Time lapse microscopy is useful for elective single-embryo transfer

Herzberger, Einat Haikin; Ghetler, Yehudith; Yaniv, Rina Tamir; Berkovitz, Arie; Gonen, Ofer; Cohen, Ilan; Shulman, Adrian; Wiser, Amir

doi:10.1080/09513590.2016.1188375

Cited by 7 publications

(5 citation statements)

References 13 publications

(18 reference statements)

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“…This might partially explain our result regarding the pregnancy rate with poor quality embryos. Perhaps more advanced methods to evaluate embryos, such as time lapse and genetic screening or pre-gestational screening (PGS) [10, 11] will provide a better definition of good and poor quality embryos and help to better predict viable pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Does the transfer of a poor quality embryo together with a good quality embryo affect the In Vitro Fertilization (IVF) outcome?

et al. 2017

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BackgroundIVF cycles which result in only one good quality embryo, and a second poor quality embryo present a dilemma when the decision involves transferring two embryos. The aim of this study was to evaluate whether a poor quality embryo has a negative effect on a good quality embryo when transferred along with a good quality embryo.MethodsWe retrospectively evaluated in vitro fertilization (IVF) cycles involving single embryo transfers (SET) and double embryo transfers (DET). Embryo quality was divided into poor “P” and good “G” quality. The main outcome measures were: live birth, implantation rate, miscarriage rate, clinical pregnancy rate and multiple pregnancy ratio.ResultsSix hundred three women were included. The study group consisted of 180 (29.9%) patients who had a double embryo transfer (DET) with one poor quality embryo and one good quality embryo (P + G). Control 1 group included 303 (50.2%) patients who had DET with two good quality embryos (G + G), and control 2 group consisted of 120 (19.9%) patients who had a single embryo transfer (SET) with one good quality embryo (G). Live birth rates were not significantly different when compared between study groups: 30.8% in the SET group (G), 27.2% in the (G + P) group and 33.7% in the (G + G) group. The SET group had the highest implantation rate (33.9%) compared to the DET groups (21.8% (G + P), 25.4% (G + G)) (P =0.022). The clinical pregnancy rate was 33.3% in the SET group (G), 33.3% in the (G + P) group, and 39.3% in the (G + G) group (P =0.39). The miscarriage rate was comparable in all groups.ConclusionA poor quality embryo does not negatively affect a good quality embryo, when transferred together in a double embryo transfer.Electronic supplementary materialThe online version of this article (doi:10.1186/s13048-016-0297-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Does the transfer of a poor quality embryo together with a good quality embryo affect the In Vitro Fertilization (IVF) outcome?

et al. 2017

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“…Forty-five studies [ 2 , 11 , 13 , 15 , 21 , 24 , 28 – 31 , 38 , 39 , 43 , 44 , 48 – 50 , 53 , 54 , 56 – 59 , 62 , 64 , 66 – 69 , 72 , 75 – 77 , 79 – 81 , 85 – 87 , 91 , 93 – 96 , 98 ] were pooled and found that the MPR was significantly lower in the SET group than in the DET group (0.05, 0.04–0.06, I 2 = 2%, P < 0.001) (Supplementary Fig. S2 ).…”

Section: Resultsmentioning

confidence: 99%

“…A significant decrease in CPR (37.4% vs. 48.0%, 0.78, 0.71–0.85, I 2 = 82%, P < 0.001, n = 60) was noted in the SET group compared with the DET group [ 11 – 15 , 19 , 23 , 24 , 27 – 31 , 38 , 39 , 41 – 44 , 48 – 51 , 53 – 59 , 62 , 64 – 67 , 69 , 70 , 72 , 74 – 81 , 84 , 86 , 87 , 90 , 91 , 93 – 98 , 100 , 101 ]. Several subgroup analyses indicated a different direction, no differences of CPR were noted between SET and DET in subgroups of patients aged ≥40 years (0.88, 0.59–1.30, I 2 = 70%, n = 5), GQE versus GQE + PQE (1.01, 0.89–1.16, I 2 = 0%, n = 9), and frozen cycles (0.79, 0.62–1.00, I 2 = 83%, n = 9; Supplementary Table S3 , Fig.…”

Section: Resultsmentioning

confidence: 99%

Comparisons of benefits and risks of single embryo transfer versus double embryo transfer: a systematic review and meta-analysis

Peng

et al. 2022

Reprod Biol Endocrinol

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Background Evidence referring to the trade-offs between the benefits and risks of single embryo transfer (SET) versus double embryo transfer (DET) following assisted reproduction technology are insufficient, especially for those women with a defined embryo quality or advanced age. Methods A systematic review and meta-analysis was conducted according to PRISMA guidelines. PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov were searched based on established search strategy from inception through February 2021. Pre-specified primary outcomes were live birth rate (LBR) and multiple pregnancy rate (MPR). Odds ratio (OR) with 95% confidence interval (CI) were pooled by a random-effects model using R version 4.1.0. Results Eighty-five studies (14 randomized controlled trials and 71 observational studies) were eligible. Compared with DET, SET decreased the probability of a live birth (OR = 0.78, 95% CI: 0.71–0.85, P < 0.001, n = 62), and lowered the rate of multiple pregnancy (0.05, 0.04–0.06, P < 0.001, n = 45). In the sub-analyses of age stratification, both the differences of LBR (0.87, 0.54–1.40, P = 0.565, n = 4) and MPR (0.34, 0.06–2.03, P = 0.236, n = 3) between SET and DET groups became insignificant in patients aged ≥40 years. No significant difference in LBR for single GQE versus two embryos of mixed quality [GQE + PQE (non-good quality embryo)] (0.99, 0.77–1.27, P = 0.915, n = 8), nor any difference of MPR in single PQE versus two PQEs (0.23, 0.04–1.49, P = 0.123, n = 6). Moreover, women who conceived through SET were associated with lower risks of poor outcomes, including cesarean section (0.64, 0.43-0.94), antepartum haemorrhage (0.35, 0.15-0.82), preterm birth (0.25, 0.21-0.30), low birth weight (0.20, 0.16-0.25), Apgar1 < 7 rate (0.12, 0.02-0.93) or neonatal intensive care unit admission (0.30, 0.14-0.66) than those following DET. Conclusions In women aged < 40 years or if any GQE is available, SET should be incorporated into clinical practice. While in the absence of GQEs, DET may be preferable. However, for elderly women aged ≥40 years, current evidence is not enough to recommend an appropriate number of embryo transfer. The findings need to be further confirmed.

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“…However, recent reports have found a slight benefit in using blastocyst culture as compared to transfers at D2 or D3 [ 24 – 25 ]. Time lapse imaging, recently introduced in IVF laboratories, may represent the most promising non-invasive tool to determine embryo development in optimal conditions and to define predictive patterns correlated with high implantation potential [ 26 – 27 ]. Nevertheless, this system is not yet available in all IVF centres.…”

Section: Discussionmentioning

confidence: 99%

Soluble CD146, an innovative and non-invasive biomarker of embryo selection for in vitro fertilization

et al. 2017

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Although progress was made in in vitro fertilization (IVF) techniques, the majority of embryos transferred fail to implant. Morphology embryo scoring is the standard procedure for most of IVF centres for choosing the best embryo, but remains limited since even the embryos classified as “top quality” may not implant. As it has been shown that i) CD146 is involved in embryo implantation and ii) membrane form is shed to generate soluble CD146 (sCD146), we propose that sCD146 in embryo supernatants may constitute a new biomarker of embryo selection. Immunocytochemical staining showed expression of CD146 in early embryo stages and sCD146 was detected by ELISA and Western-blot in embryo supernatants from D2. We retrospectively studied 126 couples who underwent IVF attempt. The embryo culture medium from each transferred embryo (n = 222) was collected for measurement of sCD146 by ELISA. Significantly higher sCD146 concentrations were present in embryo supernatants that did not implant (n = 185) as compared to those that successfully implanted (n = 37) (1310 +/- 1152 pg.mL-1 vs. 845+/- 1173 pg.mL-1, p = 0.024). Sensitivity analysis performed on single embryo transfers (n = 71) confirmed this association (p = 0.0054). The computed ROC curve established that the optimal sCD146 concentration for embryo implantation is under 1164 pg.mL-1 (sensitivity: 76%, specificity: 48%, PPV: 25% and NPV: 92%). Over this sCD146 threshold, the implantation rate was significantly lower (9% with sCD146 levels >1164 pg.ml-1 vs. 22% with sCD146 levels ≤ 1164 pg.mL-1, p = 0.01). Among the embryos preselected by morphologic scoring, sCD146 determination could allow a better selection of the embryo(s), thus improving the success of elective single embryo transfer. This study establishes the proof of concept for the use of sCD146 as a biomarker for IVF by excluding the embryo with the highest sCD146 level. A multicentre prospective study will now be necessary to further establish its use in clinical practice.

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Time lapse microscopy is useful for elective single-embryo transfer

Cited by 7 publications

References 13 publications

Does the transfer of a poor quality embryo together with a good quality embryo affect the In Vitro Fertilization (IVF) outcome?

Does the transfer of a poor quality embryo together with a good quality embryo affect the In Vitro Fertilization (IVF) outcome?

Comparisons of benefits and risks of single embryo transfer versus double embryo transfer: a systematic review and meta-analysis

Soluble CD146, an innovative and non-invasive biomarker of embryo selection for in vitro fertilization

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