Maximising success rates by improving ICSI technique: which factors affect outcome?

Abstract

OBJECTIVE: Our aim was to investigate if circulating microRNAs (miR-NAs) in human follicular fluid (FF) could be used as helpful biomarkers for predicting IVF/ICSI outcomes. DESIGN: In this prospective study, a pool of FF was retrieved for each patient during IVF/ICSI procedure. A total of 91 FF samples from women with normal ovarian reserve (n¼91) were collected at oocyte retrieval day. MATERIALS AND METHODS: For each patient, all follicles were aspirated and all FF samples were pooled. MicroRNAs were extracted from each FF pool and quantified by RT-qPCR, using TaqMan technology. The expressions of miR-320a, let-7b and miR-29a were analyzed in FF and related to IVF/ICSI outcomes. RESULTS: FF pools related to low number of mature oocytes (%2) contained significant lower miR-320a expression levels than those related to high number of mature oocytes (>2), respectively (p¼0.03). Moreover, significant high let-7b levels were found in FF pools related to embryo cohorts with a high total blastomere number/total embryo number ratio at day 3 (>8, ie accelerated development) than in those with normal developmental kinetics (ratio between 6 and 8) (p¼0.02). Interestingly, we found a significant and negative correlation between FF let-7b expression levels and blastulation rate (r¼-0.33, p¼0.003). The Receiving Operator Curve (ROC) analysis indicated that the performance of FF let-7b in predicting the expanded blastocyst development was 0.67 (0.54-0.79), with 70% sensitivity and 64.3% specificity (p¼0.02). In addition, the area under the ROC curve (AUC), evaluating the potential of FF miR-29a in predicting clinical pregnancy outcome reached 0.68 [0.55-0.79] with a high sensitivity of 83.3% and a specificity of 53.5% (p¼0.01). CONCLUSIONS: Our results suggest that circulating miRNAs constitute non-invasive powerful tools in IVF process to predict embryo development and clinical pregnancy outcomes, in order to promote personalized IVF strategy.

Automatic segmentation of intracytoplasmic sperm injection images

“…Например, в работе [9] продемонстрировано, что модификация методики внедрения сперматозоида приводит к увеличению числа успешных беременностей у женщин, для кото-рых предыдущие операции ИКСИ были неудачными. В другом исследовании [7], в котором был произведен ручной анализ 535 видеозаписей процедур ИКСИ, было показано, что при определенном способе введения микроинъектора в яйцеклетку вероятность успешного оплодотворения может быть значительно ниже, чем в среднем. Благодаря тому, что во время выполнения операции ИКСИ производится ее видеозапись, представляется весьма перспективным, используя методы компьютерного зрения, проанализировать весь процесс выполнения и выработать рекомендации оператору для успешного проведения процедуры, а также предсказать с высокой вероятностью результат операции.…”