Blastocyst expansion score and trophectoderm morphology strongly predict successful clinical pregnancy and live birth following elective single embryo blastocyst transfer (eSET): a national study

Thompson, Stephanie Marshall; Onwubalili, Ndidiamaka; Brown, Kelecia; Jindal, Sangita; McGovern, Peter G.

doi:10.1007/s10815-013-0100-4

Cited by 103 publications

(70 citation statements)

References 23 publications

(29 reference statements)

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“…We also found that blocking autophagy or PARylation increased apoptosis and decreased the total cell number in porcine IVP embryos, indicating that inhibiting either function during development can result in poor‐quality blastocysts. This phenotype is consistent with the observed defects in blastocyst development following treatment with 3ABA or 3MA, especially in blastocyst expansion, which is required for the proper development of the inner cell mass and trophectoderm (Thompson et al, ). These pro‐apoptotic outcomes might be accelerated by the accumulation of ubiquitinated substrates, such as misfolded or aggregated proteins and deformed organelles, as occurs in autophagy‐deficient mice (Moscat and Diaz‐Meco, ; Lippai and Lőw, ).…”

Section: Discussionsupporting

confidence: 87%

Poly(ADP‐ribosyl)ation is involved in pro‐survival autophagy in porcine blastocysts

Lee

Gupta

Kim

et al. 2015

Molecular Reproduction Devel

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Poly(ADP-ribosyl)ation (PARylation) prevents apoptosis through its involvement in pro-survival autophagy in cultured cells; whether or not the same is true for pre-implantation embryos has not yet been documented. In this study, we investigated the participation of PARylation and autophagy in in vitro porcine pre-implantation embryo development. The transcript levels of autophagy-related genes and poly(ADP-ribose) polymerase 1 (PARP1), an enzyme required for PARylation, were transiently up-regulated by fertilization, decreased at the late 1-cell stage, and maintained until the blastocyst stage. LC3, a marker of autophagosomes, and poly(ADP-ribose) (PAR) polymer were present in all stages of pre-implantation development. Exposure of embryos to 3-methyladenine, an autophagy inhibitor, or 3-aminobenzamide, a PARP inhibitor, suppressed the development of blastocysts. Pharmacological inhibition of PARylation further suppressed pro-survival autophagy by decreasing the expression of autophagy-related genes (ATG5, BECLIN1, and LC3) and decreasing LC3 protein abundance while increasing the rate of apoptosis in blastocysts. Deficiency in autophagy also induced abnormal accumulation of SQSTM1/p62 aggregates in porcine blastocysts. Collectively, these data suggest that PARylation is involved in selective autophagic degradation of ubiquitinated proteins, functioning in a pro-survival role, in porcine in vitro-produced embryos. These pro-survival regulatory mechanisms may be important for the control of embryo quality.

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Section: Discussionsupporting

confidence: 87%

Poly(ADP‐ribosyl)ation is involved in pro‐survival autophagy in porcine blastocysts

Lee

Gupta

Kim

et al. 2015

Molecular Reproduction Devel

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“…Numerous studies have shown that pregnancy rates are comparable with eSET and DET in favorable prognosis women (14, 34–37). Although the likelihood of clinical pregnancy and livebirth was greatest with DET, it should be noted that this observation includes preterm twin livebirths and their associated complications.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the use of elective single-embryo transfer and pregnancy outcomes in the United States, 2004–2012

Styer

Luke

Vitek

et al. 2016

Fertility and Sterility

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Objective To evaluate factors associated with elective single embryo transfer (eSET) utilization and its effect on assisted reproductive technology (ART) outcomes in the United States. Design Historical cohort Setting Not applicable Patient(s) Fresh IVF cycles of women 18–37 years using autologous oocytes with either one (SET) or two (DET) embryos transferred and reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System between 2004 and 2012. Cycles were categorized into four groups with[+] or without[−] supernumerary embryos cryopreserved. The SET group with embryos cryopreserved was designated as eSET. Interventions None Main Outcomes Measure(s) The likelihood of eSET utilization, live birth, and singleton non-low birthweight term live birth, modeled using logistic regression. Presented as adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Result(s) The study included 263,375 cycles (21,917 SET[−]cryopreservation, 20,996 SET [+]cryopreservation, 103,371 DET[−]cryopreservation, and 117,091 DET[+]cryopreservation). The utilization of eSET (SET[+]cryopreservation) increased from 1.8% in 2004 to 14.9% in 2012 (aOR 7.66, 95% CI 6.87, 8.53), and was more likely with ART insurance coverage (1.60, 1.54–1.66), Asian race (1.26, 1.20–1.33), uterine factor diagnosis (1.48, 1.37–1.59), retrieval of ≥ 16 oocytes (2.85, 2.55–3.19), and the transfer of day 5–6 embryos (4.23, 4.06–4.40); eSET was less likely in women ages 35–37 years (0.76, 0.73–0.80). Compared to DET cycles, the likelihood of the ideal outcome, term non-low birthweight singleton live birth, was increased 45–52% with eSET. Conclusions Expanding insurance coverage for IVF would facilitate the broader use of eSET, and reduce the morbidity and healthcare costs associated with multiple pregnancies.

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“…Several recent studies suggest that trophectoderm is the more important of the two (23–26). By contrast, a study by Van den Abbdeel et al, (27), found that blastocyst expansion, and both trophectoderm and inner cell mass are important for predicting pregnancy but that poor quality inner cell mass also predicts an increase in miscarriage rate.…”

Section: Discussionmentioning

confidence: 99%

Using the Society for Assisted Reproductive Technology Clinic Outcome System morphological measures to predict live birth after assisted reproductive technology

Luke

Brown

Stern

et al. 2014

Fertility and Sterility

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Objective To model morphologic assessments of embryo quality predictive of live birth Design Longitudinal cohort using cycles reported in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System between 2007 and 2011. Setting Clinic-based data Patients Fresh autologous ART cycles with embryo transfers on day 3 or day 5 and morphologic assessments reported (25,409 cycles with one embryo transferred and 96,093 cycles with two embryos transferred). Live birth rates were modeled by morphological assessments using backward-stepping logistic regression for cycle 1 and over five cycles, separately for day 3 and day 5 transfers and number of embryos transferred (1 or 2). Additional models for each day of transfer also included number of oocytes retrieved and number of embryos cryopreserved. Interventions None Main Outcome Measures Live births Results Morphologic assessments of grade, stage, fragmentation, and symmetry were significant for the day 3 models; grade, stage and trophectoderm were significant in the day 5 model; inner cell mass was significant in the models when two embryos were transferred. Number of oocytes retrieved and number of embryos cryopreserved were significant for both day 3 and day 5 models. Conclusions These findings confirm the significant association between embryo quality parameters reported to SART CORS and live birth rate following ART.

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Blastocyst expansion score and trophectoderm morphology strongly predict successful clinical pregnancy and live birth following elective single embryo blastocyst transfer (eSET): a national study

Cited by 103 publications

References 23 publications

Poly(ADP‐ribosyl)ation is involved in pro‐survival autophagy in porcine blastocysts

Poly(ADP‐ribosyl)ation is involved in pro‐survival autophagy in porcine blastocysts

Factors associated with the use of elective single-embryo transfer and pregnancy outcomes in the United States, 2004–2012

Using the Society for Assisted Reproductive Technology Clinic Outcome System morphological measures to predict live birth after assisted reproductive technology

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