ObjectiveEuploid embryo transfers yield better implantation rates. In Brazil, morphological evaluation is performed to select the best embryos, since genetic analysis is still an expensive procedure. This study aimed to evaluate whether there is an association between trophectoderm morphology and ploidy status.MethodsThe study included 113 blastocysts formed in D5/D6 from 58 in vitro fertilization cycles held from January/2016 to May/2017. All patients with indication for PGD/PGS were included in the study. The mean age of the female patients was 37.04±5.65years. Biopsied blastocysts were categorized for morphology. Cells were sent for genetic analysis using the CGH array, SNP array or NGS techniques. Statistical analysis was performed using the chi square test, and statistical significance was assigned to differences with p≤0.05.ResultsChromosome analysis revealed that 44 (38.9%) blastocysts were euploid. Blastocysts with trophectoderm grades A, B, and C had euploidy rates of 71.43%, 60% and 19.67%, respectively (p≤0.05).ConclusionAlthough the best trophectoderm morphology grades had higher euploidy rates, this indicator alone is not enough to warrant embryo genetic viability.
Objective: To present clinical and laboratory data of a Brazilian social program for cancer fertility preservation. Methods: We carried out a descriptive observational study between July 2011 and December 2018. 246 patients were included from a social program in a private assisted reproduction clinic in Santo André/Brazil for oocyte cryopreservation before starting oncological treatment. Results: 246 cancer patients resorted to fertility preservation before initiating cancer treatment. These were diagnosed with 27 different types of cancer, and the breast type is the most prevalent. 2528 MII oocytes (mean of 10.3 oocytes per patient) were vitrified. Four patients thawed their oocytes to submit in vitro fertilization, three had embryos transferred and one achieved pregnancy. Conclusion: Preservation of fertility offers patients, especially at reproductive age, a viable way to perform their cancer treatment without compromising future gestation. It is important that professionals duly counsel oncological patients so, if they wish, they can have the possibility to guarantee her fertility preserved.
Objective: To compare laboratory results of embryo development from late matured oocytes in relation to mature oocytes in D+0.Methods: We carried out a cross-sectional study during the period from January to December 2018, in which we collected data through medical records analysis. 913 oocytes were collected and divided into 3 groups: group 1 -643 MII oocytes; group 2 -119 MI oocytes and; group 3 -151 PI oocytes. These studied oocytes were from different maternal ages and infertility factors. The analyzed variables were fertilization rate, embryo cleavage, top quality embryos on the third day of development, blastocyst stage, top quality blastocysts, euploid blastocysts, top quality blastocysts and gestation. We documented the data, and performed the statistical analysis using the chisquare test (p<0.05).Results: All MII oocytes were injected (643); 103/119 MI oocytes and 88/151 PI oocytes that matured late in D + 1, were also injected. The fertilization rate of the three groups did not present statistical difference. The oocytes of group 1 had a statistically proven better prognosis than oocytes from groups 2 and 3 when compared, respectively, embryo cleavage (p=0.000), top quality embryos on the third day of development (p=0.000) and blastocyst formation rate (p=0.004). In the LMO group, there were no euploid embryos and, therefore, there no embryo transfer. Conclusion:Although late matured oocytes have made blastocyst formation possible, even if in low rates, there were no viable embryos for transfer.
ObjectiveProgesterone is a steroid hormone that acts on the endometrium. It is known for producing physical and mood-related side effects. Few studies have looked into how progesterone levels affect embryo development and quality. This study aimed to find a cutoff level for serum progesterone on the day of HCG administration from which embryo quality is impaired.MethodsThe study included 145 cycles, from which 885 oocytes and 613 embryos were obtained. All patients had their serum progesterone levels measured on the day of HCG administration. Data sets were collected from patient medical records. The chi-square test was used to assess qualitative variables and the Mann-Whitney test to evaluate quantitative variables.ResultsStatistical analysis revealed that serum progesterone levels and reproductive variables were not significantly associated. In regards to oocyte maturity, however, when progesterone levels were greater than 1.3 ng/mL the probability of oocytes being immature increased by 12.7%. The fragmentation rate of embryos categorized as "top quality" in D3 increased proportionately to increases in progesterone levels (12.23%).ConclusionHigh progesterone levels appeared to be correlated with increased embryo fragmentation rates, but high serum levels of the hormone on the day of HCG administration had no impact on reproductive variables and were not associated with impaired embryo development.
Study question Evaluate the influence of sperm selection according to the sorting technique, and its effects in clinical and laboratory parameters in IVF/PGT-A cycles. Summary answer Cycles that used microfluidic sperm selection device presented an increase in clinical pregnancy rates. What is known already A common genomic anomaly detected in subfertile men is the Sperm DNA fragmentation. It is resulted of a high concentation of free radicals produced causing oxidative stress in sperm cells. In order to achieve a normal embryonic development is necessary good spermatozoa with intact genetic material. In fact, embryonic quality parameters as lower fertilization, blastocyst formation and pregnancy rates has been related with Sperm DNA fragmentation increased cases. The microfluidic sperm selection device has been commercialized promising to select spermatozoa with a low level of DNA fragmentation and suggest a relationship between embryo quality, euploidy and pregnancy rates. Study design, size, duration A case-control study involving 494 IVF/PGT-A cycles that resulted in embryo biopsy between June, 2020 and November, 2021 at a Brazilian private practice unit (Instituto Ideia Fertil) were included in this analysis. Participants/materials, setting, methods All cycles that would perform PGT-A were splitted in two groups considering the sperm sorting technique: case - Microfluidic sperm selection device (245 cycles) and control - Density gradient centrifugation + swim-up (249 cycles) were included. The variables considered in this analysis were patient age, sperm concentration, fertilization, D3 top quality, blastocyst top quality, blastulation, ploidy and pregnancy rates. This data were analysed between groups and female age (until 37; 38-40 and over 41). Main results and the role of chance The mean age of the female and male patients found were 38.05 and 38.2 respectively and there was not statistically significant different between groups. Fertilization rate compared between case (72.4%) and control (76.5%) groups (p < 0.05) demonstrated statistically significant difference, but when stratified accordingly to the age, only the female age until 37 years old group showed significant difference (73.25%; 76.43%; p < 0.05). The variables analyzed as D3 Top Quality, Blastocyst Top Quality, blastulation and ploidy did not present difference (p = 0.552; 0.699; 0.378). The clinical pregnancy rate analyzed revealed in case group 65.33% and control 56.38% (p < 0.05), demonstrating statistically significant difference. When groups were splitted according to the female age (until 37 years old; 38-40 and over 41) the findings behaved in the same characteristics, increasing only the clinical pregnancy rate. The tests used was Mann-Whitney and Kruskal-wallis. Limitations, reasons for caution The DNA fragmentation test was not evaluated because not all patients had this test performed. Besides that, another parameter that will be analysed is live birth rate. Wider implications of the findings Microfluidic sperm sorting device made possible to select high quality spermatozoa according to motility, morphology, and low rates of fragmentation, showing the importance of having a good sperm in clinical pregnancy rate. Trial registration number none
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