Objective To study if the number of trophectoderm (TE) biopsied cells has an impact on implantation rates. Design A retrospective cohort study in a single-center study. Setting In vitro fertilization center. Patients Patients who underwent PGT-A from January 2013 to March 2016. In total, 482 vitrified/warmed single embryo transfers were included. Interventions None. Main outcome measures Clinical pregnancies rate, implantation rate. Results Overall, clinical pregnancies per embryo transfer were higher when a regular TE were biopsied compared to larger size biopsy cells (66% (175/267) vs 53% (115/215) (p < 0.005) respectively). Pregnancy rates were also analyzed according to embryo morphology at the moment of embryo biopsy, when a good-quality embryo was transferred the clinical outcome was 75% (81/108) in group 1 and 61% (60/99) in group 2 (p < 0.05). Data was also stratified by age in patients ≤ 35 years and > 35 years. The clinical pregnancy was 67% (51/76) in women ≤ 35 years and 65% (124/191) in women > 35 years when a regular size biopsy was performed. These results significantly reduced when a larger size biopsy was performed 54% (49/91) and 53% (66/124), respectively (p < 0.05). Further investigation indicated that miscarriage rate was similar between these groups (4% (7/182) in group 1 and 5% (6/121) in group 2). Conclusions These findings underscore that when a large amount of TE cells are biopsied, it may negatively affect implantation rates, but once implanted, the embryos have the same chance to miscarry or reach term.
Objective:
To describe our fertility preservation program focusing on the number of
oocytes vitrified by age.
Methods:
From January 2015 to December 2016, 686 oocyte vitrification cycles were
performed in our units for the social fertility preservation program. In
total, 288 were donors who donated their oocytes for our oocyte-banking
program, and 398 were patients who underwent elective fertility
preservation.
Results:
The mean numbers of COCs retrieved and vitrified oocytes were similar among
the donor cycles (women under 30 years). In those patients over 36 years of
age the mean numbers of COCs retrieved and vitrified oocytes were
significantly lower. We also estimated the association between age and
cancelation rates. Odd ratios (OR) for total cancelation was calculated
between patients of 31-35 years and 41-45 years; the OR was 5.17 (95% CI
1.89 - 14.17) and increased up to 25.67 (95% CI 5.01 - 131.42) between
patients 31-35 y and those older than 45 years. No differences were found
between patients of 31-35 years and 36-40 years. The OR for total
cancellation increased 3.83 (95% CI 2.06 - 7.11) and 19.00 (95% CI 4.56 -
79.11) between women 36-40 years and 41-45 years, and those older than 45
years, respectively. Finally, the oocyte survival rate in patients under 36
years of age was similar to that of our donor program (94%
vs.
95%).
Conclusions:
Based on this study, we encouraged our patients under than 36 years of age to
preserve their fertility for the future.
La selección embrionaria usando características morfológicas observadas por pocos segundos bajo el microscopio, ha sido la principal herramienta de selección en las técnicas de reproducción asistida. Sin embargo, el desarrollo embrionario es un proceso dinámico que con la introducción de incubadoras con microcámaras integradas, conocidas como incubadoras con sistema Time Lapse, ha permitido registrar eventos morfológicos y cinéticos del desarrollo embrionario que pueden ser útiles como marcadores de selección, denominándolos parámetros ‘morfocinéticos’. En este reporte de caso damos a conocer el primer embarazo en el Perú mediante la transferencia de embriones seleccionados por parámetros morfocinéticos en una incubadora con sistema Time Lapse.
La maduración in vitro de ovocitos (MIV) es una técnica de reproducción asistida muy poco difundida entre los centros de reproducción asistida, debido al bajo éxito en obtener embarazos. Sin embargo, en los últimos años, diferentes estrategias empleadas han demostrado tasas de embarazo similares a las técnicas convencionales de fecundación in vitro (FIV). En el presente reporte, describimos el caso clínico del primer nacido vivo usando MIV en combinación del cultivo extendido hasta estadio de blastocisto.
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