Research QuestionDoes the shortened warming protocol impact the cell viability and outgrowth competence of human vitrified blastocysts warmed with or without fatty acids (FAs)? DesignIn this study, 326 discarded vitrified human blastocysts donated for research by consenting couples were used. The blastocysts were randomly allocated to five groups depending on the warming solutions, protocols, and recovery culture media: the control-conventional, control-shortened, FA-conventional, FA-shortened, and FA-shortened/recovery culture with FA (RF) groups. The blastocysts were warmed with or without FAs following the manufacturer's instruction (conventional method) or using the shortened method, in which blastocysts were immersed in a thawing solution for 1 min and then cultured in the recovery medium for 2 h. The embryo volume recovery, cell viability, intracytoplasmic lipid droplets, and outgrowth competence were evaluated. ResultsThe degree of blastocyst volume recovery was significantly higher after shortened warming than after conventional warming. Cell membrane collapse was observed during the shortened warming. The blastocyst survival rate and expansion status after the recovery culture were comparable among the five groups. However, the proportion of necrotic cells was increased in the control-shortened, FA-shortened, and FA-shortened/RF groups. The adhesion rates were comparable among all the groups; however, the outgrowth area was significantly higher in the FA-conventional group than in the other groups. ConclusionsThe efficacy of the shortened warming protocol depended on the warming solutions used. The shortened protocol effectively improves the daily workflow; however, each laboratory should examine its impact thoroughly before introducing it to prioritise clinical outcomes.
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