IVF Success Rates Research Articles

Identification of chromosomal rearrangements by next-generation sequencing in blastocysts derived from couples with balanced translocations

Introduction Reciprocal translocations are one of the most common abnormalities in chromosomal structure. Couples with a balanced translocation have an increased risk for infertility and recurrent pregnancy loss. The present study aims to evaluate the ability of next-generation sequencing (NGS) to detect unbalanced chromosomal rearrangements in blastocysts derived from couples with balanced reciprocal translocations. Material & Methods First, the performance of NGS (VeriSeq, Illumina, USA) for unbalanced rearrangement detection was determined. Whole-genome amplification (WGA) products from trophectoderm biopsy samplesof 12 couples with a balanced reciprocal translocation previously analyzed by aCGH (24Sure+array, Illumina, USA) were reanalyzed by NGS. Second, a retrospective study was performed in a private ART clinic in Thailand between January to December 2017. A total of 70 embryos of 10 different couples with a balanced reciprocal translocation were analyzed by NGS and the pregnancy outcomes for couples with normal/balanced embryos available for transfer were followed up. Results NGS was 95.8% concordancefor detecting unbalanced chromosomal rearrangement with aCGH, and 99.7% for overall analyzed chromosomes. We found that NGS can detect segmental aneuploidies as small as 5 Mb in size. Results of 70 embryos revealed 30% normal/balanced embryos. 17.1% of embryos were found to be aneuploid balanced embryos and 2.9% of embryos were mosaic balanced embryos. Imbalanced segmental aneuploidies were detected in 50% of embryos, 47.1% of the imbalances were related to parental translocation while 2.9% of them were not related to parental translocation. Seven couples had normal/balanced embryos available for transfer, 57.1% (4/7) of them had clinical pregnancies as indicated by an intrauterine gestational sac with fetal heartbeat visualized by ultrasound examination at 3 months after embryo transfer. Conclusions Our results demonstrated that NGS hasa high resolution to detect imbalanced segmental rearrangements. The accurate detection of NGS for imbalanced segmental and whole chromosome aneuploidies might improve the IVF success rate and increase thechances of having a healthy child for translocation carriers.

Evaluation of the effect of delayed blastulation on genetic status and pregnancy outcome of the vitrified-warmed elective single embryo transfer (eSET)

Introduction Preimplantation testing for aneuploidy (PGT-A) identifies chromosomally normal embryos with the aim to increase IVF success rate. Trophectoderm biopsy is usually performed on day 5 when the embryos are expanded. A proportion of slower growing embryos that have not reached the expanded blastocyst stage on day 5, or slower developing day 5 morulae are frequently found to have developed to blastocyst stage and expanded by the time of day 6, enable trophectoderm biopsy for chromosome analysis. Blastocyst biopsy with PGT-A increased IVF implantation and delivery. It is not known if prolonging culture of euploid embryos impacts their implantation potential. Material & Methods This is a retrospective analysis of 1,071 IVF patients whom underwent a vitrified-thawed ICSI cycle with PGT-A during January 2016 to July 2017. The rates of full chromosome aneuploidy and segmental (> 10 MB) aneuploidy in trophectoderm biopsies were assessed by Next-generation sequencing-based assay (NGS). No results samples were excluded from the analysis. Aneuploidy rates and pregnancy outcome were compared. Statistical analysis was performed by ANOVA and Chi-square to assess the differences. A total of 5,611 embryos were examined. All embryos were laser hatched at cleavage stage and cultured to day 5/6. 4,222 were biopsied on day 5 and 1,389 were biopsied on day 6. Embryonic ploidy status was examined by analyzing respective trophectoderm cells by NGS (VeriSeq, Illumina). IVF outcome in terms of implantation rates and miscarriage rates were compared between 255 day-5 embryos and 60 day-6 embryos transfers in 315 cycles. Results An average number embryo biopsied per cycle was 6. Day 5 biopsies accounted for 75.2%. The overall aneuploidy rate ranges from 35% ( 42). Aneuploidy rates were higher in day 6 in all individual maternal age group ( 42 yrs 64% vs. 78%, p=0.29. Day 5 biopsy embryos had higher implantation rate (65% vs. 47%, p=0.19) and lower miscarriage rate (1% vs. 7%, p=0.05), than day 6 blastocyst. Delayed blastocyst embryos had an increased in aneuploidy risk, however, the euploid were able to fully developed and successfully implanted achieving a 47% implantation in all combined age group. Conclusions A better understanding on the relationship between embryo delayed development stage and endometrial synchronicity may aid to a higher success rate for cycles achieved only transferrable euploid delayed blastocyst.

Investigating knowledge and perceptions of egg sharing among healthcare professionals in the United Kingdom

ObjectiveThis study aims to determine the healthcare professionals knowledge and opinions of egg sharing and does this potentially effect egg sharing numbers in the UK? Study design304 healthcare professionals undertook a large, in-depth survey about various topics related to egg sharing. This included ranking key benefits and issues related to egg sharing. Statistical analysis was performed using SPSS. Results63.1% of respondents had little or no knowledge of egg sharing, although the majority supported the scheme once a short description was provided. Although attitudes towards egg sharing were positive, there was more support for voluntary donation. The issues surrounding egg sharing of most concern were the psychological well-being of the egg sharer if her own treatment is unsuccessful and the concern that giving away half her eggs reduces IVF success rates. Only 16.5% of respondents had previously referred a patient for egg sharing, with the majority citing lack of knowledge for the reason they hadn’t referred. ConclusionsEgg sharing allows women to receive free or subsidised IVF in exchange for donating half their oocytes collected to a recipient. Although egg sharing was intended to solve the current donor oocyte shortage, egg sharing numbers have fallen over recent years. Education of healthcare professionals about the egg sharing programme and the research that supports it could improve their perceptions of egg sharing, increasing referral rates and egg sharing numbers.

Vitamin D and Infertility: The Evidence

Vitamin D is a lipid soluble vitamin synthesized by the skin upon exposure to UV light. Approximately 10–20% of vitamin D comes from dietary sources and 25OH-D is its circulating form. Vitamin D receptors are found in reproductive tissues including ovary, uterus, and endometrium permitting investigators to hypothesize a role for vitamin D in reproduction. Indeed, a number of animal studies provide evidence of vitamin D’s importance in fertility. Studies in humans, however, generally have not supported an effect of vitamin D on fertility outcomes. Several retrospective cohort studies did not demonstrate an association between vitamin D levels and pregnancy. Similarly, one study did not find correlation between anovulatory infertility and vitamin D intake. Very low levels of vitamin D, however, were associated with miscarriage in another study. A large meta-analysis of 11 studies and 2700 women did show an improvement in IVF success rates in those with higher levels of vitamin D. Finally, two small studies on vitamin D supplementation and pregnancy did not show a benefit of increasing vitamin D intake. In conclusion, the literature at best shows a minimal impact of vitamin D on infertility and IVF outcomes.

Only women's age and the duration of infertility are the prognostic factors for the success rate of natural cycle IVF.

It is controversial who should be recommended to undergo natural cycle IVF (NC-IVF). Therefore, objective prognostic criteria which are already known at the time of counselling were defined. A retrospective observational study was performed with 201 couples (age 34.7 ± 4.1) undergoing 311 NC-IVF treatments with 201 transfers, corresponding to a transfer rate of 65.3%. The first cycle resulting in a transfer of one embryo was further analysed. Clinical pregnancy and live birth rates were analysed. Pregnancy rate and live birth rates per first cycle were 21.9% and 13.2%, respectively. Groupwise comparison revealed the following clinical pregnancy/live birth rates per transfer cycle: duration of infertility 1-2years 34.3/25.7%, 3-4years 21.8/14.9% and > 4years 9.1/4.5%. Women's age < 34years 26.3/22.4%, 34-37years 25.7/18.9% and 38-42years 15.7/3.9%. Linear regression analysis showed that pregnancy and live birth rate correlated negatively with the duration of infertility and that live birth rate but not pregnancy rate correlated negatively with increasing female age. In contrast, AMH and infertility factors did not correlate with the success rate. Statistically significant correlations remained if a multivariate logistic regression analysis was performed, supporting further that the duration of infertility (OR 0.61, 95% CI 0.42-0.86) (P = 0.006) and female age (OR 0.87, 95% CI 0.78-0.95) (P = 0.008) are the predictors for live birth rates in NC-IVF transfer cycles. Based on the success rates, NC-IVF can especially be recommended for women with short duration of infertility and young age, whereas older women and those with long duration of infertility are not the best candidates for this technique.

PGR and PTX3 gene expression in cumulus cells from obese and normal weighting women after administration of long-acting recombinant follicle-stimulating hormone for controlled ovarian stimulation.

The present study aimed to determine clinical IVF parameters and gene expression in cumulus cells (CCs) in obese and normal weighting women after administration of 150mcg of corifollitropin alfa for controlled ovarian hyperstimulation (COH). 150mcg of corifollitropin alfa and gonadotropin releasing hormone antagonist were used for COH. Analysis of CC gene expression was performed using quantitative real-time PCR. We did not find significant differences in biochemical and clinical pregnancy rates between obese and normal weighting women. Obese women required twice as much of additional gonadotropins for ovarian stimulation and had a significantly lower proportion of good quality embryos on day 5 of IVF cycle. Expression of PGR and PTX3 was significantly higher in CCs of obese women. Obese women require significantly larger amounts of gonadotropins to achieve similar IVF success rates as normal weighting women. Differences in CC gene expression and smaller proportion of good quality embryos may imply that oocytes derived from obese women are of lower quality. Further studies are needed to evaluate whether obesity itself or the higher amount of gonadotropins used in obese women causes this effect.

Role of environmental factors & oxidative stress with respect to in vitro fertilization outcome.

Background & objectives:Oxidative stress, lifestyle factors as also exposure to certain environmental factors are known to affect the fertility status in human beings. The aim of this study was to evaluate the role of OS and lifestyle and environmental factors affecting IVF outcome.Methods:A total of 253 couples were included, and biological samples such as blood, follicular fluid (FF), cumulus cells and semen were collected. Relevant biochemical parameters and metals namely lead (Pb), cadmium (Cd), copper (Cu) and zinc (Zn) were determined in the biological samples. β-human chorionic gonadotropin levels ≥100 IU/l were considered to predict viable pregnancy on the 15th day of embryo transfer (ET).Results:The mean body mass index (BMI) was significantly lower in females with positive IVF outcome compared to those with negative outcome. Couples residing in the residential area showed more percentage of positive IVF outcomes as compared to couples residing in industrial/agricultural area. FF Zn level was significantly higher (P<0.001) among the females’ participants who have undergone ET as compared to those who have not undergone ET. FF MDA and serum Cu levels were significantly higher (P<0.05) in the female participants with negative IVF outcome as compared to positive IVF outcome. Logistic regression revealed that maternal BMI (P=0.034) and FF MDA level (P=0.047) were significantly associated with the IVF outcome.Interpretation & conclusions:The success rate of IVF was about 31.8 per cent, and BMI was significantly lower in females with positive outcome. The higher levels of MDA in FF and SP might have a negative impact on IVF outcome, higher Zn level in SP, FF and serum might have a positive role in embryo transfer as well as IVF outcome. The role of stress management and nutrition supplementation during the IVF treatment may be explored.

IVF with donor eggs over 40 and other health issues impacting IVF success rates

IVF with donor eggs over 40 and other health issues impacting IVF success rates

The impact of the localisation of endometriosis lesions on ovarian reserve and assisted reproduction techniques outcomes

This case-control study was designed to evaluate the impact of endometriosis and the presence of endometrioma (OMA) per se on the serum anti-Müllerian hormone (AMH) level and also to compare the in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes after therapeutic surgery in endometriosis patients, according to the localisation of endometriosis lesions. One hundred and fifty two infertile women ≤40 years with suspicious symptoms were surgically evaluated to detect the aetiology of infertility at the Royan Institute during this study and, in parallel, 131 patients with a male factor infertility diagnosis were considered as the control group. The serum AMH level and IVF/ICSI outcomes were compared according to the nature and extension degree of endometriosis lesions. The results demonstrated that the existence of a deep infiltrating endometriosis (DIE) with and without OMA was associated with a significant decrease in AMH level, antral follicle count and ovarian sensitivity index (OSI) (p < .001 and p = .007, respectively). The multivariable logistic regression analysis adjusted for confounding factors indicated that the OSI and the existence of DIE with and without OMA were a significant predictive variable for clinical pregnancy and for live birth. On the basis of our results, the severity of endometriosis and the location of its lesions could affect an ovarian reserve and the ovarian stimulation outcomes.Impact StatementWhat is already known on this subject? Previous studies have evaluated the impact of endometrioma (OMA) on ovarian reserve and the assisted reproduction technology (ART) outcomes and controversial results have been reported; therefore, it seems that this topic still needs further research.What the results of this study add? In the present study, the effect of endometriosis lesions’ localisation on ovarian reserve and the success rate of the in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycle after therapeutic surgery were compared with that of the control group. It was found that the existence of a deep infiltrating endometriosis (DIE) with and without OMA was associated with a significant decrease in the anti-Müllerian hormone (AMH) level, antral follicle count, ovarian sensitivity index (OSI), clinical pregnancy and live birth rates.What the implications are of these findings for clinical practice and/or further research? The results of this study has a practical value in the decision making process for the ovarian stimulation protocol in patients with the different severity of endometriosis and the counselling regarding the success rate of IVF or ICSI/embryo transfer cycles.

Acquisition of oocyte competence to develop as an embryo: integrated nuclear and cytoplasmic events.

Infertility affects ~7% of couples of reproductive age with little change in incidence in the last two decades. ART, as well as other interventions, have made major strides in correcting this condition. However, and in spite of advancements in the field, the age of the female partner remains a main factor for a successful outcome. A better understanding of the final stages of gamete maturation yielding an egg that can sustain embryo development and a pregnancy to term remains a major area for improvement in the field. This review will summarize the major cellular and molecular events unfolding at the oocyte-to-embryo transition. We will provide an update on the most important processes/pathways currently understood as the basis of developmental competence, including the molecular processes involved in mRNA storage, its recruitment to the translational machinery, and its degradation. We will discuss the hypothesis that the translational programme of maternal mRNAs plays a key role in establishing developmental competence. These regulations are essential to assemble the machinery that is used to establish a totipotent zygote. This hypothesis further supports the view that embryogenesis begins during oogenesis. A better understanding of the events required for developmental competence will guide the development of novel strategies to monitor and improve the success rate of IVF. Using this information, it will be possible to develop new biomarkers that may be used to better predict oocyte quality and in selection of the best egg for IVF.

Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility.

Is adherence to the Mediterranean diet (MedDiet) associated with better IVF performance in women attempting fertility? Greater adherence to the MedDiet, defined using the validated Mediterranean diet score (MedDietScore), was associated with a higher likelihood of achieving clinical pregnancy and live birth among non-obese women <35 years of age. Diet impacts fertility and certain nutrients and food groups appear to have a greater effect on reproductive health, but there are relatively few published data on the role of dietary patterns, and the MedDiet in particular, on assisted reproductive performance. This prospective cohort study included 244 non-obese women (22-41 years of age; BMI < 30 kg/m2) who underwent a first IVF treatment in an Assisted Conception Unit in Athens, Greece, between November 2013 and September 2016. The study was designed to evaluate the influence of habitual dietary intake and lifestyle on fertility outcomes. Diet was assessed before the IVF treatment via a validated food-frequency questionnaire. Adherence to the MedDiet was assessed through the MedDietScore (range: 0-55), with higher scores indicating greater adherence. Intermediate outcomes (oocyte yield, fertilization rate and embryo quality measures) and clinical endpoints (implantation, clinical pregnancy and live birth) were abstracted from electronic medical records. Associations between MedDietScore and IVF outcomes were analysed using generalized linear models adjusting for age, ovarian stimulation protocol, BMI, physical activity, anxiety levels, infertility diagnosis, caloric intake and supplements use. No association of MedDietScore with any of the intermediate outcomes or with implantation was found. However, compared with women in the highest tertile of the MedDietScore (≥36, n = 86), women in the lowest tertile (≤30, n = 79) had significantly lower rates of clinical pregnancy (29.1 vs 50.0%, P = 0.01) and live birth (26.6 vs 48.8%, P = 0.01). The multivariable-adjusted relative risk (95% CI) for clinical pregnancy comparing women in the lowest with women in the highest tertile of the MedDietScore was 0.35 (0.16-0.78; P-trend=0.01), and for live birth it was 0.32 (0.14-0.71; P-trend = 0.01). These associations were significantly modified by women's age (P-interaction <0.01 for both outcomes). MedDietScore was positively related to clinical pregnancy and live birth among women <35 years old (P ≤ 0.01) but not among women ≥35 years. Among women <35 years, a beneficial 5-point increase in the MedDietScore was associated with ~2.7 times higher likelihood of achieving clinical pregnancy and live birth. Our finding cannot be generalized to the whole reproductive population nor to obese women nor to women attending infertility clinics around the world. In addition, due to the observational study design, causal inference is limited. The results suggest that diet modifications and greater compliance to the Mediterranean diet may help increase the chances of a successful pregnancy and delivering a live baby for women undergoing IVF treatment. This work was partially supported by a grand from Harokopio University (KE321). All authors declare no conflicts of interest. NCT03050944.

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.

Extent of chromosomal mosaicism influences the clinical outcome of in vitro fertilization treatments

To assess whether the extent of chromosomal mosaicism can influence the success rate of IVF treatments. Prospective study. Private genetic and assisted reproduction centers. The transfer of mosaic embryos was offered to 77 women for which IVF resulted in no euploid embryos available for transfer. All embryos were cultured to blastocyst stage; trophectoderm biopsy was performed on day 5/6 of development. Comprehensive chromosome screening was performed using either next-generation sequencing or array-comparative genomic hybridization methodologies. The clinical outcome obtained after transfer of mosaic embryos with low (<50%) and high (≥50%) aneuploidy percentage was compared with that resulting from a control group of 251 euploid blastocysts. A significantly higher implantation rate (48.9% vs. 24.2%), clinical pregnancy rate/ET (40.9% vs. 15.2%), and live-birth rate (42.2% vs. 15.2%) were observed comparing embryos with mosaicism <50% and ≥50%. Mosaic embryos with high aneuploidy percentage (≥50%) showed a significantly lower clinical pregnancy rate/ET (15.2% vs. 46.4%), implantation rate (24.4% vs. 54.6%), and live-birth rate (15.2% vs. 46.6%) than euploid blastocysts. In contrast, embryos with lower aneuploidy percentage (<50%) have a clinical outcome similar to euploid embryos. The results of this study further confirm that mosaic embryos can develop into healthy euploid newborns. We demonstrated that the extent of mosaicism influences the IVF success rate. Mosaic embryos with low aneuploidy percentage have higher chances of resulting in the birth of healthy babies compared with embryos with higher mosaicism levels.

Identification of polyploid embryos using a targeted NGS-based preimplantation genetic screening assay

To report our clinical experience with embryos identified as polyploid via abnormal sex chromosome ratios. Polyploid embryos contain more than two sets (n) of chromosomes (e.g. triploid (3n) and tetraploid (4n)) and often miscarry. Those that survive to term typically only live a few days. Triploidy accounts for ∼1% of all conceptions and ∼10% of miscarriages. Tetraploidy is rare. Types of triploidy include digynic fertilization (2 of 3 sets maternally derived; diploid ovum) or diandric (2 of 3 sets paternally derived; diploid sperm or fertilization by 2 sperms (dispermy)). Most PGS technologies cannot reliably detect all types of polyploidy, but can detect embryos with unbalanced sex chromosome ratios (69,XXY; 69,XYY; some forms of tetraploidy). Here, we characterize the types of polyploidy detected. Trophectoderm biopsies from >30,000 embryos were analyzed using a targeted NGS-based assay. Utilizing chromosome copy number calls for autosomes and sex chromosomes, we identified embryos expected to be polyploid. Using NGS single nucleotide polymorphism (SNP) information, we confirmed the polyploidy calls and stratified the data by oocyte age, clinical indication, and fertilization type. We identified 203 likely polyploid embryos based on unbalanced sex chromosome ratios; <1% of tested embryos. Likely polyploid embryos were seen in all age groups between 23-45 (ranging from 0.2-1.5%) and did not increase with maternal age. Of interest, 6 patient cycles had more than one polyploid embryo, 2 of which were egg donor cycles. A subset of the likely polyploid embryos were studied using NGS-based SNP analysis and, for embryos with enough informative SNPs, 74% were confirmed as polyploid based on allelic ratios.Of the 127 confirmed polyploid embryos, the majority were triploid (119) and eight were tetraploid. Consistent with previous reports, most triploid embryos were XXY (117) vs XYY (2). All tetraploids were XXXY (8). About half of all polyploidy embryos had another chromosome abnormality. Of the polyploid embryos where fertilization type was known, 81.3% had undergone ICSI meaning dispermy can be ruled out. Identifying embryos with the greatest chance of implantation and live birth is vital to improve IVF success rates. Detection of polyploid embryos is essential to decreasing miscarriage rates in PGS-derived pregnancies. In this dataset, the incidence of polyploidy did not correlate with patient age or fertilization type. Given the technical limitations of many PGS assays, some forms of polyploidy go undiagnosed (69,XXX; 92,XXXX; 92,XXYY); however, forms with skewed sex chromosome ratios are likely picked up and diagnosed as aneuploid. Here we use a combination of sex chromosome ratios and targeted NGS-based SNP analysis to confirm the presence of 69,XXY, 69,XYY and 92,XXXY in a subset of samples. This technology can be validated to detect other types of currently undetectable polyploidy, increasing the accuracy of NGS-PGS.

The extent of chromosomal mosaicism influences the clinical outcome of in vitro fertilization treatments

Recently, we have demonstrated that mosaic embryos hold the potential to implant and result in the birth of healthy babies1. The aim of this study was to determine whether the extent of chromosomal mosaicism can influence the development potential of mosaic embryos. The transfer of mosaic embryos at different aneuploidy percentage was offered to 77 women for whom IVF had resulted in no euploid embryos between May 2013-March 2016. The clinical outcome obtained after transfer of mosaic embryos with low (<50%) and high (≥50%) aneuploidy percentage, was compared with those resulting from a control group of 251 euploid blastocysts. We aimed to assess if there was any statistically significant difference in the development potential between these groups. All embryos were cultured to blastocyst stage; trophectoderm biopsy was performed on Day-5 of development or Day6/7 for slow growing embryos. Comprehensive chromosome screening PGS was performed using either NGS or array-CGH methodologies. Transfers of mosaic embryos with a high percentage of chromosomally abnormal cells (≥50%) resulted in a live birth rate of 15.1% and involved a miscarriage rate of 9%. In contrast, mosaic embryos with a lower aneuploidy percentage (<50%) resulted in a live birth rate of 42.2%, with a miscarriage occurring in 7.0% of the transfers. All pregnancies that went to term were confirmed, through sampling of the chorionic villi and/or amniotic liquid, to have a normal karyotype. Mosaic embryos with high aneuploidy percentage (≥50%) showed significantly lower implantation rate (24.4% vs 54.6%; P=0.001) and live birth rate (15.1% vs 46.6%; P=0.001) than euploid blastocysts. In contrast, embryos with lower aneuploidy percentage (<50%) have similar clinical outcomes of those euploid. The biochemical pregnancy rate and miscarriage rate were not significantly different between the two groups (Table 1). The results of this study further confirm that mosaic embryos can develop into healthy euploid newborns. We demonstrated that the extent of mosaicism affects the IVF success rate. Priority for transfer should be given to mosaic embryos with low mosaicism levels.Table 1Comparison of clinical outcomes in euploid embryos vs mosaic embryo different mosaicism levelEuploidMosaic with <50%pMosaic with >50%pNo. of embryos transferred2514533No. of transfer2504433No. of positive beta hCG160 (64%)26 (59%)0.411 (33.3%)0.001No. of Biochemical pregnancies24 (9.6%)5 (11.36%)0.83 (9.1%)0.8No. of embryos implanted137 (54.6%)22 (48.9%)0.58 (24.4%)0.01No. of Early abortion20 (8.0%)3 (6.8%)0.83 (9.1%)0.9No. of Ongoing clinical pregnancies per ET117 (46.6%)19 (42.2 %)0.75 (15.1%)0.001No. of Pregnancies went to term116 (46.4%)18 (41%)0.45 (15.1%)0.001No. of Babies Born117 (46.6%)19 (42.2 %)0.75 (15.1%)0.001 Open table in a new tab

Feature Reduction by Improvised Hybrid Algorithm for Predicting the IVF Success Rate

The most common problem nowadays is Infertility which is caused by different factors like environment, genetic or personal characteristics. IVF, IUI are some of the different treatments available to overcome the problem but the cost and emotion beyond every cycle is different which affects the success rate of the treatment. So Data Mining techniques are suggested as good tools for predicting the success rate of IVF treatment. The quality of research or knowledge obtained from the data set depends upon the data. If the data set contains irrelevant or noisy data there is possibility for decrease in the knowledge gained from it. This paper proposes an Improvised hybrid algorithm which combines the existing Ant Colony and Relative Reduct algorithm for Pre-Processing. In this work, the proposed Algorithm is compared with the existing related algorithms. It is evident from the results that the proposed algorithm achieved its target of reducing the features to minimum numbers without compromising the core knowledge of the system to estimate the success rate. Keywords: Ant Colony, Relative Reduct Algorithm, Success Rate, Feature Reduction, Accuracy

Diamond dishes could boost IVF success rates

Diamond dishes could boost IVF success rates

Melatonin improves the fertilization ability of post-ovulatory aged mouse oocytes by stabilizing ovastacin and Juno to promote sperm binding and fusion.

What are the underlying mechanisms of the decline in the fertilization ability of post-ovulatory aged oocytes? Melatonin improves the fertilization ability of post-ovulatory aged oocytes by reducing aging-induced reactive oxygen species (ROS) levels and inhibiting apoptosis and by maintaining the levels and localization of the fertilization proteins, ovastacin and Juno. Following ovulation, the quality of mammalian metaphase II oocytes irreversibly deteriorates over time with a concomitant loss of fertilization ability. Melatonin has been found to prevent post-ovulatory oocyte aging and extend the window for optimal fertilization in mice. Mouse oocytes were randomly assigned to three groups and aged in vitro for 0, 6, 12 and 24 h, respectively. Increasing concentrations of melatonin (10-9 M, 10-7 M, 10-5 M and 10-3 M) were added to the 24 h aging group. Sperm binding assays, in-vitro fertilization, immunofluorescent staining and western blotting were performed to investigate key regulators and events during fertilization of post-ovulatory aged mouse oocytes. We found that the actin cap which promotes a cortical granule(CG) free domain is disrupted with a re-distribution of CGs in the subcortex of aged oocytes. Ovastacin, a CG metalloendoprotease, is mis-located and prematurely exocytosed in aged oocytes with subsequent cleavage of the zona pellucida protein ZP2. This disrupts the sperm recognition domain and dramatically reduces the number of sperm binding to the zona pellucida. The abundance of Juno, the sperm receptor on the oocyte membrane, also is reduced in aged oocytes. Exposure of aged oocytes to melatonin significantly elevates in-vitro fertilization rates potentially by rescuing the above age-associated defects of fertilization, and reducing ROS and inhibiting apoptosis. N/A. We explored the mechanisms of the decline in fertilization ability decline in aged mouse oocytes, in vitro but not in vivo. Our findings may contribute to the development a more efficient method, involving melatonin, for improving IVF success rates. This study was supported by the National Natural Science Foundation (31571545) and the Natural Science Foundation of Jiangsu Province (BK20150677). The authors have no conflict of interest to disclose.

Role of vitamin E and D3 supplementation in Intra-Cytoplasmic Sperm Injection outcomes of women with polycystic ovarian syndrome: A double blinded randomized placebo-controlled trial

Ovulation induction has been proven to impose oxidative stress during ICSI treatment cycle. Also, data indicates that PCOS women show higher oxidative markers. Available data are not convincing about which antioxidant supplements have the potential to overcome oxidative stress in PCOS subjects. The aim of this trial was to investigate the possible role of combined vitamin E and D supplementation in the ICSI outcomes (oocyte number and quality, embryo number and quality, pregnancy rate) of PCOS subjects. A total of 105 PCOS infertile women scheduled for ICSI were enrolled in a double-blinded RCT to treatment group (vitamin E, 400mg/day - and vitamin D3, 50,000IU/one in two weeks, n=52) or placebo group (n=53) for 8 weeks. The primary outcomes were implantation rate, pregnancy and clinical pregnancy rate. Secondary outcomes included oocyte quality, embryo quality, fertilization rate, alteration in serum MDA, TAC and vitamin D3 after treatment. Further, association between serum and follicular fluid Malondialdehyde (MDA), Total Antioxidant Capacity (TAC), and serum vitamin D3 level were assessed. Pregnancy, clinical pregnancy and implantation rate were significantly higher in treatment group (P<0.001). Data analysis in both groups revealed a significant increase in serum MDA compared to baseline and a significant decrease in serum TAC compared to baseline after treatment. Further analysis showed that there is a positive weak association between vitamin D level, implantation rate (P=0.015) and increased clinical pregnancy (P=0.037). No significant association was detected between either follicular fluid or serum MDA and TAC and ICSI outcomes. In conclusion, the findings of this trial do not add clinical support to the evidence that vitamins E and D3 may play a role in the success rate of IVF via an antioxidant mechanism. IRCT2014081018662N1.

Toward optimal set of single nucleotide polymorphism investigation before IVF

Background: At present, the patient preparation for IVF needs to undergo a series of planned tests, including the genotyping of single nucleotide polymorphism (SNP) alleles of some genes. In former USSR countries, such investigation was not included in overwhelming majority of health insurance programs and paid by patient. In common, there are prerequisites to the study of more than 50 polymorphisms. An important faced task is to determine the optimal panel for SNP genotyping in terms of price/number of SNP.Materials and methods: During 2009–2015 in the University Hospital of St. Petersburg State University, blood samples were analyzed from 550 women with different reproductive system disorders preparing for IVF and 46 healthy women in control group. In total, 28 SNP were analyzed in the genes of thrombophilia factors, folic acid cycle, detoxification system, and the renin-angiotensin system. The method used was real-time PCR.Results: A significant increase in the frequency of pathological alleles of some polymorphisms in patients with habitual failure of IVF was shown, compared with the control group. As a result, two options defined panels for optimal typing SNP before IVF were composed. Standard panel includes 8 SNP, 5 in thromborhilic factors, and 3 in folic acid cycle genes. They are 20210 G > A of FII gene, R506Q G > A of FV gene (mutation Leiden), -675 5G > 4G of PAI-I gene, L33P T > C of ITGB3 gene, -455 G > A of FGB gene, 667 C > T of MTHFR gene, 2756 A > G of MTR gene, and 66 A > G of MTRR gene. Extended panel of 15 SNP also includes 807 C > T of ITGA2 gene, T154M C > T of GP1BA gene, second polymorphism 1298 A > C in MTHFR gene, polymorphisms of the renin-angiotensin gene AGT M235T T > C and -1166 A > C of AGTR1 gene, polymorphisms I105V A > G and A114V C > T of detoxification system gene GSTP.Conclusion: The results of SNP genotyping can be adjusted for treatment tactics and IVF, and also medical support getting pregnant. The success rate of IVF is increased as the result, especially in the group with the usual failure of IVF.