To assess if a history of repeated implantation failure (RIF) or local endometrial injury (LEI) for RIF affects the pregnancy course in women who conceived in the subsequent in vitro fertilization (IVF)-embryo/blastocyst transfer (ET/BT) cycle. Materials and Methods: Of 42 pregnant women with a history of three consecutive failed ET/BT cycles with negative pregnancy tests, 11 patients had a clinical pregnancy in the immediate subsequent ET/BT cycle following (the RIF group), whereas 31 patients had a clinical pregnancy in the subsequent ET/BT cycle following single curettage LEI in the proliferative phase of the preceding spontaneous cycle (the RIF/LEI group). Information on the obstetric complications were retrieved from medical records and compared with that of women who had a live birth in the first ET/BT attempt (the control group). Results: The clinical pregnancy rate, ongoing pregnancy rate, and live birth rate were significantly higher in the RIF/LEI group than in the RIF group (p < 0.010). There were no significant differences in the incidence of pregnancy of unknown location, ectopic pregnancy, miscarriage, stillbirth, preterm birth, premature rupture of the membranes, placenta previa, placental abruption, preeclampsia, pregnancy-induced hypertension, gestational diabetes, fetal growth restriction, caesarean section, and blood transfusion were similar between the three groups (p > 0.31). Conclusion: In this pilot survey, neither a history of RIF nor LEI intervention for RIF increased the incidence of obstetric complications in the women who conceived in the subsequent ET/BT cycle.

The aim of this study was to compare the branched-chain amino acid (BCAA) and tyrosine concentration in the follicular fluid of infertile women with and without ovarian hyperstimulation syndrome (OHSS) in an in vitro fertilization program combined with controlled ovarian stimulation. Follicular fluid was aspirated during oocyte retrieval from 20 infertile patients who developed moderate-to-severe OHSS and 20 age- and body mass index-matched normoresponders. BCAA and tyrosine concentration were measured using enzymatic methods. The follicular fluid BCAA concentration was similar between the two groups (P=0.55), whereas tyrosine concentration was significantly lower in the OHSS compared to that in the normoresponder group (P=0.027) and the BCAA/tyrosine ratio was significantly higher in the OHSS compared to that in the normoresponder group (P=0.034). These results suggest an association between low follicular fluid tyrosine concentration and OHSS. Dopamine receptor agonists may be used as potential anti-OHSS medicines and tyrosine, as a dopamine precursor, may play a role against the development of OHSS.

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trophectoderm biopsy and analyzed via SNP analysis, qPCR, or aCGH. Cycles were segregated on the context of the day they were vitrified: Day 5, 6 or 7. Cycles were binned in 6 sub-categories based on ICM and trophectoderm criteria of ''high'', ''medium'', and ''low'' quality and further sorted by expansion (modified Gardner classification). Embryos were only frozen once they achieved at least expansion 3. The main outcome measure was implantation rate. Bivariate associations were examined using Pearson's Chisquare test, independent samples t-test, as appropriate. All statistical tests were two-sided and P value <0.05 was considered statistically significant. Clopper-Pearson interval was used to calculate binomial CI for all reported proportions. Adjusted OR and its 95% CI for aneuploidy rate was calculated.RESULTS: A total of 1822 patients underwent 2336 SET FET cycles (Table 1). When raw data were analyzed, all sub-categories achieved higher IRs when frozen on Day 5 (highest 100%, lowest 66.7%) as compared to Day 6 (highest 61.6%, lowest 36.8%) or Day 7 (highest 33.3%, lowest 25.0%). Embryos 3BB to 6AA frozen on Day 5 had statistically higher IRs than those frozen on Day 6 (p<0.05). Any embryo frozen on day 5 showed higher implantation rates than those frozen on day 6, although statistical significance was not achieved in all groups.CONCLUSIONS: Blastocyst-stage ET has progressively become the norm in many ART clinics. Advancements in extended culture methods have successfully enabled the development of embryos to day 5, 6, or 7 in vitro, which has given embryologists more insight into implantation potential. This study suggests that faster developing euploid blastocysts cryopreserved on Day 5 showed a trend towards higher clinical outcomes following a FET cycle. Further large randomized control trials are needed to confirm these findings. OBJECTIVE: To investigate whether the metabolic footprint of single human blastocysts can differentiate between good quality day 5 blastocysts and poor quality day 5 blastocysts that are or are not capable of producing a good quality blastocyst on day 6. DESIGN: Retrospective analysis MATERIALS AND METHODS: Individual embryos were cultured to the blastocyst stage in 25 mL of CCRM (in house prepared sequential) medium in the EmbryoScopeÒ. Medium samples (n¼88) were collected on day 5 following 48 hours of culture from wells containing a good quality (grade 3BB and better, vitrified/transferred) or poor quality (assessed again on day 6) blastocyst. Control medium from wells without an embryo in the same dish were also collected. An internal standard containing 20 isotopically labeled substrates was added to all samples. A zwitterionic polymeric hydrophilic interaction liquid chromatography (ZIC-pHILIC) column was used to separate polar metabolites after MTBE extraction, followed by electrospray ionization (ESI) prior to triple quadropole mass spectrometer (TQ-S) coupled to LC-MS/MS. A standard curve was used for absolute quantitation of each compound (Skyline software). Metabol...

The influence of the location of a trophectoderm biopsy in human blastocysts on the development of those blastocysts has not yet been investigated. In our prospective study (n=92), our multivariate logistic regression analysis indicated that blastocoel development was influenced by the location of the trophectoderm biopsy (p=0.049) and by the type of human blastocyst used (fresh or thawed) (p=0.037), regardless of the patient's age (p=0.507) and the number of days for the human blastocyst in the pretrophectoderm biopsy (p=0.239). Therefore, when a trophectoderm biopsy is close to the inner cell mass (ICM) in human blastocysts, it improves the progress of blastocoel development.Clinical evidence suggests that the progress of blastocoel development is a predictor of clinical outcomes after single blastocyst transfer. Therefore, when the trophectoderm biopsy is done from near the ICM, improvement of clinical outcomes after single blastocyst transfer may be expected.