BackgroundThe increasing prevalence of obesity in women of child‐bearing age is of growing concern in the health community. Obesity is associated with sub‐optimal reproductive performance; therefore, it is understandable that the number of young women with elevated body mass index (BMI) accessing assisted reproductive treatment (ART) is on the rise. Consequently, this study not only assessed the impact of BMI on fertilisation rates, embryo development and freezing during ART in women aged ≤38 years but also determined their subsequent pregnancy and delivery rates.MethodsData were retrospectively analysed from all cycles initiated in 2006/2007 for women aged ≤38 years. The BMI categorisations were as follows: normal – 18.5–24.9 kg/m2; overweight – 25–29.9 kg/m2; obese – 30–34.9 kg/m2; morbidly obese class I – 35–39.9 kg/m2; morbidly obese class П –≥40 kg/m2.ResultsObese and morbidly obese women required a significantly higher follicle stimulating hormone start dose than normal BMI women; however, they obtained significantly fewer oocytes (P < 0.05). Although BMI did not affect embryo development, morbidly obese class Π women had significantly reduced pregnancy rates compared to normal BMI women (30.5 vs 41.7%, respectively; P < 0.05). Furthermore, increasing BMI was positively correlated to increasing rates of preterm delivery (P < 0.05). Increasing BMI was also positively correlated to increasing delivery rates of singleton term macrosomic offspring (≥4000 g).ConclusionObesity in women aged≤38 years does not affect embryo development; however, it does reduce clinical pregnancy rates in women with a BMI≥40 and increases rates of preterm labour and delivery of macrosomic offspring.
routine protocol and were block randomized by age at the time of blastocyst formation by the embryology team utilizing serially numbered opaque envelopes. The treatment group had trophectoderm biopsy, PGS, and fresh or frozen euploid embryo transfer. The control group underwent fresh or frozen unscreened blastocyst transfer. The primary outcome was time to live birth. Secondary outcomes included clinical loss and ongoing aneuploid pregnancies. Life table analyses and Kaplan-Meier survival curves were employed for the primary outcome and Chi-square analysis for secondary outcomes. RESULTS: There were 181 patients enrolled and 128 underwent randomization with designated outcomes of live birth, completed study protocol, drop out of care, and ongoing treatment. The mean age was 37.4 (AE3.3) in the control group and 37.1 (AE2.9) in the PGS group; mean AMH was 0.59 (AE.28) ng/mL and 0.68 (AE0.41); and mean AFC was 8.2 (AE2.4) and 8.0 (AE2.4) respectively with no statistically significant differences between groups. When time to live birth was analyzed, there were 69 total deliveries, 37 in the control and 32 in the PGS groups. Randomization to PGS resulted in significantly less time to live birth from a mean of 301 days in the control group to 209 days in the PGS group (p¼0.02). There were 18 clinical loses, 5 in the PGS group and 13 in the control group (p¼0.079). This included two instances of termination of pregnancy for a trisomy 18 and a trisomy 13 pregnancy in the control group. CONCLUSIONS: PGS significantly decreased time to live birth by an average of three months in patients with diminished ovarian reserve. Further, PGS appears to have a decreased risk for ongoing aneuploid gestations as there were two terminations required for trisomic gestations in the control group. Offering this embryonic screening paradigm to these patients serves as a way to decrease time to live birth and may decrease the risk of clinical miscarriage and abnormal ongoing gestations.
The aim of this study was to compare serum-starved and non-starved donor cells in sheep nuclear transfer with a special emphasis on cloning outcomes. Sheep oocytes, derived either in vivo or in vitro, were fused with cultured serum-starved or actively growing adult granulosa cells. Resulting blastocysts were transferred to recipients fresh or after vitrification, and subsequent pregnancies followed to term. Donor cell treatment did not significantly affect preimplantation development, pregnancy rates, fetal loss or neonate survival rates. Of 22 lambs born, ten survived the immediate perinatal period but all succumbed at various timepoints within the first few weeks of life. The results of the study suggest that the use of serum-starved cells offers no advantages or disadvantages to cloning outcomes. Neither were significant differences in outcomes observed when using either in vivo- or in vitro-derived oocytes or embryos transferred fresh or after vitrification. Yet, these results continue to highlight problems associated with somatic cell cloning as indicated by offspring mortality. It remains unclear whether the high offspring mortality in the current study was related to species, associated with the cell lines used or the result of other causes.
Here we present ultrastructural and immunocytochemical evidence that ovine ooplasm is directing the initial assembly of the nucleolus independent of the species of the nuclear donor. Intergeneric porcine-ovine somatic cell nuclear transfer (SCNT) and intrageneric ovine-ovine SCNT embryos were constructed and the nucleolus ultrastructure and nucleolus associated rRNA synthesis examined in 1-, 2-, 4-, early 8-, late 8-, and 16-cell embryos using transmission electron microscopy (TEM) and light microscopical autoradiography. In addition, immunocytochemical localization by confocal microscopy of nucleolin, a key protein involved in processing rRNA transcripts, was performed on early 8-, late 8-, and 16-cell embryos for both groups of SCNT embryos. Intergeneric porcine-ovine SCNT embryos exhibited nucleolar precursor bodies (NPBs) of an ovine (ruminant) ultrastructure, but no active rRNA producing fibrillo-granular nucleoli at any of the stages. Unusually, cytoplasmic organelles were located inside the nucleus of two porcine-ovine SCNT embryos. The ovine-ovine SCNT embryos, on the other hand, revealed fibrillo-granular nucleoli in 16-cell embryos. In parallel, autoradiographic labeling over the nucleoplasm, and in particular, the nulcleoli was detected. Bovine-ovine SCNT embryos at the eight-cell stage were examined for nucleolar morphology and exhibited ruminant-type NPBs as well as structures that appeared as fibrillar material surrounded by a rim of electron dense granules, perhaps formerly of nucleolar origin. Nucleolin was localized throughout the nucleoplasm and with particular intensity around the presumptive nucleolar compartments for all developmental stages examined in porcine-ovine and ovine-ovine SCNT embryos. In conclusion, this study suggests that factors within the ovine ooplasm are playing a role in the initial assembly of the embryonic nucleolus in intrageneric SCNT embryos.
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