Jorge Ten

• Ph.D
• Instituto Bernabeu and University of Alicante

Background Data sciences and artificial intelligence are becoming encouraging tools in assisted reproduction, favored by time-lapse technology incubators. Our objective is to analyze, compare and identify the most predictive machine learning algorithm developed using a known implantation database of embryos transferred in our egg donation program,...

Study question Are there morphokinetic differences between balanced and unbalanced embryos after PGT-SR? Summary answer The total time embryos remain at the morula stage (TiCAV- TM) could be a morphokinetic marker to consider in PGT-SR cycles. What is known already Due to the preimplantation genetic testing for structural rearrangements (PGT-SR)...

Study question Do luteal phase (LF) embryos have the same outcomes in laboratory and morphokinetics parameters and clinical and genetic rates that follicular phase (FF) embryos? Summary answer Laboratory outcomes, ploidy and clinical rates result similar between two phases. In morphokinetic analysis we obtained significant differences in the durat...

Study question Is it possible to score the mosaic embryos in order to prioritise them according to their pregnancy potencial? Summary answer The machine-learning score underscores the crucial role of embryo quality over mosaicism, prioritizing high-quality, day-5 biopsied embryos for enhanced live birth outcomes in ART. What is known already Afte...

Study question Does the Duostim protocol, evaluated by embryologists and AI, yield similar embryo quality in both cycles, and what impact does it have on reproductive outcomes? Summary answer Duostim protocol, when assessed by both AI and embryologists, maintains consistent embryo quality, making it a promising therapeutic option in assisted repro...

Study question Is there an optimal range of morphokinetic parameters that have a higher LB rate, if so what is the percentage of LB improvement? Summary answer Optimal embryo development range in morphokinetic parameters was identified in t6, t8, tB, t8-t4 and t8-t2 leading to a 5% improvement in LB. What is known already Achieving LB is the main...

Study question Does Progesterone Primed Ovarian Stimulation (PPOS) demonstrate comparable efficiency to the GnRH-antagonist protocol in terms of laboratory/reproductive outcomes in PGT-A cycles with donated oocytes? Summary answer PPOS demonstrates efficiency in PGT-A cycles with donated oocytes, comparable to the GnRH-antagonist protocol, providi...

Embryo culture is one of the most important steps in an assisted reproduction laboratory. Embryos can be cultured individually, one embryo per media drop, or in groups, culturing several embryos in the same media drop. Due to the controversy generated on this subject, we wondered which embryo culture method would have the best results in terms of q...

Purpose: Evaluate which factors are involved in the increased rate of mosaicism in embryos. Methods: A systematic review and meta-analysis was performed. After an exhaustive search of the literature, a total of seven papers were included in the analysis. In addition, data collected from IVF cycles performed in our fertility clinic were also anal...

Objective To compare the oocyte yield between follicular-phase stimulation (FPS) and luteal-phase stimulation (LPS) in suboptimal responders. Design Prospective, randomized, crossover clinical trial. Patient(s) Forty-one patients with infertility according to the POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) cri...

Study question Can an automatic AI scoring system predict ploidy, live birth and utilization? Are there differences in AI scoring between donor and own gametes? Summary answer CHLOE-EQ Score is directly associated with oocyte quality, ploidy, utilization, live birth, embryo quality, direct uneven cleavage (DUC), blastulation, utilization and selec...

Study question Which strategy is best for poor-prognosis patients: Two ICSI-PGTA cycles fresh oocytes (follicular plus luteal phase) or one ICSI-PGTA cycle with vitrified and fresh oocytes?" Summary answer Laboratory outcomes, ploidy rates and clinical results after euploid blastocyst transfer are similar between the two DualStim/PGTA strategies....

Study question Is there a relationship between the chromosomal status of biopsied embryos and the presence of polymorphic variants in the female karyotype in IVF cycles? Summary answer The chromosomal status of biopsied embryos is prejudiced because of the presence of specific maternal polymorphic variants (qh-, qh+ and ps+) or combinations of the...

Study question Do polymorphic variants in the karyotype of women undergoing an IVF cycle directly affect oocyte and embryo laboratory parameters? Summary answer The presence of certain polymorphic variants negatively affects the oocyte survival rate and the blastocyst quality in an IVF cycle. What is known already In the recent years, there has b...

Research question: What is the effect of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in young oocyte donors in terms of ovarian response to stimulation, fertilization rate, embryo development and clinical outcomes in recipients? Design: This retrospective, multicentre cohort study evaluated 115 oocyte donors who...

Research Question : To establish a machine learning model that would allow to predict aneuploidies and mosaicism in embryos coming from IVF treatments, and thus would help to determine which variables are associated with these chromosomal alterations. Design : The study design is observational and retrospective. A total of 6989 embryos from 2476 P...

Study question Is there a role for sperm selection based on the capacity to pass through cumulus oophorous column in improving the laboratory outcomes in ICSI cycles? Summary answer A higher rate of blastocyst formation and quality are obtained with the use of CCs to select spermatozoa for ICSI compared to conventional density gradients. What is...

Study question Does group embryo culture improve blastocyst formation compared to individual culture? Summary answer Individual culture provides an increased blastocyst formation rate. What is known already Embryo culture is one of the most important steps of an IVF treatment. Several studies pointed out that group embryo culture could help embry...

Study question Are quality control (QC) parameters in NGS results related to mosaicism rate in trophoectoderm samples? Summary answer A high number of filtered reads in PGT-A results correlates with a higher mosaicism rate. But the overall noise does not influence the mosaicism rate. What is known already The implementation of NGS have led to inc...

Study question What is the effect of mRNA SARS-CoV-2 vaccines on oocyte donors regarding oocyte quality, embryo development and clinical outcomes? Summary answer Oocyte quality, fertilization, blastocyst formation, embryo quality and pregnancy rates were similar following donors' mRNA SARS-CoV-2 vaccination compared to previous oocyte donation cyc...

Study question What is the optimal endometrial preparation protocol for a frozen embryo transfer (FET) with regards to clinical results? Summary answer A similar pregnancy and miscarriage rate is expected with either protocol of endometrial preparation for frozen embryo transfer. What is known already An optimal endometrial preparation for FET is...

Study question What factors are involved in chromosomal mosaicism in human blastocysts? Summary answer Progenitors’ age and embryo biopsy day are associated with mosaicism rate. What is known already Chromosomal abnormalities are common in embryos analyzed in preimplantation genetic testing for aneuploidy (PGT-A) cycles. Mosaicism is a usual even...

Study question Which is the most predictive parameter when machine learning (ML) is applied to a known implantation database (KID) of day 5 embryo transfer database in an egg donation program? Summary answer Time to hatching (tiHB) is the most predictive embryonic parameter when machine learning algorithms were used on reproductive data in an oocy...

Research question : Is the embryo cryopreservation process the cause for high birth weight and large-for-gestational-age (LGA) in Frozen Embryo Transfer (FET) singletons? Design : This retrospective cohort study evaluated 670 oocyte recipients who made fresh (367 cycles) or frozen embryo transfer (303 cycles) at Instituto Bernabeu between July 201...

Uterine microbiota may be involved in reproductive health and disease. This study aims to describe and compare the vaginal and endometrial microbiome patterns between women who became pregnant and women who did not after in vitro fertilization. We also compared the vaginal and endometrial microbiome patterns between women with and without a history...

Study question Could the presence of chromosomal polymorphisms in women undergoing fertility treatments influence ovarian reserve, oocyte preservation or IVF clinical outcomes? Summary answer Polymorphic variants of chromosomes seem to adversely influence the Anti-Müllerian Hormone (AMH) serum levels and the post-thawing oocyte survival rate. Wha...

Study question Is it possible to predict the likelihood of an IVF embryo being aneuploid and/or mosaic using a machine learning algorithm? Summary answer There are paternal, maternal, embryonic and IVF-cycle factors that are associated with embryonic chromosomal status that can be used as predictors in machine learning models. What is known alrea...

Study question Is the freezing process responsible to increase the birthweight or the incidence of Large for Gestational Age (LGA) in Frozen Embryo Transfers (FET)? Summary answer Neither the birthweight nor the LGA incidence were different in embryos that underwent the freezing-thawing process. What is known already Freezing-thawing constitutes...

Study question What is the effect of artificial laser-assisted collapse before vitrification on pregnancy and implantation rates after transfer of vitrified-warmed blastocysts? Summary answer The artificial shrinkage by laser-induced collapse before vitrification significantly increased the implantation and clinical pregnancy rates after single th...

Study question For donor oocyte recipients, are clinical outcomes superior for fresh versus frozen euploid embryos? Summary answer Among donor oocyte recipients receiving euploid embryos, fresh embryos are associated with superior clinical outcomes when compared with frozen embryos. What is known already A recent large retrospective cohort nation...

Study question Could cryptic subtelomeric traslocations in early recurrent miscarriage patients be diagnosed by preimplantation genetic testing? Summary answer PGT is a powerful tool to detect subtelomeric cryptic traslocations identifying the cause of early recurrent miscarriage and allowing subsequent genetic counselling. What is known already:...

The evaluation of sperm DNA fragmentation has been postulated as a predictive molecular parameter of the semen fertilising potential, as well as the ability to give rise to a healthy embryo and an ongoing pregnancy. However, there are controversial results due to oocyte quality, the use of different measurement techniques and interpretation criteri...

There is a high incidence of chromosome abnormalities in human embryos that leads to a failed IVF cycle. Different studies have shown that maternal age is the determining factor in the appearance of chromosomal alterations in the embryo. However, the possible influence of ovarian stimulation on oocyte and embryo aneuploidies and mosaicism is contro...

Research Question Are discordances in niPGT-A results attributable to the technique used for chromosomal analysis? Design A prospective blinded study was performed (September 2018-December 2019). In total 302 chromosomal analyses were performed: 92 TE-PGT-A biopsies and their corresponding spent embryo culture medium (SCM) evaluated by two methods...

Objective: Monozygotic twinning incidence following preimplantation genetic testing in embryos at cleavage-stage does not appear to increase; however, data regarding the possible impact of the blastocyst-stage preimplantation genetic testing is lacking. We compared the incidence of monozygotic twinning in preimplantation genetic testing cycles per...

Background: The vaginal microbiome plays an important role in maintaining health, and there is evidence that microbial colonization of the upper genital tract can also influence successful embryo transfer. The aim of this study is to determine whether the vaginal and endometrial microbiome in people undergoing assisted reproduction techniques could...

Background: In young women with poor ovarian response, luteal-phase ovarian stimulation (LPOS) is a potential method for collecting competent oocytes. The aim of this study was to assess the efficacy of LPOS compared with follicular phase ovarian stimulation (FPOS) in young women with poor ovarian response (POR). Methods: This single-center, pro...

There is no evidence for the superiority of conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) using donor oocytes. This retrospective descriptive study aimed to compare the outcomes of conventional IVF (n = 506) and ICSI (n = 613) with donor oocytes in (n = 968) normozoospermic patients. Although the fertilization...

Purpose To determine the consequences of an altered sperm fluorescence in situ hybridization (FISH) result for ART outcomes and the indications for a sperm FISH analysis. Methods Data from 439 infertile men were collected. Bivariate analyses were performed to determine the association of men’s age, seminal alterations, and sperm FISH indication, w...

Purpose To investigate if the vaginal microbiome influences the IVF outcome. Methods Thirty-one patients undergoing assisted reproductive treatment (ART) with own or donated gametes and with cryotransfer of a single euploid blastocyst were recruited for this cohort study. Two vaginal samples were taken during the embryo transfer procedure, just be...

STUDY QUESTION Do mitochondrial DNA (mtDNA) copy number and heteroplasmy in human embryos affect the ongoing pregnancy rate? SUMMARY ANSWER Our study suggests that mtDNA copy number above a specific threshold is associated with the ongoing pregnancy rate. WHAT IS KNOWN ALREADY Mitochondria play a vital role in cell function. Recently, there has b...

Objective: To compare the clinical outcomes of an elective vitrification program with those of a fresh embryo transfer program including vitrification of the remaining embryos. Material and methods: Retrospective study of 99 cycles from the elective vitrification program (Group A) and 150 cycles from the nonelective vitrification program (Group B)...

The survival of human blastocysts to vitrification with two different carriers is compared. Both vitrification carriers used in this study are in the category of closed carriers, as they completely isolate the samples from direct contact with liquid nitrogen or its vapours during cooling and storage, until warming. This characteristic is appealing...

The endocannabinoids are cannabinoids synthesized by mammalian tissues. These compounds are closely related to the regulation of the male reproductive system. However, little is known about the effects produced by 2-arachidonoylglycerol (2AG) on in vitro human sperm functions. This study was undertaken to determine the effects produced by 2AG on fr...

Chromosomal mosaicism is a relatively common finding in human IVF embryos. However, the association between mosaicism in trophoectoderm and inner mass cells, the mechanisms involved, and its effects on implantation are far from established. We retrospectively reanalyzed array-CGH results from 1,362 trophoectoderm biopsies. We detected chromosomal m...

La transferencia de embriones de mala calidad, se asocia a un mayor número de anomalías congénitas, tanto cromosómicas como malformaciones anatómicas. RESUMEN Objetivo: Conocer la posible relación entre la calidad de los embriones transferidos en ciclos de Fe-cundación In Vitro (FIV) y Microinyección Intracitoplásmica de Espermatozoides (ICSI) con...

Unlabelled: Chromosomal polymorphisms involve heterochromatic regions and occur in the general population. However, previous studies have reported a higher incidence of these variants in infertile patients. The aim of this study was to examine the relationship between polymorphic variants and infertility and their association with aneuploidies in...

Background: Fertilization is a key physiological process for the preservation of the species. Consequently, different mechanisms affecting the sperm and the oocyte have been developed to ensure a successful fertilization. Thus, sperm acrosome reaction is necessary for the egg coat penetration and sperm-oolema fusion. Several molecules are able to i...

To know the molecular aspects that occur in the process of human sperm binding to the human zona pellucida (ZP) is one of the great challenges of reproduction biology. Moreover knowing if the fertilization process may be affected by cryopreservation of female gametes is still another issue discussed in the literature. Based on this, the main object...

To know the molecular aspects that occur in the process of human sperm binding to the human zona pellucida (ZP) is one of the great challenges of reproduction biology. Moreover knowing if the fertilization process may be affected by cryopreservation of female gametes is still another issue discussed in the literature. Based on this, the main object...

La azoospermia y la criptozoospermia son enfermedades relativamente comunes entre los varones, teniendo que recurrir a tratamientos de reproducción asistida (TRA) si desean tener descendencia. En este trabajo se valoró el comportamiento cinético y la morfología embrionaria en los primeros días de desarrollo en función de si la muestra seminal emple...

The human androgen receptor (AR) gene contains a highly polymorphic CAG repeat sequence within exon 1. In-vitro studies have shown a relationship between CAG repeats in the AR gene and its transactivation potential. This variation in length may play a role in anovulatory infertility. The objective of this study was to investigate whether CAG polymo...

Objective To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Design Prospective cross-sectional study. Setting Multicenter study. Patient(s) Seven hundred embryo transfers and 1,028 early-stage human embryos. Intervention(s) None. Main Outcome Measure(s) Implantation according to the presenc...

Objective To describe and compare the ultrastructural alterations, DNA fragmentation and acrosome status that could cause sperm immobilisation prior to intracytoplasmic sperm injection, in samples from normozoospermic and teratozoospermic males. Material and methods For this study we used 15 sperm samples from consenting normozoospermic donors and...

Investigate whether R72P on p53 gene polymorphism has a higher prevalence among women with a history of recurrent implantation failure (RIF) and pregnancy loss (RPL) and its influence in their IVF cycle outcome. p53 polymorphism R72P has been studied in 181 women. The control group included 83 oocyte donors. In the study group 98 women were include...

Objective: The aim of this study was to investigate whether N680S FSHR polymorphism has a predictive value for the ovarian response to stimulation with gonadotropins and cycle outcome in our egg donor program. Methods: The oocyte donor candidates were selected according to the Instituto Bernabeu egg donation program requirements and ASRM and ESH...

The search of metabolites which are present in biological samples and the comparison between different samples, allow the construction of certain biochemical patterns. The Mass Spectrometry (MS) methodology applied to the analysis of biological samples makes it possible the identification of many metabolites. Each obtained signal (m/z) is character...

Tubulin is a protein constituent of cytoskeletal microtubules, closely related to sperm motility. However, the changes in tubulin distribution following capacitation and acrosome reaction are poorly understood. This study immunolocalized and quantified the expression of α-tubulin in fresh, capacitated and acrosome-reacted samples. Immunocytochemica...

It has been hypothesized that exposure to heavy metals may impair male reproduction. To measure the effect produced by low doses of heavy metals on semen parameters, it is necessary to clarify in which body fluids those measurements must be performed. Sixty-one men attending infertility clinics participated in our study. Concentrations of lead, cad...

Fragile X syndrome is associated with low ovarian reserve and poor ovarian response. The aim of this study was to investigate whether CGG repeats on the fragile X mental retardation 1 (FMR1) gene have predictive value for ovarian response to stimulation with gonadotrophins and for clinical outcome in our oocyte donation program. Oocyte donor candid...

We present here a new metabolomic methodology to predict embryo implantation ability in in vitro fertilization (IVF). In the present study we have included a total of 23 patients scheduled for IVF. Embryos were selected to be transferred by using morphological criteria on day 3 of in vitro culture. The relative amino acid concentrations in the embr...

Animal studies have shown the reproductive toxicity of a number of heavy metals. Very few human observational studies have analyzed the relationship between male reproductive function and heavy metal concentrations in diverse biological fluids. The current study assessed the associations between seminal and hormonal parameters and the concentration...

Human translocation carriers may present alterations in meiosis. Understanding the mechanism of meiotic segregation of reciprocal translocations is important for estimation of the risk of either pregnancy loss or birth defects. The objective of this work was to estimate meiotic segregation rates in preimplantation embryos from preimplantation genet...

Introduction “Quality of life” is used in healthcare to refer to an individual's emotional, social and physical wellbeing, including their ability to function in the ordinary tasks of living where the impact of a disease may reduce. Many studies demonstrate that infertile patients commonly experience feelings of depression, isolation, anxiety, grie...

We present a new methodology to predict embryo viability in assisted reproductive technology (ART) treatments by determining the relative amino acid concentrations in human embryo culture medium on day 3, using high-performance liquid chromatography with mass spectroscopy analysis without derivatization. The model was performed with soft independen...

To compare specific nutrient intake between normospermic and oligoasthenoteratospermic patients attending infertility clinics in two Mediterranean provinces of Spain. Case-control study. Private fertility clinics in southeastern Spain. Thirty men with poor semen quality (case subjects) and 31 normospermic control subjects of couples attending our f...

The aim of this study was to perform preimplantation genetic diagnosis (PGD) for X-linked retinoschisis using multiple displacement amplification (NIDA) for whole genome amplification and linked markers to the RS1 gene. The study evaluates the ability of MDA to amplify the whole genome directly from a single blastomere. NIDA products were used for...