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Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ICSI
Our results refer only to patients undergoing Day 5 SET. Although vitamin D deficiency appears to compromise pregnancy rates in this population, no guidance can be provided regarding a potential relationship between vitamin D deficiency and ovarian reserve or response to ovarian stimulation.
Total fertilization failure: is it the end of the story?
Increasing the number of retrieved and mature oocytes may increase the success of fertilization in patients with a history of previous failed fertilization. However, live birth rate is still low in embryo transfer cycles.
Live birth rates after IVF are reduced by both low and high progesterone levels on the day of human chorionic gonadotrophin administration
This study comprehensively assessed the relationship between live birth delivery rates and progesterone levels on the day of hCG administration during ovarian stimulation for IVF. Clinically relevant lower (≤:0.5 ng/ml) and higher (>1.5 ng/ml) progesterone level limits were determined.
In-vitro maturation of oocytes vs in-vitro fertilization with a gonadotropin-releasing hormone antagonist for women with polycystic ovarian syndrome:
The IVM protocol can be an alternative for infertile women with PCOS who wish to prevent the potential adverse effects of gonadotropin treatment. Prospective studies are needed to compare the outcomes of these two treatment protocols.
GnRH antagonist versus long GnRH agonist protocol in poor IVF responders: a randomized clinical trial
Although long GnRH agonist and fixed GnRH antagonist protocols seem to have comparable pregnancy rates per transfer in poor responders undergoing IVF, the higher cancellation rate observed in the antagonist group suggests the long GnRH agonist protocol as the first choice for ovarian stimulation in these patients
Uterine peristalsis before embryo transfer affects the chance of clinical pregnancy in fresh and frozen-thawed embryo transfer cycles
Patients with uterine peristalsis of <3.0 waves/min before embryo transfer had a higher chance of pregnancy compared with those with higher frequencies. This could be a promising quantitative marker of uterine receptivity and pregnancy outcome in an embryo transfer cycle. The predictive validity of the cut-off value needs to be tested in further study.
Oil for Embryo Culture: Mouse Embryo Assay is the Ultimate Test for Toxicity
Conclusions: This study demonstrates that the bioassay proved to be the ultimate test for detecting toxic oil compared to analytical methods, which did not reveal any differences between good and toxic oil. Additionally, the method used for the mouse embryo assay can impact the sensitivity of detecting toxic substances. The blastocyst development data show that the
threshold for detection of toxic components is lower (more sensitive) when using
Reproduction later in life is a marker for longevity in women
Women who are able to naturally have children later in life tend to live longer and the genetic variants that allow them to do so might also facilitate exceptionally long life spans, according to a new study.
“Discovery Park ticks all of the boxes. It’s close to all forms of transport to continental Europe as well as direct flights to North America and Asia, there are state of the art facilities and valuable support from the local government.” “It makes sense for us to be here, making the vital solutions that nurture eggs, sperm and embryos during the IVF process locally and answering the needs of IVF clinics across Europe.”
In-Vitro Fallout: Donor IVF Teen Says “I Wish I Had Never Been Born”
She was adopted as a “leftover” IVF embryo. Gracie keenly feels the loss of her genetic roots, but the law in the UK prevents her from ever knowing who her biological parents are. The pain is so acute, some days she says she wishes she were never born.
After IVF Mix-Up and Surrogacy, ‘Inconceivable’ Mom Achieves Pregnancy NATURALLY
Now a mother to five – one conceived naturally, two conceived via surrogacy after the IVF mix-up, and two others born via IVF – Carolyn is expecting child number six, who was conceived….naturally.
In a recent interview with the Independent Robert Winston warned of deception in the IVF market. Fertility companies, he believes, are exaggerating the effectiveness and safety of new techniques.
Working with cryoliquids and liquid nitrogen in particular (-196C) requires strict rules to be followed. These rules are designed to prevent or reduce two major hazards"anoxia and cryogeneic burns caused by contact with liquid nitrogen.
Bourn Hall’s Indian arm to expand fertility clinics across the country
The Indian arm of British healthcare company Bourn Hall International has decided to invest $100 million to expand its fertility clinics across the country. The wholly-owned subsidiary of the British firm is now operating two fertility clinics — Kochi and Gurgaon.
Air apparent: Using bubbles to reveal fertility problems
Doctors in California are the first fertility specialists in the county to use a new ultrasound technique to assess fallopian tubes by employing a mixture of saline and air bubbles that is less painful, avoids X-ray exposure and is more convenient to patients during an already vulnerable time. Using the technique, the physician delivers the mixture of saline and air bubbles into the uterus through a small catheter, which then flows into the fall
Young women with polycystic ovary syndrome are 5 times more likely to develop type 2 diabetes
Young women with Polycystic Ovary Syndrome (PCOS) have a startlingly higher risk of developing type 2 diabetes, even if young and not overweight, a leading expert on reproductive health says. "With the dramatic rise in diabetes, this research highlights the need for greater awareness and screening, especially in high risk groups including young women with PCOS."
Fertisafe Plus™ Product brochure [PDF] [This link may be from a sponsor]
Fertisafe Plus™ is a long lasting, CE marked, ready to use broad spectrum antimicrobial disinfectant. Quaternary Ammonium free and odourless, it is proven to kill bacteria, viruses and fungi, yet is embryo and sperm safe. [link provided for general information only]
Fertaid Mail - FertAid Interact. [This link may be from a sponsor]
FertAid is developing a new interactive module where items can be listed for discussion, products can be promoted, jobs, etc. It is envisaged the module will be open to all IVF Clinic staff not just embryology.
The film explains what it means to be a balanced translocation carrier and the problems with fertility that may be experienced. IVF with translocation preimplantation genetic diagnosis (translocation PGD) is suggested as a way to improve the chances of a successful pregnancy and a healthy baby.
Video Links / [Posted:30/6/2014] / [Source:support.illumina.com] Viewed: 1767
Comments Linked to this Mailout
Title
Young women with polycystic ovary syndrome are 5 times more likely to develop type 2 diabetes
Summary
Not a surprising observation but one that may pose a risk for IVF clinics
Comment
Women with PCOS present frequently at IVF Clinics because it is associated with infertility. One issue that may flow from this is whether clinics have a duty of care and clinically check the diabetes status before treatment (I am sure this is done!) to ensure if there is any pregnancy risk and to ensure all management is in place before treatment. The role of uterine exposure in children and adult health may play a bigger role with PCOS clients. There may be other risks such a prescribing diabetic risk mediation such as growth hormone.
Title
Oil for Embryo Culture: Mouse Embryo Assay is the Ultimate Test for Toxicity
Summary
Irvine Scientific have released a study on the detection capabilities of different culture systems of adulterated mineral oil
Comment
The study added formalin to mineral oil (IRVINE) and tested mouse embryo development in a dose response manner. The study showed that a microdrop culture system detected the toxicity at a lower level than microwell. They suggested the microdrop was a better system for performing the MBA than the microwell. I however saw the data in a different light that suggested maybe the microwell was a better culture system since it was less effective in transmitting the toxicity to the embryos. Would be interesting to see the outcomes for IVF with the 2 systems.
Title
In-vitro maturation of oocytes vs in-vitro fertilization with a gonadotropin-releasing hormone antagonist for women with polycystic ovarian syndrome:
Summary
A retrospective review of IMV and IVF for a PCOS group. Even though the IVM arm was not a good as the IVF arm (Not significantly), it still is worth considering for these high risk couples.
Comment
In the 2104 IVF census, IVM was being used by fewer clinics than in 2013. Given the workload and other high tech pressures and space limitations, IVM seems to be falling out of favour. IN this study, IVF pregnancy rates of 40% were better than 25% for IVM but all IVF/ET in IVF/PCOS cycles are at considerable risk. OHSS can appear in the most unexpected of cases (mainly due to the large numbers of smaller follicles). At least with IVM, one can do a fresh ET with a much lower risk of OHSS. Most clinics these days are freezing day 5 embryos, cancelling the transfer and looking of pregnancies in warmed blastocyst transfers. IVM has problems competing with the results from this management strategy.
Title
GnRH antagonist versus long GnRH agonist protocol in poor IVF responders: a randomized clinical trial
Summary
A well constructed study showing that previous poor responders fair better on a long down regulation agonist cycle than an antagonist cycle mainly due to lower cancellation rate.
Comment
Much of IVF is follow the leader and in recent years, clinics are using antagonist cycles because of less management, less patient contact an shorter stimulation phase. Overall it works well but in the group in this study of proven poor responders, the agonist approach had a significantly better outcome (babies/cycle strated). The pregnancy rates appeared higher which when combined with fewer cancellations delivered a better outcome. Most couples will tolerate a longer stimulation phase and more injections if it leads to a greater chance of a live birth. More so if their previous (presumably unsuccessful) cycle only produced a few ooctyes.
Title
Total fertilization failure: is it the end of the story?
Summary
This study looks at 61 repeat cycles after ICSI/TFF (total fertilisation failure) and asks what is different between the cycles that achieved fertilisation and those that did not- # oocytes.
Comment
Of 136 TFF cycles, 61 clients returned for another attempt. 36/61 (60%) achieved an embryo transfer and ~40% did not. The authors observed that the successful cycles had more oocytes suggesting FF is a numbers game. The more eggs to inject, the more likely some may fertilise. Even with a poor quality semen sample, ICSI allows the embryologists to be far more selective in which sperm to inject. These odds suggest that for all TFF, the rule is to have second attempt and stimulate a little harder (maybe). However, the fly in the ointment is that regardless of whether it is an egg or sperm problem, few transfers result in pregnancy and fewer in a live birth. Possibly the best option is two goes with the husbands semen and then go to donor sperm.
Title
In-Vitro Fallout: Donor IVF Teen Says “I Wish I Had Never Been Born”
Summary
A rather sad case but one clinics have been exposed to in the past.
Comment
The case involves a young girl, conceived embryo donation, who wants to know her biological heritage but cannot by donor protective laws. Couple who need donated gametes or embryos usually do not want to know the identity of their donor, they are just happy to have a chance to conceive. But these emotions do not apply to their children some of whom may want (some desperately) to know their origins. Many countries have created quite complex bureaucracies to allow young adults to find their biological parent(s) that in turn make clinic management quite complicated.
IVF Training - Questions relating to mailout links -
Open Challenge and complete Questions
Question
Type
Options
Live birth rates are compromised when the serum progesterone at hCG was:
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6
Vitamin D deficiency (defined as serum 25-OH vitamin D levels <20 ng/ml) was associated with a reduced pregnancy for day 5 SET cases in the order of:
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4
Uterine peristalsis before embryo transfer affects the chance of clinical pregnancy in:
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3
Most uterine peristaltic wave frequencies ranged between
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3
Clinical pregnancies decreased markedly when uterine peristaltic wave frequencies exceeded
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3
Which culture system is more sensitive to toxic oil overlay
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2
Which stimulation regimen delivers a better outcome (babies/cycle) for poor responders (<4 eggs in previous cycle).
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2
What proportion of cases may be expected to achieve fertilisation in a second ICSI attempt after Total Failed Fertilisation (TFF)
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6
In a recent study a Second ICSI Attempt After Total Failed Fertilisation (TFF), what was the most significant difference associated with success?
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5
What are the main risks from working with cryogenic material
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2
What are the main precautions you can take to minimise the risks?
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3
Which of the following precautions should you take to make the laboratory safer?
2
6
Prescription eye wear is safe to use with cryogenic material in place of safety googles
1
2
The unprotected hand should never manipulate any item that has been in contact with cryogenic material
1
2
Even if you are wearing the correct safety gloves, you should never submerge your hands in cryogenic material
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2
Low Oxygen, nitrogen rich, cold atmosphere will be found
1
2
Dewars need to be checked regularly to ensure there is no leakage (loss of vacuum in dewar walls)
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2
Areas where Dewars are stored should have permanent air extraction (from the floor) to remove potential nitrogen build up
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Oxygen monitors MUST be checked on a regular basis
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Anoxia is:
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3
The normal level of Oxygen in the atmosphere is
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A dangerous LOW level of oxygen is
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A dangerous low level of oxygen is caused by
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The response to low oxygen levels is
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Low oxygen can be detected
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4
The risk of anoxia can be influenced by
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Activities that may cause a decrease in oxygen can include
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Nitrogen will vaporise during any manipulation of cryo dewars or samples.
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2
One litre of nitrogen will produce when heated to room temperature
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7
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Vit Kit - Warm NX is an adaptable, cost-effective system for use in the thawing of oocytes, pronuclear zygotes, cleavage stage embryos, and blastocyst stage embryos. Unlike many vitrification kits that feature a mono-buffered system and M199 base med
Vit Kit - Freeze NX is an adaptable, cost-effective system for use in the vitrification of oocytes, pronuclear zygotes, cleavage stage embryos, and blastocyst stage embryos. Vit Kit - Freeze NX is the latest advancement in vitrification media aimed t
S-Cryolock is the slimmer version of the original. It is a versatile, simple and efficient vitrification device that is intended for the holding, cryopreservation and storage of oocytes or embryos in liquid nitrogen.
Source
Irvine Scientific
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