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In recent years, there has been increasing interest in the potential of androgen replacement in menopausal women and specifically adrenal androgen replacement. There is unfortunately increasing unmonitored use of dehydroepiandrosterone (DHEA) among adults in the United States with only limited and preliminary human data. An extensive body of literature in laboratory animals exists to suggest DHEA used in extremely large doses has multifaceted effects; though the inapplicability of this data to humans is not appreciated, as the physiology of adrenal androgens in humans and a few primates is unique. Currently, there is much international and multidisciplinary interest in the physiology and use of DHEA "replacement" in men and menopausal women. The scientific community anxiously await the results of these investigations, but in the interim DHEA and/or DHEA-Sulfate (DHEAS) supplementation is not recommended as a therapeutic option in menopause outside of clinical trials.

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OBJECTIVE:The appearance of time lapse incubators has opened the possibility of studying dynamic embryo behaviors. Blastocyst collapse has been studied in different mammal models. Strong contractions seem to be deleterious for embryo hatching. There is a high consumption of energy in the process of contraction and re-expansion, which could affect the extrusion of the blastocyst from de Zona Pellucida (ZP) and, consequently, the possibility of implantation.DESIGN: Retrospective study to validate the results obtained from IVI Murcia and IVI Valencia (Marcos, J et al, Hum Reprod 2015) analyzing a second data set of embryos, in a different laboratory and with different culture conditions. Marcos et al. found that blastocyst collapse affects implantation, but not hatching rate. Time of collapse and duration of contraction were similar in non-implanted collapsed blastocyst (KID-CB) when compared to implanted collapsed ones (KID+ CB).MATERIALS AND METHODS: 340 cycles from the oocyte donation program of IVI Zaragoza; 499 blastocysts (both fresh and cryopreserved) were transferred, from whose 375 had known implantation data (KID).Embryos where incubated in Embryoscope TM (Vitrolife) at 37oC, 5% CO2, 5% 02 and single step media (GLOBAL, Quermed). Only strong contractions where considered for the analysis (more than 50% of Trofoectoderm (TF) detachment from ZP).Hatching rate, implantation rate, duration and time of contractions where compared between contracted (CB) and non-contracted (NCB) blastocysts.RESULTS: From the 499 blastocysts transferred, 25.1% presented at least one contraction. According with the study of Marcos et al, there were no differences in hatching rate between CB (46.8%, [CI95% 38.0-55.6]) and NCB (43.5%,), but implantation rate was statistically lower in CB (33.7%, [CI95% 24.2-43.2] compared with NCB (47%, [CI95% 41.5-53.2], P¼0.02). Taking into account only KID CB, our data agree again with Marcos respecting to duration of contraction, which is similar between ) vs 2.07 h (1.65-2.56h)), but not in the time of collapse (119.89 (116.49-123.28H) ) KID+ CB, p¼0.0002).CONCLUSIONS: Blastocyst collapse is a negative feature of embryo dynamics, as implantation is affected. Our data confirm the relevance of this parameter as it has been validated in a different setting, with different patients and culture conditions. In consecuence, this dinamic characteristic should be taken into account in the embryo selection for transfer.References:1. Collapse of blastocysts is strongly related to lower implantation succes: a time-lapse study.