The present results indicate that cumulus cells removal at 6 h of insemination is a relatively safe operation, which yielded comparable normal fertilization rate, multinucleation and clinical pregnancy rates compared with 20 h group. This protocol may be beneficial for early obsevation of fertilization failure and make early rescue ICSI possible.

BACKGROUND Conflicting results have been reported regarding the technique of brief insemination used in IVF. The aim of this meta-analysis was to determine if better clinical outcomes of IVF are associated with a brief co-incubation of gametes than with a standard overnight co-incubation. METHODS A computerized search was conducted of the published literature of four databases, using search terms related to gamete, time of co-incubation and outcome measure. Eligible studies compared outcomes of IVF with a brief co-incubation of gametes to that of a control group of standard insemination and reported rates of live birth (primary outcome), normal fertilization, polyspermy, good quality embryos, implantation, clinical pregnancy or ongoing pregnancy (secondary outcomes). A total of 11 studies were included in the meta-analysis. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for the data. Statistical heterogeneity was tested using Cochran Q and I² values. RESULTS Brief co-incubation of gametes was associated with significantly higher rates of clinical pregnancy (RR: 1.84, 95% CI: 1.24-2.73) and ongoing pregnancy (RR: 1.73, 95% CI: 1.27-2.33) than standard insemination. Brief co-incubation of gametes was associated also with a significantly higher rate of implantation (RR: 1.80, 95% CI: 1.43-2.26) than standard insemination. However, the rates of normal fertilization (RR: 0.98, 95% CI: 0.93-1.02), good quality embryos (RR: 1.24, 95% CI: 1.0-1.53) and polyspermy (RR: 0.84, 95% CI: 0.7-1.01) were not significantly different with brief co-incubation of gametes compared with standard insemination. CONCLUSIONS Reduced gamete exposure time may be associated with beneficial outcomes. Drawbacks inherent to the quality of several studies limit the quality of the available evidence. Adequately powered randomized controlled studies need to be performed to evaluate the efficacy of brief insemination.

Background: Many studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear. This paper was designed to investigate the efficacy of GH co-treatment during IVF for the patients with poor embryonic development. Method: A randomized controlled trial including 158 patients with poor embryo development was conducted between July 2017 and February 2019. One hundred and seven patients were randomized for GH treatment (GH group) and 51 patients for untreated (control group). The primary end-points were the clinical pregnancy and live birth rates in the two groups. The oocyte competence were assessed through calculating the mitochondrial DNA (mtDNA) copy number in corresponding cumulus granulosa cells (CGCs). Quantitative PCR were used for calculation of mtDNA copy number. Results: Relative to the control group, GH co-treatment resulted in a significantly higher number of retrieved oocytes (10.29 ± 5.92 versus 8.16 ± 4.17, P = 0.023) and cleaved embryos (6.73 ± 4.25 versus 5.29 ± 3.23, P = 0.036). The implantation rate, clinical pregnancy rates per cycle, and live birth rate per cycle were higher in the GH group than in the control group (36.00% versus 17.86%, P = 0.005; 43.93% versus 19.61%, P = 0.005; 41.12% versus 17.65%, P = 0.006). CGCs of the GH group had significantly higher mtDNA copy numbers than CGCs of the control group (252 versus 204, P < 0.001). Conclusions: These data provided further evidence to indicate that GH supplementation may support more live births during IVF, in patients with poor embryonic development. It also appears that oocytes generated under GH co-treatment have a better developmental competence.

Purpose This study aimed to analyze the impact of different biopsy protocols on the rate of mosaic blastocysts. Methods This is a retrospective cohort study which included 115 cycles with pre-implantation genetic testing for aneuploidy (PGT-A). Two groups were allocated based on the biopsy protocols: method 1 group, the zona pellucida (ZP) was drilled on day 3 embryos followed by trophectoderm (TE) biopsy; and method 2 group, the ZP was opened on day 5 or 6 blastocysts followed by TE biopsy. All biopsy samples were assessed using next-generation sequencing (NGS) at a single reference laboratory. The euploid, aneuploid, and mosaic blastocyst rates and clinical outcomes were compared. Results The mosaicism rate in the method 1 group was 19.58%, significantly higher than the method 2 group (8.12%; P < 0.05). No statistically significant difference was observed in euploid, aneuploid blastocyst rates, and clinical pregnancy rates between the two groups. Logistic regression analysis indicated that the biopsy protocols were independently associated with the mosaicism rates among all the variables. Conclusions The present study showed that different biopsy protocols may have an impact on the mosaic blastocyst rate. ZP opening on day 3 combined with TE biopsy might increase the incidence of mosaic blastocysts.

Vitrification is an important way to cryopreserve human embryos and the recommended time of embryo exposure to the vitrification solution is 1 min. However, practically speaking, the duration of embryos exposure to equilibration solution can vary from 5 to 15 min. The purpose of this study was to investigate the effect of different equilibration times on the outcomes of frozen-thawed embryo transfer cycles. The data were collected from our medical records from January 2012 to June 2013 and a total of 517 cycles were included. These cycles were divided into four groups according to the equilibration time: (i) 5-6 min; (ii) 7-8 min; (iii) 9-10 min and (iv) 11-12 min. The results show that there were no differences in terms of survival rate and fully intact embryo rate among the four groups. However, lower clinical pregnancy, embryo implantation and live birth rates were observed in the 5-6 min exposure group (54.6%, 31.9% and 48.2%, respectively) compared with the three other groups. The corresponding rates in the 9-10 min group (73.5%, 47.6% and 64.7%) were the highest. This study indicated that different equilibration times influenced the clinical outcomes of human embryo vitrification and vitrification with shortened equilibration time compromised the clinical outcomes. Appropriate prolongation of the equilibrium time would probably improve the clinical outcomes.