Reproductive biomedicine online

Description

An international journal, produced on web and in paper copy, devoted to biomedical research and ethical issues surrounding human conception and the welfare of the human embryo. The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy. Relevant topics include fertility and infertility, contraception, IVF and assisted reproduction, the preimplantation diagnosis of genetic disease, cloning, embryo stem cells, implantation and organogenesis, miscarriage, genetic disorders afflicting the embryo, and their alleviation, fetal operations and treatments, and the growth of embryos affected by these processes to term. Ethical and political topics arising through the treatment and care of various clinical conditions are presented. Counselling, news from wide sources, interviews with leading scientists and clinicians, replies to patients' queries, a manufacturers' corner, job opportunities, and other matters of relevance to the journal's fields of study will be presented on web, paper or both. Patients will not be counselled about their condition.

Impact factor 2.68

  • 5-year impact
    2.52
  • Cited half-life
    4.80
  • Immediacy index
    0.72
  • Eigenfactor
    0.01
  • Article influence
    0.70
  • Website
    Reproductive BioMedicine Online website
  • Other titles
    Reproductive biomedicine online (Online), RBM online
  • ISSN
    1472-6491
  • OCLC
    52067842
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • M. Franz, J. Ott, A. Watrelot, L. Küssel, H. Husslein
    [Show abstract] [Hide abstract]
    ABSTRACT: Fertiloscopy represents an alternative to laparoscopy in the diagnostic evaluation of unexplained infertility or for the purpose of ovarian drilling. The learning curve of fertiloscopy in an experienced laparoscopic surgeon was evaluated in a prospective multicentre observational trial. A total of 110 fertiloscopies were carried out. At Centre 1, a beginner, and at Centre 2, an expert in fertiloscopy, performed the procedures. In three cases in Centre 1, and in 0 cases in Centre 2, the procedure was converted to transabdominal laparoscopy owing to intraoperative complications. Median operating time was longer at Centre 1 during the first 40 procedures (P < 0.001) and equal thereafter. Analyzing fertiloscopies with and without ovarian drilling separately, operating time was only longer for the first 20 procedures in each group (P < 0.001 and P = 0.002). In a multivariate analysis, intraoperative complications and fertiloscopy with ovarian drilling (compared with diagnostic fertiloscopy) were associated with longer duration of surgery (P < 0.001 for both parameters). An increasing consecutive number of fertiloscopies was associated with shorter duration of surgery (P < 0.001). Experienced laparoscopists should consider a transition towards fertiloscopy in the diagnostic workup of unexplained infertility or for the purpose of ovarian drilling.
    Reproductive biomedicine online 01/2015;
  • S. La Vignera, E. Vicari, R.A. Condorelli, C. Franchina, G. Scalia, G. Morgia, A. Perino, R. Schillaci, A.E. Calogero
    [Show abstract] [Hide abstract]
    ABSTRACT: The frequency of human papillomavirus (HPV) infection in the semen of patients with male accessory gland infection (MAGI) was evaluated. One hundred infertile patients with MAGI were classified into group A: patients with an inflammatory MAGI (n = 48) and group B: patients with a microbial form (n = 52). Healthy age-matched fertile men (34.0 ± 4.0 years) made up the control group (n = 20). Amplification of HPV DNA was carried out by HPV-HS Bio nested polymerase chain reaction for the detection of HPV DNA sequences within the L1 ORF. Ten patients in group A (20.8%) and 15 patients in group B (28.8%) had a HPV infection; two controls (10.0%) had HPV infection. Patients with MAGI had a significantly higher frequency of HPV infection compared with controls; patients with a microbial MAGI had significantly higher frequency of HPV infection compared with patients with an inflammatory form (both P < 0.05). Patients with MAGI and HPV had a slight, but significantly lower sperm progressive motility and normal morphology compared with patients with MAGI HPV-negative (P < 0.05). Elevated frequency of HPV infection occurred in patients with MAGI, suggesting that HPV should be investigated in the diagnostic work-up of these patients.
    Reproductive biomedicine online 01/2015;
  • Huidan Wang, Haitao Chen, Yingying Qin, Zhuqing Shi, Xiaoming Zhao, Jianfeng Xu, Bowen Ma, Zi-Jiang Chen
    [Show abstract] [Hide abstract]
    ABSTRACT: In this retrospective study, the relationship between demographic characteristics, past medical history, general lifestyle habits and susceptibility of premature ovarian failure (POF) in Han Chinese population was investigated. Five hundred and fifty-three patients with POF and 400 women with normal ovarian function were recruited. A questionnaire was designed to gather information from responders. Logistic regression was carried out to calculate odds ratios (OR), 95% confidence intervals (95% CI) and P-values. History of pelvic surgery, mumps, having relatives with menstrual abnormalities and exposure to chemical agents were significantly associated with increased risk of POF (OR 5.53 [2.15 to 14.23]; 3.26 [2.38 to 4.47]; 28.12 [8.84 to 89.46]; 4.47 [2.09 to 9.58]). Vegetarian diet, tea and mineral water consumption reduced the risk of POF (OR 0.27 [0.19 to 0.37]; 0.04 [0.03 to 0.07]; 0.63 [0.47 to 0.85], respectively). Heredity, pelvic surgery, mumps and exposure to chemical agents were identified as risk factors for POF, whereas vegetarian diet, tea consumption and mineral water drinking were protective. Therefore, genetic consultation could help those women whose relatives manifested an early or premature menopause to avoid the consequences of possible premature ovarian function cessation. Avoidance of exposure to endocrine disrupters and flavonoids intake should be considered.
    Reproductive biomedicine online 01/2015;
  • Tanja Burnik Papler, Eda Vrtačnik Bokal, Aleš Maver, Luca Lovrečić
    [Show abstract] [Hide abstract]
    ABSTRACT: The development of an objective and accurate test that could help select embryos with the highest chance of achieving pregnancy in IVF procedures is an important goal of reproductive medicine. For this purpose, cumulus cell gene expression is being studied to find biomarkers of pregnancy. Several recent studies have proposed potential biomarkers of pregnancy expressed in cumulus cells; however, these have mostly not been validated on an independent set of samples. The aim of this study was to analyse the expression of EFNB2, RGS2 and VCAN genes proposed as biomarkers of pregnancy in cumulus cells by quantitative polymerase chain reaction. Gene expression was evaluated in 43 individual cumulus cell samples, derived from a highly homogenous group of 43 women. The same protocol for ovarian stimulation was used for all women, and elective single embryo transfer was performed. Expression levels of RGS2 and VCAN did not differ between cumulus cells of implanted and non-implanted embryos. EFNB2 showed borderline higher expression in cumulus cells of non-implanted embryos, which is contradictory to previous studies. Altogether, the results of previous studies in which EFNB2, RGS2 and VCAN were proposed as biomarkers of pregnancy could not be replicated in our set of cumulus cell samples.
    Reproductive biomedicine online 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Vitrification is now the dominant approach for cryopreservation of human oocytes and embryos; however, serious disagreement persists, particularly about biosafety issues. Techniques are categorized as either ‘open’ or ‘closed’ according to occurrence of direct contact between the medium and liquid nitrogen during cryopreservation. Advocates of closed systems emphasize the potential danger of disease transmission mediated through liquid nitrogen, and praise the safety of their approach; those who use the open systems refer to the lack of evidence of disease transmission and regard their systems as more consistent and efficient. The purpose of this review is to clarify whether open and closed systems are really open and closed; if closed systems are safe and free of any danger of contamination; if closed systems are equally efficient as open ones for cryopreservation of human embryos and oocytes by considering overall outcome; and finally, if ethical and legal concerns are sound when risks and benefits are considered in a broader sense. On the basis of these answers, implementation of rational measures to lower the theoretical danger of disease transmission are proposed while maintaining the achievements in cryopreservation that have contributed substantially to the advancement in assisted reproduction techniques during the past decade.
    Reproductive biomedicine online 01/2015;
  • Jinxiang Wu, Shiqiang Wu, Yuanzhi Xie, Zhengyao Wang, Ruiyun Wu, Junfeng Cai, Xiangmin Luo, Suzhen Huang, Liuxia You
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to explore the effect of zinc on hydrogen peroxide-induced sperm damage in assisted reproduction techniques. First, sperms were selected from semen samples of 20 healthy men prepared by density gradient centrifugation. Selected sperm were treated with either 0.001% H2O2, 12.5 nM ZnCL2, 0.001% H2O2 + 12.5 nM ZnCL2 or 0.9% NaCl2 (control). After this treatment, the motility, viability, membrane integrity and DNA fragmentation of sperms in each group were analysed by Goodline sperm detection system, optical microscopy and sperm DNA fragmentation assay. Poorer motility, vitality, membrane integrity and more DNA damage were found in sperms treated by H2O2, compared with control. When sperms were treated with both H2O2 and zinc, however, all indicators were improved compared with H2O2 alone. There was a close association between oxidative stimulation and sperm injury; zinc could inhibit hydrogen peroxide-induced damage of sperm in assisted reproductive technology. However, the presence of zinc in culture medium can decrease the sperm quality without addition of peroxide.
    Reproductive biomedicine online 01/2015;
  • Zhangying Wu, Ming Yuan, Yan Li, Fangfang Fu, Wenqinq Ma, Haixia Li, Wenwen Wang, Shixuan Wang
    [Show abstract] [Hide abstract]
    ABSTRACT: Endometriosis is a complex disease that is influenced by genetic and environmental factors. In endometriosis, WNT4 plays a likely role owing to its biological functions. In this study, the TaqMan allelic discrimination technique was used to investigate the relationship between endometriosis and four single nucleotide polymorphisms in WNT4 (rs7521902 [A/C], rs16826658 [G/T], rs7515106 [C/T] and rs2235529 [A/G]) in Chinese Han women. A total of 646 patients with endometriosis and 766 normal controls were recurited. Regression analyses revealed that rs2235529 was a risk locus for endometriosis (P 1.80E-03, OR, 95% CI = 1.311, 1.129 to 1.522), particularly in patients with stage III and IV disease. No significant association was found between endometriosis and rs7521902 (A/C), rs16826658 (G/T), or rs7515106 (C/T). For each of the four single nucleotide polymorphisms, no association was found between patients with endometriosis-related infertility or primary infertility and the controls. The results demonstrated that WNT4 rs2235529 is associated with endometriosis in Chinese Han women, which may result in aberrant expression of WNT4, leading to the pathogenesis of endometriosis.
    Reproductive biomedicine online 01/2015;
  • Kim Dreyer, Peter G.A. Hompes, Velja Mijatovic
    [Show abstract] [Hide abstract]
    ABSTRACT: Consensus globally is that hydrosalpinges need to be treated before IVF owing to their negative influence on outcomes. The current standard treatment is laparoscopic salpingectomy. A potential less invasive treatment is proximal occlusion of a hydrosalpinx by hysteroscopic placement of an Essure® device. Tubal occlusion after Essure® placement needs to be verified by hysterosalpingography (HSG). This is a painful examination, however, that exposes patients to radiation. Hysterosalpingo-foam sonography (HyFoSy) is a less invasive alternative test to confirm proximal tubal occlusion. This prospective diagnostic accuracy study evaluated if HyFoSy is as accurate as HSG to confirm proximal tubal occlusion after placement of an Essure® device as treatment for a hydrosalpinx before IVF. Thirty-eight treated hydrosalpinges in 26 women were evaluated. Proximal occlusion was verified by HyFoSy (index test) and HSG (standard reference). The accuracy of HyFoSy was 97.4% (95% CI 92.3% to 100.0%). Sensitivity and specificity were 97.1% (95% CI.84.6% to 99.5%) and 100.0% (95% CI 40.2% to 100.0%), respectively. After an Essure® device is placed as treatment for a hydrosalpinx before IVF, HyFoSy is as able as HSG to confirm proximal tubal occlusion. If HyFoSy demonstrates tubal patency, a subsequent HSG needs to be carried out to validate this finding.
    Reproductive biomedicine online 01/2015;
  • Reproductive biomedicine online 12/2014; 29.
  • Bin Xu, Qiong Zhang, Jie Hao, Dabao Xu, Yanping Li
    [Show abstract] [Hide abstract]
    ABSTRACT: The efficacy of two granulocyte colony-stimulating factor (G-CSF) protocols for thin endometrium were investigated. Eight-two patients were diagnosed with thin endometrium (<7 mm). Thirty patients with previously cancelled embryo transfers received intrauterine G-CSF in subsequent frozen embryo transfer (FET) cycles. Patients were divided into the G-CSF only and G-CSF with endometrial scratch subgroups. Compared with previous cycles, endometrial thickness increased from 5.7 ± 0.7 mm to 8.1 ± 2.1 mm after G-CSF treatment (P < 0.001). Endometrial thickness increases were not significantly different between the two subgroups. The G-CSF with endometrial scratch subgroup established nominally higher though non-significant clinical pregnancy and live birth rates than the G-CSF only subgroup (53.8 % versus 42.9% and 38.5% versus 28.6%, respectively). Fifty-two patients underwent FET despite edometrial thickness less than 7 mm, and were included as controls. Significantly higher embryo implantation and clinical pregnancy rates were observed in the G-CSF group compared with the control group (31.5% versus 13.9%; P < 0.01; 48.1% versus 25.0%; P = 0.038, respectively). Endometrial scracth did not impair G-CSF treatment for thin endometrium and favoured pregnancy and live birth rates. For patients with thin endometrium, embryo transfer cancellation and G-CSF treatment in subsequent FET cycles is beneficial.
    Reproductive biomedicine online 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Over the past 30 years, The World Health Organization has serially measured norms for human sperm. In this study, 1999 and 2010 semen analysis norms as predictors of pregnancy were compared during intrauterine insemination (IUI). A retrospective cohort study was conducted using data collected from the Stanford Fertility Center, between 2005 and 2007, with 981 couples undergoing 2231 IUI cycles. Collected semen was categorized according to total motile sperm counts (TMSC): ‘N. 1999 TMSC’, ‘AbN. 1999/N. 2010 TMSC’, or ‘AbN. 2010 TMSC’. Sample comparison was also based on individual semen parameters: ‘N. 1999 WHO’, ‘AbN. 1999/N. 2010 WHO’, or ‘AbN. 2010 WHO’. Pregnancy (defined by beta-HCG concentration) rates were calculated. Data were compared using correlation coefficients, t-tests and chi-squared tests, with and without adjusting for confounders. Pregnancy rate comparison based on TMSC (‘N. 1999 TMSC’, ‘AbN. 1999/N. 2010 TMSC’ and ‘AbN. 2010 TMSC’) showed a negative correlation (r = −0.41, P = 0.05). Pregnancy rate did not differ when comparisons were based on the presence of abnormal parameters, even when controlling for confounders. Therefore, TMSC based on the 1999 parameters shows best correlation with pregnancy rate for IUI; updating these norms in 2010 has little clinical implication in infertile populations.
    Reproductive biomedicine online 12/2014;
  • C. Motteram, B. Vollenhoven, N. Hope, T. Osianlis, L.J. Rombauts
    [Show abstract] [Hide abstract]
    ABSTRACT: The effectiveness of combined co-treatment with aspirin, doxycycline, prednisolone, with or without oestradiol patches, was investigated on live birth (LBR) rates after fresh and frozen embryo transfers (FET) in IVF and intracytoplasmic sperm injection cycles. Cases (n = 485) and controls (n = 485) were extensively matched in a one-to-one ratio on nine physical and clinical parameters: maternal age, body mass index, smoking status, stimulation cycle number, cumulative dose of FSH, stimulation protocol, insemination method, day of embryo transfer and number of embryos transferred. No significant differences were found in fresh cycles between cases and controls for the pregnancy outcomes analysed, but fewer surplus embryos were available for freezing in the combined adjuvant group. In FET cycles, LBR was lower in the treatment group (OR: 0.49, 95% CI 0.25 to 0.95). The lower LBR in FET cycles seemed to be clustered in patients receiving combined adjuvant treatment without luteal oestradiol (OR 0.37, 95% CI 0.17 to 0.80). No difference was found in LBR between cases and controls when stratified according to the number of previous cycles (<3 or ≥3). There is no benefit of this combined adjuvant strategy in fresh IVF cycles, and possible harm when used in frozen cycles.
    Reproductive biomedicine online 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this case series study was to investigate the effect of adjusting the length of progesterone exposure on clinical pregnancy rates in cryopreserved embryo transfer cycles of patients with out-of-phase classic endometrial dating. Eighty infertile women with previous implantation failure and good-quality embryos underwent endometrial biopsy before cryopreserved embryo transfer and were included in this study. The main outcome measures were clinical pregnancy rate and histologic endometrial dating. After adjusting the length of progesterone exposure according to endometrial dating, a significantly higher implantation rate was observed in blastocyst transfers (P = 0.02) and the clinical pregnancy rate for all cycles was 36.4%, similar to that in patients with in-phase endometrium (22.5%). In conclusion, the use of classic histologic endometrial dating to estimate the timing of the window of implantation and to adjust progesterone exposure accordingly may increase the implantation rate in frozen embryo transfer cycles.
    Reproductive biomedicine online 12/2014;
  • V. Viardot-Foucault, S. Nadarajah, W.K. Lye, H.H. Tan
    [Show abstract] [Hide abstract]
    ABSTRACT: Scheduling gonadotrophin-releasing hormone antagonist (GnRH-ant) cycles for IVF intracytoplasmic sperm injection in patients is a challenge because of unpredictable ovum retrieval procedures on weekends, when less manpower is available. Recently, the use of GnRH-ant pre-treatment to delay an IVF and intracytoplasmic sperm injection (ICSI) cycle showed no negative effect on clinical pregnancy rates. An age-matched, case-control study was conducted to evaluate the effectiveness of such pre-treatment for scheduling purposes. Patients (n = 140) undergoing their first ovarian stimulation for IVF–ICSI were included. Patients starting their stimulation on Tuesdays or Wednesdays were most likely to have their ovum retrieval procedure on Saturdays. Seventy patients received a 3-day course of GnRH-ant before starting stimulation, and were compared with 70 age-matched controls not receiving pre-treatment. The main outcomes were the proportion of ovum retrieval procedures occurring on Saturdays, clinical pregnancy rate and live birth rates. A five-fold reduction in the number of ovum retrievals occurred on Saturdays compared with controls (7.1% versus 34.3%; OR 0.15; 95% CI 0.05 to 0.42; P < 0.001), with no significant differences in clinical pregnancy rate (40.9% versus 37.5%) and live birth rate (27.3% versus 31.3%). GnRH-ant pre-treatment is an effective tool for scheduling of GnRH-ant cycles.
    Reproductive biomedicine online 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Little is known about the effects of human embryo cryopreservation on developmental potential. Initial beta-HCG, indicating embryo implantation, was measured in 322 single embryo transfer cycles (246 fresh and 76 thawed-warmed). Median initial beta-HCG was higher for fresh compared with thawed-warmed transfers (126 versus 100 mIU/ml; P = 0.04). Blastocyst slow cooling resulted in a lower initial beta-HCG compared with vitrification (P = 0.01). Live birth rates were lower for blastocyst slow cooling (25%) compared with vitrification (71%) and fresh transfer (70%). We conclude that cryopreservation may impair an embryo's ability to produce beta-HCG, but that vitrification does not impair developmental potential. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
    Reproductive biomedicine online 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: KIAA0319L, PXK and JAZF1 gene polymorphisms were investigated to determine whether they conferred susceptibility to unexplained recurrent pregnancy loss (URPL) in a group of Chinese Han patients. Genotyping and sequencing of the single nucleotide polymorphisms (SNP) rs2275247(A/G) in KIAA0319L, rs2176082(C/T) and rs6445975(G/T) in PXK and the rs1635852(C/T) in JAZF1 were carried out in 84 couples with URPL and 102 healthy couples with at least one live birth. Frequencies of the SNP rs2176082(C/T) in PXK gene were significantly different between women with URPL and control women: P < 0.05; OR 95% CI 0.530 (0.287 to 0.979); OR 95% CI 0.482 (0.254 to 0.911) but were not significantly different after Bonferroni correction. The frequencies of the SNP rs2176082(C/T) in PXK gene showed no difference between the husband of a woman with URPL and a control husband: OR 95% CI 1.494 (0.821 to 2.721); OR 95% CI 1.567 (0.841 to 2.921). No statistically significant differences were observed in the distribution of any genotype or allele frequency or any genetic model of the other three SNPs between couples with URPL and control couples. Therefore, the rs2176082(C/T) polymorphism of PXK might play a possible role in the development of URPL in Chinese Han women. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
    Reproductive biomedicine online 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite a growing body of research examining the psychosocial issues involved in oocyte donation, few studies have examined the role of information in the process of donor selection. The aim of this interview-based qualitative study was to understand how donor oocyte recipients relate to information provided about potential oocyte donors, how they use this information to select donors and their preferences for, and reactions to, various types of information provided to them. Donor oocyte recipients who underwent treatment between 1995 and 2011 were recruited for participation from an academic centre for reproductive medicine. Twenty-two oocyte donor recipients participated. Findings indicate that recipients use information to select donors who they believe would enable them to fulfill their priorities: having a healthy child and 'passing' as genetically related. Obtaining more specific information prompted a focus on donor imperfections and presented a burden of choosing. Moreover, for participants preferring distance, having more information created dilemmas by making the donors less abstract. Although more information and options are often desired by oocyte donor recipients, increased choice can also present psychological dilemmas and emotional costs. Further research is needed to investigate the influence of information-related conflicts on patient decision-making, post-treatment emotional adjustment and disclosure decisions. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
    Reproductive biomedicine online 12/2014;
  • F. Olivennes, G. Trew, A. Borini, F. Broekmans, P. Arriagada, D.W. Warne, C.M. Howles
    [Show abstract] [Hide abstract]
    ABSTRACT: In this randomized, controlled, open-label, phase IV study, ovarian response after a follitropin alfa starting dose determined by the CONSORT calculator was compared with a standard dose (150 IU). Normo-ovulatory women (aged 18–34 years) eligible for assisted reproductive techniques were recruited (23 centres: nine European countries and Chile); 200 women were randomized (CONSORT [n = 96]; standard dosing [n = 104]). Significantly lower mean daily (121.5 versus 167.4 IU; P < 0.001) and total (1288.5 versus 1810.0 IU; P < 0.001) doses of follitropin alfa were administered in the CONSORT group. Clinical pregnancy rates were CONSORT (36.0%) and standard dosing (35.5%); estimated difference (confidence interval 0.6%; −13.5 to 14.6). Ovarian hyperstimulation syndrome occurred in 6.3% and 12.5% of patients in the CONSORT and standard-dosing groups, respectively. The primary efficacy analysis found a significantly lower mean [SD] number of oocytes retrieved in the CONSORT (10.0 [5.6]; P = 0.037) versus standard-dosing group (11.8 [5.3]). Although the CONSORT calculator was statistically inferior to standard dosing in the number of oocytes retrieved, clinical pregnancy rates (fresh embryo transfers) were similar in both groups, and incidence of ovarian hyperstimulation syndrome was lower in the CONSORT group.
    Reproductive biomedicine online 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: In many clinics, good-quality embryos are selected for embryo transfer and cryopreservation at the cleavage stage, and poor-quality embryos are discarded. The aim of this retrospective study was to examine how many repeated IVF cycles could be avoided by culturing the cleavage stage poor-quality embryos to blastocyst stage and transferring them after vitrification and warming (604 IVF and intracytoplasmic sperm injection [IVF-ICSI] cycles were included). Poor-quality cleavage stage embryos not eligible for transfer or cryopreservation were cultured until day 5 or 6, and those developing to the blastocyst stage were vitrified. The rate of vitrified blastocysts and clinical pregnancy and delivery rate of the warmed blastocysts was evaluated. The effect of the extended culture on the cumulative delivery rate, and the number of avoided new treatment cycles was calculated. The surplus blastocysts resulted in clinical pregnancy, spontaneous abortion and delivery rates of 24.6%, 27.3% and 17.2% respectively. The use of surplus blastocysts raised cumulative delivery rate from 43% to 47% and 53 repeated new cycles were avoided. This study shows that the cumulative delivery rate can be increased, and repeated IVF-ICSI treatments avoided by using blastocysts developing from poor-quality cleavage stage embryos, which otherwise would have been discarded. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
    Reproductive biomedicine online 12/2014;