Sudan Black B. Embryo re-expansion and hatching capability were used to assess viability (control = 27; FBS + CLA = 30; CLA = 17). Transfers of one or two embryos to recipients were performed to evaluate in vivo survival: T1 [recipients that received one blastocyst (n=17 embryos, Control=5, FBS+CLA=6 and CLA=6)]; T2 [recipients that received two blastocysts (n =54 embryos, Control=18, FBS+CLA=14 and CLA=22)]. There was no difference in cleavage rate (62.1%; 74%; 74% for Control; FBS + CLA, CLA, respectively), blastocyst production in relation to the cleaved structures (59.7%; 47.7%; 38 3% for Control; FBS + CLA, CLA, respectively) and blastocyst production relative to the total oocytes (37.1%, 35.4%, 28.3% for Control; FBS + CLA, CLA, respectively) between treatments (P> 0.05). A reduction of lipid droplets was observed in embryos cultured in medium supplemented with CLA compared to embryos cultured in the FCS in the absence and presence of CLA (P <0.05). The reexpansion rate was higher in the Control group (70.4%) compared to the CLA (47.1%) and lowest for FBS+CLA (43.3%) (P<0.05). The hatching rates were similar among treatments, 42.1%; 23.1%; 25% for control; SFB + CLA; CLA respectively (P>0.05). Only one pregnancy was observed in early and confirmatory diagnosis, as the result of a Control group embryo transfer. Although embryos cultured with CLA have shown smaller intracytoplasmic lipid content, no difference was observed in viability following vitrification between treatments.(AU)

Efeito da adição do ácido linoleico conjugado no cultivo in vitro de embriões F1 Holandês x Zebu na sobrevivência pós-vitrificação / Effect of conjugated linoleic acid addition in in vitro culture medium in F1 Holstein X Zebu embryo survival post vitrification

Avaliou-se o efeito da adição do ácido linoleico conjugado (CLA) ao meio de cultivo in vitro na viabilidade pós-vitrificação de embriões F1 Holandês x Zebu. Foram utilizados três meios de cultivo: controle (n=340 oócitos): meio SOF e soro fetal bovino (SFB), sem o CLA; SFB+CLA (n=359 oócitos): meio SOF, SFB e CLA; CLA (n=339 oócitos): meio SOF e CLA, sem o SFB. Todos os blastocistos produzidos foram submetidos à vitrificação, pelo método de Open Pulled Straw. Quinze blastocistos de cada tratamento foram fixados para quantificação lipídica por coloração com Sudan Black B. Para avaliar a viabilidade embrionária, foi observada a capacidade de reexpansão e eclosão pós-aquecimento dos embriões (controle=27; SFB+CLA=30; CLA=17). Foram realizadas transferências em um ou dois embriões por receptora para avaliação da sobrevivência in vivo: T1 [receptoras que receberam um blastocisto (n=17 embriões, sendo controle=5, SFB+CLA=6 e CLA=6)]; T2 [receptoras que receberam dois blastocistos, (n= 54 embriões, sendo controle=18, SFB+CLA=14 e CLA=22)]. Não houve diferença nas taxas de clivagem (62,1%; 74,0%; 74,0% para controle; SFB+CLA; CLA, respectivamente), produção de blastocistos em relação aos clivados (59,7%; 47,7%; 38,3% para controle; SFB+CLA; CLA, respectivamente) e produção de blastocistos em relação ao total de oócitos (37,1%; 35,4%; 28,3% para controle; SFB+CLA; CLA, respectivamente) (P>0,05). Houve diminuição de gotículas lipídicas nos embriões cultivados em meio suplementado com CLA em relação aos embriões cultivados na presença do SFB e na ausência do CLA (P<0,05). A taxa de reexpansão foi maior no grupo controle (70,4%) em relação ao CLA (47,1%) e menor no grupo SFB+CLA (43,3%) (P<0,05). O CLA foi eficaz em reduzir a deposição de lipídeos intracitoplasmáticos nas células embrionárias, porém não houve diferença de viabilidade após a desvitrificação dos embriões.(AU)

The effect of adding conjugated linoleic acid (CLA) to the culture media on the viability after cryopreservation of F1 Holstein X Zebu embryos was evaluated. Three different culture media were tested: control (n = 340 oocytes): SOF medium and fetal bovine serum (FBS) without the CLA; FBS + CLA (n = 359 oocytes): SOF, FBS and CLA; CLA (n = 339 oocytes): SOF and CLA without the FBS. The produced blastocysts were subjected to vitrification, by the Open Pulled Straw method. Fifteen blastocysts per treatment were fixed for lipid quantification by staining with Sudan Black B. Embryo re-expansion and hatching capability were used to assess viability (control = 27; FBS + CLA = 30; CLA = 17). Transfers of one or two embryos to recipients were performed to evaluate in vivo survival: T1 [recipients that received one blastocyst (n=17 embryos, Control=5, FBS+CLA=6 and CLA=6)]; T2 [recipients that received two blastocysts (n =54 embryos, Control=18, FBS+CLA=14 and CLA=22)]. There was no difference in cleavage rate (62.1%; 74%; 74% for Control; FBS + CLA, CLA, respectively), blastocyst production in relation to the cleaved structures (59.7%; 47.7%; 38 3% for Control; FBS + CLA, CLA, respectively) and blastocyst production relative to the total oocytes (37.1%, 35.4%, 28.3% for Control; FBS + CLA, CLA, respectively) between treatments (P> 0.05). A reduction of lipid droplets was observed in embryos cultured in medium supplemented with CLA compared to embryos cultured in the FCS in the absence and presence of CLA (P <0.05). The reexpansion rate was higher in the Control group (70.4%) compared to the CLA (47.1%) and lowest for FBS+CLA (43.3%) (P<0.05). The hatching rates were similar among treatments, 42.1%; 23.1%; 25% for control; SFB + CLA; CLA respectively (P>0.05). Only one pregnancy was observed in early and confirmatory diagnosis, as the result of a Control group embryo transfer. Although embryos cultured with CLA have shown smaller intracytoplasmic lipid content, no difference was observed in viability following vitrification between treatments.(AU)

A new simple and reliable vitrification device based on Hollow Fiber Vitrification (HFV) method evaluated using IVP bovine embryos

A new vitrification device based on hollow fiber vitrification (HFV) was constructed using a glass capillary, which lead to simplified construction process and increased practicality of the device. The hollow fiber was attached to heat-pulled tip of the glass capillary using forceps. A protective sheath fitted on the capillary provided protection for the cellulose triacetate hollow fiber with loaded embryos and allowed safe storage in liquid nitrogen for long periods of time (2-12 month), transfer between tanks with liquid nitrogen and transportation within these tanks. No embryos were lost in the process. The device was tested using seven-day-old and eight-day-old IVP bovine blastocysts and expanded blastocysts as a model. Obtained survival (90% at 24 h post warming) and hatching rates (62% at 72 h post warming) of day 7 blastocysts and expanded blastocysts were comparable to those gained using various vitrification carriers. Vitrified embryos did not show an increase in the number of cells with damaged membrane or a decrease in total cell number per embryos in comparison to their non-vitrified counterparts. Day 7 and 8 expanded blastocysts did not differ significantly in terms of survival at 24 (97.01 vs. 97.50%) and 48 h post warming (95.52 vs. 95%), but showed significantly higher survival and hatching rates than day 7 and 8 blastocysts. These results indicated that high and repeatable survival rates can be obtained by selection of IVP bovine embryos at the developmental stage of expanded blastocyst for HFV. Further modification of the method may be required to achieve high and stable results with different developmental stages of IVP bovine embryo. The vitrification device presented in the current article may contribute to wider application of HFV method in livestock production.(AU)

A new simple and reliable vitrification device based on Hollow Fiber Vitrification (HFV) method evaluated using IVP bovine embryos

A new vitrification device based on hollow fiber vitrification (HFV) was constructed using a glass capillary, which lead to simplified construction process and increased practicality of the device. The hollow fiber was attached to heat-pulled tip of the glass capillary using forceps. A protective sheath fitted on the capillary provided protection for the cellulose triacetate hollow fiber with loaded embryos and allowed safe storage in liquid nitrogen for long periods of time (2-12 month), transfer between tanks with liquid nitrogen and transportation within these tanks. No embryos were lost in the process. The device was tested using seven-day-old and eight-day-old IVP bovine blastocysts and expanded blastocysts as a model. Obtained survival (90% at 24 h post warming) and hatching rates (62% at 72 h post warming) of day 7 blastocysts and expanded blastocysts were comparable to those gained using various vitrification carriers. Vitrified embryos did not show an increase in the number of cells with damaged membrane or a decrease in total cell number per embryos in comparison to their non-vitrified counterparts. Day 7 and 8 expanded blastocysts did not differ significantly in terms of survival at 24 (97.01 vs. 97.50%) and 48 h post warming (95.52 vs. 95%), but showed significantly higher survival and hatching rates than day 7 and 8 blastocysts. These results indicated that high and repeatable survival rates can be obtained by selection of IVP bovine embryos at the developmental stage of expanded blastocyst for HFV. Further modification of the method may be required to achieve high and stable results with different developmental stages of IVP bovine embryo. The vitrification device presented in the current article may contribute to wider application of HFV method in livestock production.

Freeze-all cycle for all normal responders?

PURPOSE: The purpose of this study is to evaluate the freeze-all strategy in subgroups of normal responders, to assess whether this strategy is beneficial regardless of ovarian response, and to evaluate the possibility of implementing an individualized embryo transfer (iET) based on ovarian response. METHODS: This was an observational, cohort study performed in a private IVF center. A total of 938 IVF cycles were included in this study. The patients were submitted to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone (GnRH) antagonist protocol and a cleavage-stage day 3 embryo transfer. We performed a comparison of outcomes between the fresh embryo transfer (n = 523) and the freeze-all cycles (n = 415). The analysis was performed in two subgroups of patients based on the number of retrieved oocytes: Group 1 (4-9 oocytes) and Group 2 (10-15 oocytes). RESULT(S): In Group 1 (4-9 retrieved oocytes), the implantation rates (IR) were 17.9 and 20.5% (P = 0.259) in the fresh and freeze-all group, respectively; the ongoing pregnancy rates (OPR) were 31 and 33% (P = 0.577) in the fresh and freeze-all group, respectively. In Group 2 (10-15 oocytes), the IR were 22.1 and 30.1% (P = 0.028) and the OPR were 34 and 47% (P = 0.021) in the fresh and freeze-all groups, respectively. CONCLUSION(S): Although the freeze-all policy may be related to better in vitro fertilization (IVF) outcomes in normal responders, these potential advantages decrease with worsening ovarian response. Patients with poorer ovarian response do not benefit from the freeze-all strategy.

Efeito da adição do ácido linoleico conjugado no cultivo in vitro de embriões F1 Holandês x Zebu na sobrevivência pós-vitrificação

ABSTRACT The effect of adding conjugated linoleic acid (CLA) to the culture media on the viability after cryopreservation of F1 Holstein X Zebu embryos was evaluated. Three different culture media were tested: control (n = 340 oocytes): SOF medium and fetal bovine serum (FBS) without the CLA; FBS + CLA (n = 359 oocytes): SOF, FBS and CLA; CLA (n = 339 oocytes): SOF and CLA without the FBS. The produced blastocysts were subjected to vitrification, by the Open Pulled Straw method. Fifteen blastocysts per treatment were fixed for lipid quantification by staining with Sudan Black B. Embryo re-expansion and hatching capability were used to assess viability (control = 27; FBS + CLA = 30; CLA = 17). Transfers of one or two embryos to recipients were performed to evaluate in vivo survival: T1 [recipients that received one blastocyst (n=17 embryos, Control=5, FBS+CLA=6 and CLA=6)]; T2 [recipients that received two blastocysts (n =54 embryos, Control=18, FBS+CLA=14 and CLA=22)]. There was no difference in cleavage rate (62.1%; 74%; 74% for Control; FBS + CLA, CLA, respectively), blastocyst production in relation to the cleaved structures (59.7%; 47.7%; 38 3% for Control; FBS + CLA, CLA, respectively) and blastocyst production relative to the total oocytes (37.1%, 35.4%, 28.3% for Control; FBS + CLA, CLA, respectively) between treatments (P> 0.05). A reduction of lipid droplets was observed in embryos cultured in medium supplemented with CLA compared to embryos cultured in the FCS in the absence and presence of CLA (P 0.05). The reexpansion rate was higher in the Control group (70.4%) compared to the CLA (47.1%) and lowest for FBS+CLA (43.3%) (P 0.05). The hatching rates were similar among treatments, 42.1%; 23.1%; 25% for control; SFB + CLA; CLA respectively (P>0.05). Only one pregnancy was observed in early and confirmatory diagnosis, as the result of a Control group embryo transfer. Although embryos cultured with CLA have shown smaller intracytoplasmic lipid content, no difference was observed in viability following vitrification between treatments.

RESUMO Avaliou-se o efeito da adição do ácido linoleico conjugado (CLA) ao meio de cultivo in vitro na viabilidade pós-vitrificação de embriões F1 Holandês x Zebu. Foram utilizados três meios de cultivo: controle (n=340 oócitos): meio SOF e soro fetal bovino (SFB), sem o CLA; SFB+CLA (n=359 oócitos): meio SOF, SFB e CLA; CLA (n=339 oócitos): meio SOF e CLA, sem o SFB. Todos os blastocistos produzidos foram submetidos à vitrificação, pelo método de Open Pulled Straw. Quinze blastocistos de cada tratamento foram fixados para quantificação lipídica por coloração com Sudan Black B. Para avaliar a viabilidade embrionária, foi observada a capacidade de reexpansão e eclosão pós-aquecimento dos embriões (controle=27; SFB+CLA=30; CLA=17). Foram realizadas transferências em um ou dois embriões por receptora para avaliação da sobrevivência in vivo: T1 [receptoras que receberam um blastocisto (n=17 embriões, sendo controle=5, SFB+CLA=6 e CLA=6)]; T2 [receptoras que receberam dois blastocistos, (n= 54 embriões, sendo controle=18, SFB+CLA=14 e CLA=22)]. Não houve diferença nas taxas de clivagem (62,1%; 74,0%; 74,0% para controle; SFB+CLA; CLA, respectivamente), produção de blastocistos em relação aos clivados (59,7%; 47,7%; 38,3% para controle; SFB+CLA; CLA, respectivamente) e produção de blastocistos em relação ao total de oócitos (37,1%; 35,4%; 28,3% para controle; SFB+CLA; CLA, respectivamente) (P>0,05). Houve diminuição de gotículas lipídicas nos embriões cultivados em meio suplementado com CLA em relação aos embriões cultivados na presença do SFB e na ausência do CLA (P 0,05). A taxa de reexpansão foi maior no grupo controle (70,4%) em relação ao CLA (47,1%) e menor no grupo SFB+CLA (43,3%) (P 0,05). O CLA foi eficaz em reduzir a deposição de lipídeos intracitoplasmáticos nas células embrionárias, porém não houve diferença de viabilidade após a desvitrificação dos embriões.

Freeze-all, oocyte vitrification, or fresh embryo transfer? Lessons from an egg-sharing donation program.

OBJECTIVE: To compare the outcomes of ETs using cryopreserved embryos, cryopreserved oocytes, or fresh embryos. DESIGN: Observational, cohort study. SETTING: Private university-affiliated fertility center. PATIENT(S): This study included 8,210 mature oocytes obtained from 425 oocyte donors. Of those, 5,440 were used for the donors' own cycles (Fresh Oocyte Cycles Group), and 2,770 were cryobanked for 425 recipients (Banked Donor Egg Group). All of the oocytes were sperm injected, resulting in 4,585 embryos from the donors' own cycles and 2,128 embryos from the recipients' cycles. For the donor cycles, embryos were either cryopreserved and transferred during a subsequent cycle (Thaw Cycles Group, 3,209 embryos), or they were transferred during a fresh cycle (Fresh Cycles Group, 1,307 embryos). For the recipient cycles, embryos derived from vitrified oocytes were transferred (Vitrified Oocytes Group, n = 425 cycles, 2,128 embryos). INTERVENTION(S): Oocyte/embryo vitrification and intracytoplasmic sperm injection. MAIN OUTCOME MEASURE(S): Embryo quality, pregnancy, and implantation rates. RESULT(S): Decreased embryo quality and lower rates of blastocyst formation were observed among embryos derived from vitrified oocytes. The highest pregnancy and implantation rates were noted for the Thaw Cycles Group, followed by the Banked Donor Egg Group; the Fresh Cycles Group had the lowest rates. CONCLUSION(S): Oocyte vitrification followed by intracytoplasmic sperm injection leads to lower embryo developmental competence compared with when fresh insemination methods are used. However, pregnancy and implantation rates are higher when embryos are transferred into a "more receptive" endometrium, free of the adverse effects of gonadotropin. Moreover, the freeze-all method leads to exceptional clinical outcomes.

Changes in tri-methylation profile of lysines 4 and 27 of histone H3 in bovine blastocysts after cryopreservation.

Pregnancy rates from cryopreserved embryos remain lower than non-cryopreserved counterparts, even though these embryos appear morphologically normal. How epigenetic events, such as histone modifications, are affected by cryopreservation of embryos remains unknown. The current study evaluated the effect of conventional freezing/thawing of in vitro produced bovine blastocyst embryos on histone modifications, H3K4me3 and H3K27me3. At day 7 of in vitro culture, blastocyst stage embryos were either frozen by conventional freezing method (-0.5 °C/min in 1.5 M ethylene glycol; F/T group) or remained in culture for an additional 18 h (Ctrl). Frozen embryos were stored in liquid N2 for 14 days, thawed and placed in culture for 36 h for recovery. Control and re-expanded frozen-thawed blastocysts from both groups were fixed in 4% paraformaldehyde and stored in PBS +0.1% triton-X at 4 °C. Immunofluorescence, utilizing antibodies against H3K4me3 and H3K27me3, was conducted and staining intensity was analyzed as percentage of total DNA. Day 7 blastocyst development rate was 35.55% (352/990) with blastocyst recovery at 54.23% (77/142) 36 h post-thawing. Total cell numbers per blastocyst were not different amongst groups (117.8 ± 12.49 and 116.1 ± 14.69, F/T and Ctrl groups respectively). Global staining for the active mark, H3K4me3, was lower in F/T blastocysts compared to Ctrl (17.24 ± 2.80% vs. 34.95 ± 3.77%; P < 0.01). However, staining for the inhibitory mark, H3K27me3, was nearly 2-fold higher in F/T blastocysts (40.41 ± 3.83% vs. 21.29 ± 3.92%; P < 0.01). These results suggest that bovine blastocysts, subjected to conventional freezing methods, have altered histone modifications that may play a role in poor pregnancy rates.

Fertility Preservation Options for Men and Women With Cancer.

Approximately 0.2% of Americans aged 20 to 39 years are childhood cancer survivors. Advances in cancer detection and therapy have greatly improved survival rates for young cancer patients; however, treatment of childhood cancers can adversely impact reproductive function. Many cancer patients report a strong desire to be informed of existing options for fertility preservation and future reproduction prior to initiation of gonadotoxic cancer therapies, including surgery, chemotherapy, and radiotherapy. This article discusses, in detail, the effects of cancer treatment on fertility in men and women, and outlines both current and experimental methods of fertility preservation among cancer patients.

Strategies to preserve the reproductive future of women after cancer.

Malignant and cardiovascular diseases are the main causes of death in Brazil. Estimates for 2013 predict the occurrence of 189,150 new cases of cancer in Brazilian women. With advanced detection tools, patients are diagnosed and treated for cancer at a younger age and are more likely to survive. The cytotoxic action of chemotherapeutic agents and radiotherapy very frequently implies serious damage to the gonads, and consequences due to the hypoestrogenism, such as osteoporosis, infertility and premature ovarian failure, are expected. Oncofertility, then, appears as a new area of reproductive medicine, which is dedicated to the development of strategies for the reduction of therapeutic sequels in cancer survivals, ultimately aiming the maintenance of their quality of life and the possibility of biological maternity. This article aims to present an overview of possible options for female fertility preservation after cancer and future perspectives in oncofertility.