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Predicting live birth for poor ovarian responders: the PROsPeR concept
KEY MESSAGE: PROsPeR is a simple and accurate live-birth estimate designed specifically for poor ovarian responders and
is suitable for routine practice. PROsPeR produces a score (0, 1 or 2), with the predicted live-birth rate reduced
by a factor of three with each additional predictor present.
The impact of antenatal Bisphenol A exposure on male reproductive function at 20–22 years of age
After adjustment for maternal smoking, abstinence and varicocele, sperm concentration and motility were significantly correlated to maternal serum BPA (r = 0.18: P = 0.04 for both). No other associations of maternal serum BPA with testicular function were observed.
When only one embryo is available, is it better to transfer on Day 3 or to grow on?
Conclusions: These findings support Day 3 cleavage-stage embryo transfer instead of growing on to Day 4–6 for blastocyst-stage transfer when only a single embryo is available.
Controversies in ART: can the IVF laboratory influence preimplantation embryo aneuploidy?
More recent reports suggest that rates of embryo mosaicism, representing mitotic errors, may vary between IVF centres. This would suggest perhaps a laboratory-controlled variable is influencing mitotic cell division during preimplantation embryo development. Various IVF laboratory-controlled factors may be impacting chromosome separation and segregation. Variables including type of culture media, pH, temperature, osmolality and oxygen concentrat
A mouse model for the effects of IVF procedures on the development of embryos
Chen et al. are to be congratulated on their informative characterisation of the impacts of different ART techniques on murine preimplantation embryonic development and for their careful attempts to replicate clinical embryo culture conditions. Their work paves the way for better understanding of the later-life implications of altered early developmental trajectories. While there is a clear theoretical mechanism that could link the observed anoma
Differential impacts of gonadotrophins, IVF and embryo culture on mouse blastocyst development [Mouse]
Results
Ovarian stimulation increased embryo number but reduced the percentage of blastocysts. Morphokinetic analysis showed that gonadotrophin treatment led to advanced development (P < 0.05) due to earlier post-pronuclear breakdown. The blastocyst rate was reduced in IVF embryos compared with those fertilized in vivo before culture (P < 0.001). Morphokinetics showed that embryo development was slower in all the IVF groups (P < <0.05), due to a
Male mice, caged in the International Space Station for 35 days, sire healthy offspring
Male mice raised in space using specially developed cages were returned safely to Earth. The sperm production/fertilizing ability of the mice were normal and the reproduction ability of the offspring were not affected by their parents' stay in outer space. The findings on the effects of the environment in space on the male reproductive system will contribute to the accumulation of basic knowledge for humankind to expand the range of its activity
Whilst there are five other equally interesting papers in this issue, as Editor in Chief, it strikes me that the four I have highlighted are not entirely unconnected to each other. They tell of a story of a population of young people who may enter their fertile years somewhat poorly prepared to make decisions about their fertility such that if their fertility plans are not realised, find themselves at the mercy of “doctor shopping” or COI’s withi
No defects found in reproductive ability of male mice returning from short stay in space
Male mice raised in space using specially developed cages were returned safely to Earth. The sperm production/fertilizing ability of the mice were normal and the reproduction ability of the offspring were not affected by their parents' stay in outer space. The findings on the effects of the environment in space on the male reproductive system will contribute to the accumulation of basic knowledge for humankind to expand the range of its activity
If there is only 1 embryo, is it better to transfer on day 3 or day 5?
Summary
The answer is there is a better chance of pregnancy if the embryo is transferred on day 3.
Comment
Controlled ovarian hyperstimulation (COH) works because in most cases, there are more oocytes collected and more embryos generated allowing for a choice of the best embryo for testing and transfer. In some cases, either due of diminished ovarian response, poor fertilization or for unknown reasons, there is only one embryo on day 2 or day 3. The clinician then should discuss with each client their option of either transferring on day 3 or allowing the embryo to continue to grow in vitro to day 5 (or day 6) to, if you like test its viability. If the embryo develops into a viable blastocyst, then it can be transferred. If the embryo fails to develop then the client has been spared the emotional and financial cost of an unnecessary transfer and pregnancy test.
|Some clinics have firm rules about their preference for either a day 3 or day 5 transfer but the question remains whether the culture environment is as good as a uterine one to support the development of a single embryo? Is it better to return the embryo to the uterus and give it the best opportunity to develop but without knowing its fate or is it better to determine by extended culture, the viability of the embryo? Another option available to clients and clinics is to cryostore the embryos (usually on day 3 and try to increase the embryo pool by attempted another cycle). The authors report that in all cases, the clinician (who may have had a preference for either immediate or delayed transfer) discussed these options with the clients. The authors indicated that in this study, that the decision for day of transfer is based on the institutional protocol (i.e embryo viability based on embryo number and grade), unless they wanted a procedure such as PGT-A then the embryo will have to be grown on. The implication therefore was that embryos committed to extended culture appeared to be of better quality.
|In this retrospective paper from an Australian clinic, 1384 cycles that resulted in a single embryo on day 3 were reviewed. The question was asked what happened if the embryo was transferred on day 3 or extended to day 5. The real question was what was the chance of a live birth from either transfer option. The data set had some complexities because some embryos were frozen on day 3 and when thawed, either were transferred or cultured for several days. This decision was influenced by embryo viability.
| The authors compared all the cases that were processed day 3 (n=1017) or were committed to extended culture (n=367) and using this base, concluded day 3 resulted in significantly more clinical pregnancies and more live births. The difference was 9.7% compared to 4.4% (P=0.002).
|The data was complicated because in some cases, the embryos were discarded and the transfer was cancelled. The cancelled cases were because the embryo was non-viable based on the clinics protocol. This occurred in 10% of day 3 cases and 37% of extended culture cases. The authors reported in a supplementary table the results per transfer and still identified a superior clinical pregnancy rate for day 3 transfer over day 5 transfer (14.7% x 8.7%) and a live birth rate/transfer of 9.9% x 5.3%.
|In other words, when there is only one embryo, uterine culture delivers a better outcome from day 3 rather than the culture system for day 5 transfers. Remember, the better embryos may have been preferenced to extended culture making this observation even more worrying since one may have expected day 5 transfers to deliver more pregnancies. It would be interesting to see what a randomised study may find. Thus, there is just a small suggestion that the extended culture media may need further development to optimize single embryo culture systems.
|The authors recognized that various compounding factors such as age and male factor infertility were examined in this report and fond not in significantly alter the results. They did make the point that one primary argument for extended culture is to allow for better embryo selection and for genetic testing. Cases where there is only one embryo makes this argument not appropriate. Another issue to recognize is that the embryo quality in cases where there was poor embryology and that such embryos may not reflect those that are port of a larger cohort.
|While COH is the industry standard, in some countries, there are clinics offering minimal stimulation which aims to generate only one or two embryos. The results from this study argue that maybe day 3 transfers may be a better option.
|The debate over day 3 or day 5 transfers has seen a preference for clinics to move to day 5 transfers coincide with a desire for single embryo transfers to minimize multiple pregnancies. This data suggests that there may be a small price to pay insofar as the suitability of the culture system to full support extended culture. |
Title
Does exposure to zero gravity effect male reproducitve processes?
Summary
For at least 35 days, the anwer is no.
Comment
THIS IS A COPY OF THE OPEN ACCESS ABSTRACT FOR Matsumura, T., Noda, T., Muratani, M. et al. Male mice, caged in the International Space Station for 35 days, sire healthy offspring. Sci Rep 9, 13733 (2019) doi:10.1038/s41598-019-50128-w |
Abstract|
The effect on the reproductive system and fertility of living in a space environment remains unclear. Here, we caged 12 male mice under artificial gravity (~1 gravity) (AG) or microgravity (MG) in the International Space Station (ISS) for 35 days, and characterized the male reproductive organs (testes, epididymides, and accessory glands) after their return to earth. Mice caged on earth during the 35 days served as a “ground” control (GC). | Only a decrease in accessory gland weight was detected in AG and MG males, however, none of the reproductive organs showed any overt microscopic defects or changes in gene expression as determined by RNA-seq. The cauda epididymal spermatozoa from AG and MG mice could fertilize oocytes in vitro at comparable levels as GC males. | When the fertilized eggs were transferred into pseudo-pregnant females, there was no significant difference in pups delivered (pups/transferred eggs) among GC, AG, and MG spermatozoa. In addition, the growth rates and fecundity of the obtained pups were comparable among all groups. We conclude that short-term stays in outer space do not cause overt defects in the physiological function of male reproductive organs, sperm function, and offspring viability.| [Required link https://rdcu.be/bWvt0] |
IVF Training - Questions relating to mailout links -
Open Challenge and complete Questions
Question
Type
Options
Extending embryo culture to day 5 allows a clinic to pursue which of the following?
2
5
Extending embryo culture to day 5 allows a clinic to pursue which of the following?
2
5
In this paper exploring the value of extended culture where there is only a single embryo available for transfer, the authors reported the live birth rate to
1
3
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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
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