Reproductive biomedicine online最新文献

{"title":"Increased Patient Engagement with Utilization of Online Cryomanagement Platform","authors":"C. Lynch ,&nbsp;E. Pandolfi ,&nbsp;P. Walimbe ,&nbsp;C. Ng ,&nbsp;S. Gonsalez ,&nbsp;V. Desai","doi":"10.1016/j.rbmo.2024.104062","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104062","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>Cryomanagement of the increasing inventory of cyropresserved samples is labour intensive and often done utilizing a variety of inventory, billing and patient communication systems within the clinic. Utilizing an integrated and automated cryomanagement system including patient engagement and education tools and decision making on sample disposition reduces the workload for the embryologist and enhances consistency.</p></div><div><h3>METHODS</h3><p>Retrospective, deidentified data analysis was performed of 418, 895 patient accounts across 122 US clinics from 2015 to 2024.</p><p>Data was extracted from the automated cryomanagement platform database - a live feed of clinic information – and encrypted. Logic was created to develop calculations utilising the coding language Structured Query Language (SQL). Revenue collected was compared with collectable charges to generate the collection/response rate. Data was analysed by collection rate by tissue type and by length of engagement with the cryomanagement platform. Chi squared analysis was run on Prism software to calculate statistical significance.</p></div><div><h3>RESULTS</h3><p>An inverse relationship was identified between storage duration and patient engagement. Patient engagement fell from 97.44% to 68.44% in relation to oocytes, 94.87% to 45.08% for embryos, and 87.01% to 29.41% for sperm over the 9yr period analysed (storage time 0 - &gt;14yrs). Patients who began storage with the cryomanagment platform had overall higher engagement than those who initiated storge without the use of the cryomanagment platform. Patient engagement in those having exclusively interacted with the platform significantly exceeded those who had not at each storage point examined. At &gt;7yrs storage, patient engagement was improved by 9% in patients with oocytes stored (92.90% v 85.54%), 25% in patients with embryos stored (82.30% v 61.43%), and 44% in patients with sperm stored (64.09% v 35.94%).</p></div><div><h3>CONCLUSIONS</h3><p>This analysis indicates that patient engagement increases when interacting with an online cryomanagement system as opposed to directly with their clinic. The ability to independently access communications, education and disposition information online may be perceived as having greater anonymity or privacy and preferred to patients.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141164093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of direct swim-up technique in the IVF lab: a less invasive and more efficient sperm preparation method. A randomized prospective study of an alternative to the gold-standard techniques","authors":"R. Bravo Martin ,&nbsp;L. Herrero Grassa ,&nbsp;L. Cascales Romero ,&nbsp;M. Aparicio Gonzalez ,&nbsp;B. Boyano Rodriguez ,&nbsp;L. G. Arias Jimenez ,&nbsp;A. Garcia Roa ,&nbsp;J. A. Ortiz Salcedo ,&nbsp;J. Ten Morro ,&nbsp;A. Bernabeu Garcia ,&nbsp;R. Bernabeu Perez","doi":"10.1016/j.rbmo.2024.103997","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.103997","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>Sperm preparation is one of the steps needed in an IVF lab. The current gold-standard techniques are density gradient (DG) and swim-up (SU) protocol. Both techniques include one or more centrifugation steps, which can result in peroxidative damage to sperm membranes. Hence, a direct swim-up (DSU) of motile spermatozoa from seminal plasma, with no centrifugation steps, could result in better ART outcomes. The aim of this study is to evaluate the use of DSU in terms of semen quality, laboratory outcomes and clinical outcomes, when compared to the gold-standard techniques.</p></div><div><h3>METHODS</h3><p>We designed a randomised, non-inferiority prospective study including three different sperm preparation techniques: density gradients, swim-up, and direct swim-up. From December 2023, we have hitherto evaluated 49 ICSI cycles (20 DG cycles, 14 SU cycles and 15 DSU cycles), with both autologous and donated oocytes, but only including fresh partner samples. Severe oligoasthenozoospermic samples were excluded from the study. We performed the statistical analysis with a Kruskal-Wallis test followed by Bonferroni correction. The following confounding variables were included: gamete age (both female and male), type of oocyte (fresh or frozen) and number of oocytes (collected/donated).</p></div><div><h3>RESULTS</h3><p>As shown in table 1, we observed that good-quality blastocyst rate and blastocyst utilisation rate were significantly higher at the DSU group, especially when compared to DS group. Sperm quality after preparation was equivalent among the three groups. Regarding laboratory outcomes, fertilisation and blastulation rates were equivalent among the three study groups.</p></div><div><h3>CONCLUSIONS</h3><p>These preliminary results suggest that sperm preparation following DSU technique improves laboratory outcomes, in terms of good-quality blastocyst rate and blastocyst utilisation rate. Other laboratory outcomes do not seem to be negatively affected by the preparation technique applied. Sample size will increase throughout 2024 to increase the statistical power of this prospective study, as well as to evaluate clinical outcomes.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rescue of embryos identified as chaotic by Next Generation Sequencing-based (NGS-based) preimplantation genetic testing for aneuploidy (PGT-A). Is re-biopsy and re-testing a valid option?","authors":"Y. Franco Iriarte ,&nbsp;A. Villa ,&nbsp;I. Orozco ,&nbsp;G. Bescos ,&nbsp;F. Sotos ,&nbsp;E. Carrillo De Albornoz ,&nbsp;B. Bueno ,&nbsp;E. Melia ,&nbsp;A. Rexarch ,&nbsp;S. Iniesta ,&nbsp;A. Martinez ,&nbsp;V. Cabezuelo ,&nbsp;A. Bermejo ,&nbsp;A. Vegas Carrillo De Albornoz ,&nbsp;F. Martinez ,&nbsp;C. Christie ,&nbsp;A. Freedman ,&nbsp;K. Miller","doi":"10.1016/j.rbmo.2024.104004","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104004","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>NGS-based PGT-A testing technology enables the detection of chromosomal aneuploidies, including mosaicism, in trophectoderm biopsy samples. However, technical constraints such as limited number of cells in the biopsy sample, damaged cells in the biopsy sample, suboptimal transport conditions of the biopsy sample, the and the sequencing technology itself may result in suboptimal sequencing parameters, leading to amplification failures, absence of diagnosis, or incorrect copy number assessments. A chaotic diagnosis, defined as the presence of 6 or more genetic abnormalities, is one such failure outcome. Typically, chaotic embryos are excluded from transfer or discarded.</p><p>The objective was re-biopsy embryos initially deemed chaotic to check the euploidy, indicating their potential suitability for embryo transfer.</p></div><div><h3>METHODS</h3><p>A retrospective dataset of 24 chaotic embryos that underwent re-biopsy and re-testing with NGS-based PGT-A from 2022-2023 was included in the analysis. The re-tested embryos were evaluated for ploidy status and embryo transfer outcomes-</p><p>Blastocyst embryo grading was performed according to Gardner criteria. Good quality embryos exhibiting appropriate expansion and ICM and trophectoderm quality (AA, AB, BA, or BB) were included in the study. Chaotic embryos that survived the thawing procedure were re- biopsied and re-analyzed by NGS-based PGT-A testing</p></div><div><h3>RESULTS</h3><p>22 of 24 chaotic embryos (92% thaw survival) were re- biopsied and re-analyzed by NGS-based PGT-A testing compared to a thaw survival rate of 98% for all thawed blastocyst in our laboratory. The euploidy rate after rebiopsy was 14% (3/15). Two patients had frozen embryo transfers from embryos initially diagnosed as chaotic but after re-biopsy/re-analysis reclassified as euploid. For both patients, the previously diagnosed chaotic embryo was the only embryo available for transfer. Both patients achieved live birth outcomes. The first patient was a 30-year old woman reporting a full-term live birth of a healthy, phenotypically male infant. The second patient was a 38-year old woman also reporting a healthy, phenotypically male infant.</p></div><div><h3>CONCLUSIONS</h3><p>In conclusion, patients and clinicians should be aware that “chaotic” embryos have the potential to achieve healthy babies and should considered for re-biopsy and re-analysis for potential embryo transfer, especially for patients with only one or a limited number of embryos available for embryo transfer.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximizing the efficacy of commercial vitrification and warming for human blastocysts by cryoprotectant management: challenging validation results of a one-step model","authors":"J. Gunst ,&nbsp;K. Hostens ,&nbsp;V. Standaert ,&nbsp;S. Roggeman ,&nbsp;A. Van De Vijver","doi":"10.1016/j.rbmo.2024.104017","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104017","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>In recent decades, vitrification and warming of human oocytes and embryos involved a labour-intensive, multi-step process. Emerging data on human blastocysts indicate that one-step warming, employing various sucrose concentrations following multi-step vitrification yields comparable survival rates, developmental potential and similar ongoing pregnancy rates. This study aims to optimize human blastocyst cryopreservation by exploring a total one-step approach, assessing osmotic responsiveness through survival, re-expansion, and 24-hour developmental competence.</p></div><div><h3>METHODS</h3><p>Research consented vitrified blastocysts, using Rapid-i and ethylene glycol / 1,2-propanediol standard vitrification procedures, were used in this validation. All warming steps were performed at 37°C. In a first series, 90 blastocysts were randomly allocated to 6 different groups (15 per group) and warmed in a single step using 1, 0.5 or 0.25 M sucrose. In a second series, surviving blastocysts underwent ethylene glycol / 1,2-propanediol /sucrose single step vitrification at either 37°C or room temperature (RT) again followed by single step warming using the same sucrose concentration. Considering the results from the first series, additional embryos were included and only treated at 37°C.</p></div><div><h3>RESULTS</h3><p>Combined results of both series are summarized in the table. Overall, &gt;95 % of blastocysts were considered transferable following single step warming (138/145). The first series indicated better results when single-step vitrification was performed at 37°C and more embryos were added to these subgroups in series 2. Following single-step vitrification and warming at 37°C, re-expansion potential favoured 1M sucrose 47/49 (96%) versus 0.5M 20/25 (80%) (P=0.03) and 0.25M 18/24 (75%) (P=0.01). No statistical difference in developmental competence was observed. Compared to validation data after standard multi-step vitrification and warming, single-step vitrification combined with single-step warming in 1M sucrose are comparable in terms of survival and re-expansion, but seem to be better in developmental competence.</p></div><div><h3>CONCLUSIONS</h3><p>First series confirms the increasing evidence that single-step blastocyst warming after standard vitrification gives highly efficient results. Furthermore, our findings suggest that a 1-step approach for vitrification can work. This has the potential to further optimize cryopreservation techniques, mitigating potential cytotoxicity through minimal cryoprotectant exposure during vitrification and warming of blastocysts. Our findings provide a valuable framework for further investigation with possible clinical applications.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the use of an in-house derived statistical morphokinetic algorithm, predictive of live birth, introduce any sex-ratio bias? A review of 3009 live birth outcomes","authors":"R. Smith ,&nbsp;A. Barrie ,&nbsp;K. Berrisford ,&nbsp;S. Corcoran ,&nbsp;N. Davis ,&nbsp;S. Montgomery ,&nbsp;R. Oakley ,&nbsp;S. Owen ,&nbsp;A. Campbell","doi":"10.1016/j.rbmo.2024.104027","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104027","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>Gender (male or female) designated at birth is referred to as secondary sex ratio (SSR); the WHO quotes SSR for natural conception as 103 -110 males per 100 female births.</p><p>Assisted reproduction has been reported to impact SSR in relation to blastocyst transfer, IVF insemination, morphology and more recently morphokinetic events.</p><p>Algorithm scores (1-10), predictive of live birth (LB), were retrospectively analysed from 3009 live births, to determine the impact in relation to SSR.</p></div><div><h3>METHODS</h3><p>IVF and ICSI embryos were time-lapse monitored (EmbryoScope, Vitrolife) and transferred at the blastocyst stage after morphokinetic algorithm selection.</p><p>The established in-house morphokinetic algorithm utilises variables t3,t4,t5,t8,tSB,tB, and trophectoderm grade to give a LB prediction score from 1 to 10. (10 indicating the highest chance of LB). Scores were grouped as A (1-5) and B (6-10) and were analysed from 3009 LB, with gender recorded at birth, from 12 networked fertility clinics (2011-2022). The relationships between score group and insemination method were considered in respect to SSR.</p></div><div><h3>RESULTS</h3><p>The overall SSR was 105.0 (95% CI: 104.3-105.0) which is comparable to SSR for natural conception. The proportions of births per score group were group A 11% (n=330) and group B 89% (n=2679). Group B favored males with 107 per 100 female births (95% CI: 106.6-107.4) compared with group A with 88 males (95% CI: 82.6-92.3, p=0.0906). A similar trend was observed for insemination type, with IVF favoring males: SSR 113 (95% CI: 110.1-117.0) vs ICSI SSR 99 (95% CI: 99.7-100.1, p =0.0937) Combining IVF insemination and score group A produced the highest incidence of male births, SSR 116 (95% CI:112.2-120.3) with ICSI and group A with the lowest, SSR 83 (95% CI: 76.1-90.0, p=0.0309).</p></div><div><h3>CONCLUSIONS</h3><p>Our data is in line with reported SSR for natural conception. Both IVF and higher algorithm scores were related to increased numbers of male births per 100 females. When these variables were combined, the highest number of male births were achieved per 100 females. This review requires follow-up to confirm the findings due to relatively small number of embryos in the group deemed to have a lower propensity for live birth, by morphokinetic algorithm.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does sperm origin impact the developmental capacity of euploid embryos?","authors":"M.A. Aladham","doi":"10.1016/j.rbmo.2024.104018","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104018","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>Embryos with different sperm origins exhibit distinct morphokinetics yet to be determined. A considerable potential role of sperm-derived factors that influence cleavage patterns has been suggested. Implementing time-lapse monitoring incubation (TLM) allows us to analyze the developmental endpoints of cultured embryos precisely.</p></div><div><h3>METHODS</h3><p>This prospective controlled study consisted of IVF-ICSI patients undergoing cycles with surgically retrieved sperm (SRS), abnormal ejaculated oligo-astheno-terato (OAT) sperm, and the control group (CS) from fertile couples at Fakih IVF/Dubai between Jan 2020 and Dec 2022 in Dubai/ UAE (DSREC08-2019-131). 195 ICSI cycles (around 400 zygotes per group) were cultured in an Embryoscope, a time-lapse monitoring system (TLM), and analyzed. The mean age of the patients was (22-40 years female/ 22-45 years male). The morphokinetics tPB (time to polar body), until tB (time to blastocyst), and cleavage pattern were extracted retrospectively. Trophoectoderm biopsy was performed for preimplantation genetic testing for aneuploidy (PGT-A) and analyzed by next-generation sequencing (NGS).ICSI cycle characteristics, and patient data, were correlated to measured outcomes of euploid blastocyst formation rate. Multi-variables influencing morphokinetics parameters were controlled. The Chi2 test was performed in SPSS, P-value&lt;0.05.</p></div><div><h3>RESULTS</h3><p>Among 917 biopsied embryos, 517 embryos (56.38%) were euploid, and 400 embryos (43.62%) were aneuploid. The OAT sperm showed a significantly lower euploid rate (50.1%) than SRS and CS 57.7% and 61.2% respectively. Within each group, OAT sperm revealed a similar rate of euploid and aneuploid embryos. However, the euploid rate was higher within the CS and SRS groups than the aneuploid rate P=0.008. Cell cycle duration t8-t5 (S3) was significantly longer (12.00 ±8.44 hours) in SRS than CS and OAT sperm (9.37hrs and 9.08hrs respectively, P=0.0079). SRS and OAT sperm displayed a higher incidence of uneven2- and uneven4-cell stages than CS, P=0.001. The uneven2-cell stage had a lower euploid rate (26.1%) than aneuploid (32.8%) P=0.029. SRS had a higher insignificant incidence of 1-3 direct cleavage (DC). 1-3DC displayed a lower euploid rate than aneuploid rate (4.1%Vs 9.8% respectively, P=0.001). 2-5 DC had no impact on ploidy status.</p></div><div><h3>CONCLUSIONS</h3><p>Embryos with different sperm origins display altered cleavage patterns and modified morphokinetics as alternative approaches to self-correct and develop into euploid embryos.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embryo quality after sperm selection using density gradient centrifugation or microfluidic technology: a sibling oocyte study","authors":"K. Wouters,&nbsp;I. Mateizel,&nbsp;C. Schoemans,&nbsp;I. Segers,&nbsp;J. Van Asbroeck,&nbsp;D. Jankovic,&nbsp;M. Krunic,&nbsp;H. Tournaye,&nbsp;N. De Munck","doi":"10.1016/j.rbmo.2024.104058","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104058","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>This sibling oocyte study was designed to determine how embryo quality is influenced after sperm selection using microfluidic sperm sorting (MSS) technology compared to a standard density gradient centrifugation (DGC).</p></div><div><h3>METHODS</h3><p>A single-centre prospective non-inferiority sibling oocyte study was performed between October 2023 and February 2024, comparing DGC to MSS. Primary endpoint was embryo utilisation rate. Only ICSI cycles with ejaculated sperm and at least 6 mature oocytes (MII) were included. Sample-size calculation indicated a number of 253 MII for each arm.</p><p>Each raw semen sample was split in two fractions processed by DGC and by MSS using Zymot 850µl® device. During ICSI, half of the MII were injected with sperm processed by DGC and the other half by MSS. The inseminated oocytes were individually cultured in cleavage/blastocyst medium (Origio) for maximum 7 days.</p></div><div><h3>RESULTS</h3><p>The mean female age was 34.5±4.4 years and partner age was 37.5±5.5 years.</p><p>Sperm concentration (x106/ml) was similar following DGC (2.9±1.2) or MSS (3.5±5.0) (p=0.16). Progressive motility (% A+B) was significantly lower following DGC vs MSS (74.0%±17.2 vs 89.9%±10.4 (p&lt;0.01), respectively. The DFI of the raw semen samples was 5.6%±3.6. A number of 51 ICSI-cycles were included with 658 cumulus-oocyte-complexes retrieved of which 532 MII were randomized to either DGC (n= 265) or MSS (n=267) groups.</p><p>Fertilisation rate was not significantly different between DGC and MSS (208/265, 78.5% vs 209/267, 78.3%, respectively; p=0.96). Similarly, good embryo quality on day 3 (159/208, 76.4% vs 161/209, 77.0%, respectively; p=0.97) and good blastocyst quality (≥Bl3BB) (86/208, 41.3% vs 76/209, 36.4%, respectively; p=0.30) were not different between the two groups.</p><p>Utilisation rates (number of transferred and cryopreserved embryos) were similar between the two groups: both per MII (104/265, 39.2% vs 107/267, 40.1%, respectively; p=0.91) and per fertilised oocyte (104/208, 50.0% vs 107/209, 51.2%, respectively; p=0.88) in DGC vs MSS.</p></div><div><h3>CONCLUSIONS</h3><p>Since fertilisation, embryo quality and utilisation rate are similar in both groups, the use of Zymot 850µl® device offers the advantage of eliminating the negative effects and time-consuming nature of centrifugation. Another advantage is that scheduling of semen samples can be planned more efficiently.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141164068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are there the same ethical considerations in assisted reproduction among professionals, patients, donors, and the general population?","authors":"R. Nuñez Calonge ,&nbsp;J. A. Guijarro Ponce","doi":"10.1016/j.rbmo.2024.104015","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104015","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>Assisted reproduction techniques (ART) have opened numerous ethical questions concerning not only the professionals but also patients and donors. To date, there are no studies comparing the interests of the different moral agents involved in these processes and whether the ethical issues raised are the same in all these groups.</p><p>The aim of this work was to compare the attitudes of professionals, gamete donors, patients, and population toward bioethical problems in assisted reproduction and the ethical values that support these opinions.</p></div><div><h3>METHODS</h3><p>A cross-sectional electronic survey was conducted including a sample of 233 people. Data were collected from 123 assisted reproduction centers (including clinicians, embryologists, nurses, and administrative staff) and 110 non-professionals (oocyte and sperm donors, patients, and the general population).</p><p>Participants filled out an anonymous questionnaire asking for their socio-demographic characteristics and 100 questions based on the main ethical problems around 4 values: solidarity, trust, religiosity, and morality.</p><p>After a depuration process through Factorial Analysis a definitive questionnaire with 41 items was obtained. The average of scores in the four values and the numerical evaluation of these with the Student's T test were compared.</p></div><div><h3>RESULTS</h3><p>Doctors have a greater moral concern than the rest and a less supportive attitude. Nursing presents a more religious, trusting profile and the most restrictive of the entire sample. Laboratory personnel have high values in morality and agnosticism. Non-care professionals have a high level of trust and a moral attitude. People without a direct relationship with reproduction present a more solidary and distrustful profile, but they clearly present a greater disregard for moral issues. Donors are the group that presents less concern for ethical or moral aspects and greater confidence in medical decisions.</p><p>The professional / non-professional dichotomy is the one that occupies more extreme values, being able to affirm that the professionals display a greater preoccupation by the morality, a greater confidence, and a more restrictive attitude, without influence with religiosity.</p></div><div><h3>CONCLUSIONS</h3><p>There is a different moral consideration towards the problems derived from assisted reproduction techniques, being higher in doctors and laboratory personnel and lower in donors.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Ploidy Status and Clinical Outcomes between Day 5 and Day 6 Low-grade Blastocysts in Preimplantation Genetic Testing for Aneuploidy Cycles","authors":"S.T. Dang ,&nbsp;T.D. Nguyen ,&nbsp;A.T. Do ,&nbsp;P.T. Dao ,&nbsp;X.T. Pham ,&nbsp;H.P. Tran","doi":"10.1016/j.rbmo.2024.104030","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104030","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>Human embryos typically reach the blastocyst stage around 5 or 6 days post-fertilization, signifying potential for successful implantation. While numerous studies compare day 5 (D5) and day 6 (D6) embryos, data for low-grade embryos remains scarce. This study aims to investigate the correlation between low-grade embryo ploidy status and clinical outcomes based on low-grade blastocyst transfer timing (D5 versus D6), utilizing next-generation sequencing (NGS)-based PGT-A. The research aims to provide insights for selecting days of low-grade blastocyst with higher pregnancy potential.</p></div><div><h3>METHODS</h3><p>A retrospective study spanning January 2022 to December 2023 enrolled 347 women undergoing PGT-A with trophectoderm biopsy. Next-generation sequencing (NGS) determined the ploidy status of low-grade embryos among 313 D5 and 276 D6 blastocysts. Pregnancy rates were analyzed from 46 cycles of frozen embryo transfer, including 17 D5 and 29 D6 frozen embryos at HP Fertility, Hai Phong International Hospital of Obstetrics and Pediatrics. Blastocyst evaluation utilized Gardner scoring, and low-grade blastocysts were defined as grade C for inner cell mass or trophectoderm.</p></div><div><h3>RESULTS</h3><p>The average age of patients in the D5 group was 35.2 years, and 35.8 in the D6 group. The overall euploidy rate was 44% in this embryo cohort, with a no-result rate of 0.36%. Euploidy rates for low-grade embryos were 29.0% on D5 compared to 26.6% on D6 (p=0.33). Mosaic embryo rates were significantly higher on D5 compared to D6 (25.8% vs 19.0%, p=0.03), while aneuploidy rates were comparable (45.1% vs 54.4%, p=0.49). Compared to D6 low-grade euploid embryos, D5 embryos exhibited higher pregnancy rates (51.7% vs 35.3%, p=0.46) and clinical pregnancy rates (41.4% vs 17.6%, p=0.15), albeit not significantly.</p></div><div><h3>CONCLUSIONS</h3><p>We observed a higher mosaicism rate among D5 low-grade blastocysts compared to D6. Overall euploidy rates were similar, with a tendency towards lower aneuploidy rates in D5 embryos compared to D6 embryos. Our data suggest that the stage of low-grade blastocysts may influence clinical outcomes after transfer when identified as euploid. Therefore, consideration of the low-grade embryo biopsy date is warranted when transferring frozen embryos.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some tips and tricks after over 1,000 nuclear transfers in mice","authors":"I. Volodyaev ,&nbsp;E. Korchivaya ,&nbsp;Y. Silaeva ,&nbsp;A. Trofimova ,&nbsp;E. Yutkin ,&nbsp;I. Mazunin","doi":"10.1016/j.rbmo.2024.104010","DOIUrl":"https://doi.org/10.1016/j.rbmo.2024.104010","url":null,"abstract":"<div><h3>BACKGROUND AND AIM</h3><p>Though the nuclear transfer methods have been known for 40 years and widely discussed in reproductive medicine since 2017, there are a lot of unpublished technical nuances that a worker is doomed to face in case they decide to implement this technology in clinical or research practice. Having started with nuclear transfers in 2019, we encountered many practical difficulties that had to be overcome with long and painstaking work. Here we intend to summarize our practical experience.</p></div><div><h3>METHODS</h3><p>Pronuclear transfer in mice with the use of nocodazole, cytochalasin B and latrunculin for cytoskeleton depolymerization, and Sendai virus or electrofusion for karyoplast-cytoplast fusion. Embryos incubated and transferred to mice.</p><p>Concentrations of all the substances, the base media, storage time, and the initial heteroplasmy have been varied to optimize the method in more than 1,000 procedures.</p></div><div><h3>RESULTS</h3><p>Pronuclear transfer methods have been optimized, with all technical tips and tricks noted and ready to be presented. Also, a method to distinguish two very close haplotypes of mtDNA has been developed and tested for its accuracy.</p></div><div><h3>CONCLUSIONS</h3><p>Here, methods have been optimized, and the heteroplasmy assessment developed. Pronuclear transfer can well be used in practical issues, if following the tips and tricks we report.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}