Developmental capacity of different morphological types of day 5 human morulae and blastocysts

Purpose To assess the potential effects of short-term exposure to particulate air pollution during follicular phase on clinical, laboratory, and pregnancy outcomes of women undergoing IVF/ET. Methods Retrospective cohort study of 400 first IVF/ET cycles of women exposed to ambient particulate matter during follicular phase. Particulate matter (PM) was categorized into quartiles (Q 1 : ≤30.48 µg/m 3 , Q 2 : 30.49-42.00 µg/m 3 , Q 3 : 42.01-56.72 µg/m 3 , and Q 4 : >56.72 µg/m 3 ). Results Clinical, laboratory, or treatment variables were not affected by follicular phase PM exposure periods. Women exposed to Q 4 period during the follicular phase of conception cycles had a higher risk of miscarriage (odds ratio, 5.05; 95% confidence interval: 1.04-25.51) when compared to women exposed to Q 1-3 periods. Conclusion Our results show an association between brief exposure to high levels of ambient PM during the preconceptional period and early pregnancy loss, although no effect of this exposure on clinical, laboratory, and treatment outcomes was observed.

Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Impact of short-term preconceptional exposure to particulate air pollution on treatment outcome in couples undergoing in vitro fertilization and embryo transfer (IVF/ET)

Perin

Maluf

Czeresnia

et al. 2010

“…After consultation with the patients, time of embryo transfer was adjusted to day 3 or day 5 according to doctor-patient agreement. Blastocysts were graded according to our established grading system 5 days after oocyte fertilization [16,17]. Surplus blastocysts, not selected for transfer were cryopreserved using embryo vitrification procedure [17].…”

Section: Methodsmentioning

confidence: 99%

Human chorionic gonadotropin levels are equally predictive for pregnancy outcome after fresh and vitrified-warmed blastocyst transfer

Reljič

Knez

Vlaisavljević

2013

Purpose The aim of the present study was to evaluate if the live birth predictive values of β-hCG levels differ in fresh and vitrified-warmed blastocyst transfer cycles. Methods In the retrospectively designed study, 775 cycles with positive β-hCG values 13 days after fresh blastocyst transfer (fresh ET; n =568) or vitrified-warmed blastocyst transfer (FET; n =207) were selected for analysis. Average β-hCG levels stratified according to pregnancy outcome (biochemical pregnancy, spontaneous abortion, ectopic pregnancy, and singleton or twin birth) were compared between fresh ET and FET cycles. To determine the optimal sensitivity and specificity of β-hCG levels for live birth prediction, a ROC curve was constructed. Fisher's exact test was used to compare the positive predictive values (PPV). Results Average β-hCG levels stratified according to pregnancy outcome were not statistically different between fresh ET and FET cycles. In fresh ET and in FET group, the β-hCG levels were significantly higher in pregnancies resulting in live birth compared to non-viable pregnancies (1,035 vs. 462 IU/L, p < 0.001 and 968 vs. 411 IU/L, p <0.001). Optimal cut-off level for live birth prediction was 495 IU/L (sensitivity 83.0 %, specificity 71.8 %) after ET and 527 IU/L (sensitivity 80.0 % and specificity 76.6 %) after FET. The PPV for live birth rate in the groups after ET and FET were 90.6 % and 84.9 % respectively, without statistically significant difference (p >0.05). Conclusion Beta-hCG levels after fresh and vitrified-warmed blastocyst transfer are equally predictive for pregnancy outcome. Clinicians can be encouraged to interpret β-hCG results in the same manner.

“…Meanwhile, the transfer of blastocysts is suggested to be physiologically more associated with a better synchronization of the uterus and endometrium. Additionally, the extended culture allows a kind of natural pre-selection as not all embryos on day 2 or 3 reach the blastocyst stage and selecting them by an embryologist on the basis of morphological grading at the blastocyst stage has higher predictive value for implantation [1][2][3]. Moreover, embryos selected for transfer on day 5 are suggested to be at lower risk of aneuploidy-although chromosomal Capsule Time-lapse imaging allows the detailed recording of embryonal morphokinetics until the day of transfer.…”

Section: Introductionmentioning

confidence: 99%

The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging—a retrospective observational study

Neyer

Zintz

Stecher

et al. 2015

Purpose Various time-lapse studies have postulated embryo selection criteria based on early morphokinetic markers. However, late paternal effects are mostly not visible before embryonic genome activation. The primary objective of this retrospective study was to investigate whether those early morphokinetic algorithms investigated by time-lapse imaging are reliable enough to allow for the accurate selection of those embryos that develop into blastocysts, while of course taking into account the correlation with the type of injected spermatozoa. Methods During a period of 18 months, a total of 461 MII oocytes from 43 couples with severe male factor infertility and previous Bexternal^IVF failures after cleavage-stage embryo transfer (ET) were fertilized by intracytoplasmic morphologically selected sperm injection (IMSI). Thereof, 373 embryos were monitored in a time-lapse incubator until ET on day 5. Blastocyst outcome in combination with three previously postulated MKc (cc2: t3-t2, 5-12 h; t3, 35-40 h; t5, 48-56 h) and the morphology of the selected sperm were analyzed. Results A significant increase in the rate of blastocysts (54.0 vs. 36.3 %; P<0.01) and top blastocysts (25.3 vs. 10.8 %; P<0.001) was observed in the group of those meeting all three morphokinetic criteria (MKc3). However, MKc3 were only met in 23.3 % of all embryos. Moreover, TBR was influenced by the type of injected spermatozoa. In both groups, TBR decreased dramatically (MKc3, 35.0 vs. 17.0 %; MKc<3, 14.2 vs. 8.4 %) when class II/III sperm instead of class I were injected. Conclusion Early morphokinetic parameters might give some predictive information but fail to serve as a feasible selective tool for the prediction of blastocyst development given the influence of the type of spermatozoa injected.