[Show abstract][Hide abstract] ABSTRACT: In contrast to the impact of elevated progesterone on endometrial receptivity, the data on whether increased progesterone levels affects the quality of embryos is still limited. This study retrospectively enrolled 4,236 fresh in vitro fertilization (IVF) cycles and sought to determine whether increased progesterone is associated with adverse outcomes with regard to top quality embryos (TQE). The results showed that the TQE rate significantly correlated with progesterone levels on the day of human chorionic gonadotropin (hCG) trigger (P = 0.009). Multivariate linear regression analysis of factors related to the TQE rate, in conventional IVF cycles, showed that the TQE rate was negatively associated with progesterone concentration on the day of hCG (OR was -1.658, 95% CI: -2.806 to -0.510, P = 0.005). When the serum progesterone level was within the interval 2.0-2.5 ng/ml, the TQE rate was significantly lower (P <0.05) than when the progesterone level was < 1.0 ng/ml; similar results were obtained for serum progesterone levels >2.5 ng/ml. Then, we choose a progesterone level at 1.5ng/ml, 2.0 ng/ml and 2.5 ng/ml as cut-off points to verify this result. We found that the TQE rate was significantly different (P <0.05) between serum progesterone levels < 2.0 ng/ml and >2.0 ng/ml. In conclusion, the results of this study clearly demonstrated a negative effect of elevated progesterone levels on the day of hCG trigger, on TQE rate, regardless of the basal FSH, the total gonadotropin, the age of the woman, or the time of ovarian stimulation. These data demonstrate that elevated progesterone levels (>2.0 ng/ml) before oocyte maturation were consistently detrimental to the oocyte.
[Show abstract][Hide abstract] ABSTRACT: Objective:
To investigate the vertical transmission of hepatitis B virus (HBV) via embryos to children and whether HBV in embryos has an effect on the development of the fetus and pregnancy outcomes of in vitro fertilization and embryo transfer (IVF-ET).
Long-term follow-up study.
Research laboratory in a university hospital.
Thirty-one couples with a hepatitis B surface antigen (HBsAg)-negative woman and HBsAg-positive man, and 41 couples with a HBsAg-positive woman and HBsAg-negative man, whose unfertilized oocytes and nonviable embryos were tested for HBV DNA, RNA, or HBsAg.
HBV DNA, RNA, or HBsAg analyses in unfertilized oocytes and nonviable embryos.
Main outcome measure(s):
HBV serologic markers analyses.
We obtained follow-up data for 71 couples. A total of 24 babies were born, and no newborns exhibited defects at birth. Twelve babies were born to couples with HBV-positive oocytes and/or embryos. The pregnancy outcomes were not associated with the presence of HBV in oocytes and embryos. Three patterns of HBV serologic markers were screened. Twenty babies were anti-HBs-positive. Three babies were negative for HBsAg, antibody to hepatitis B surface antigen (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), HBeAg, and antibody to hepatitis B e antigen (anti-HBe). One baby was seropositive for anti-HBs, anti-HBc, and anti-HBe at 6 months of age but seroconverted from anti-HBe-positive to anti-HBe-negative at 9 months of age.
The presence of HBsAg in oocytes and embryos may not result in the vertical transmission of HBV in the offspring of HBV carriers.
No preview · Article · Dec 2015 · Fertility and sterility
[Show abstract][Hide abstract] ABSTRACT: Objective: To analyze the incidence of ectopic pregnancy (EP) in fresh compared with frozen-thawed cycles. Design: Retrospective cohort study. Setting: Teaching hospital. Patient(s): Thirty-one thousand nine hundred twenty-five women undergoing in vitro fertilization-embryo transfer (IVF-ET) from January 2006 to December 2013. Intervention(s): Fresh IVF-ET compared with frozen-thawed ET (FET). Main Outcome Measure(s): Incidence of EP with fresh IVF-ET compared with frozen-thawed ET cycles, clinical pregnancy rate, and rate of EP per clinical pregnancy. Result(s): For the fresh IVF cycles, 19,173 patients underwent oocyte retrieval; 15,042 had an ET, 6,431 of these patients (42.7%) had a clinical pregnancy, and among these 297 (1.97%) appeared to have an EP. The group of patients undergoing frozen-thawed ET (12,752 patients) included 12,255; there were 5,564 pregnancies (45.4%) and 124 ectopic implants (1.01%). The incidence of an EP per clinical pregnancy was 4.62% for the fresh transfer group compared with 2.22% for the frozen-thawed cycle group; this difference was statistically significant. In addition, the fresh ET cycles had the highest risk of EP, followed by day-3 embryo FET cycles; blastocyst FET cycles had the lowest risk of EP, and the differences were all statistically significant. Conclusion(s): Frozen-thawed ET cycles were associated with a statistically significantly lower risk of EP when compared with fresh cycles. These findings are consistent with ovarian stimulation being associated with an increased risk of EP. (C) 2014 by American Society for Reproductive Medicine.
No preview · Article · Sep 2014 · Fertility and Sterility
[Show abstract][Hide abstract] ABSTRACT: This study measured the antioxidant activity of follicular fluid (FF) in infertile patients and assessed its possible correlation between ovarian stimulation and pregnancy outcomes. Samples from 191 infertile patients undergoing in vitro fertilization-embryo transfer (IVF-ET) were determined by α-diphenyl-β-picrylhydrazyl (DPPH) radical scavenging, reducing power, superoxide radical scavenging, β-Carotene bleaching assay, ferrothiocyanate and thiobarbituric acid assays. The comparison between a positive IVF outcome and FF's antioxidant activity was also studied. The results showed FF had strong antioxidant activity, which equated to common antioxidants Vc and BHT (100 μg/mL). Patients with endometriosis had less efficient antioxidant activity in FF than that of patients with tubal occlusion or polycystic ovary syndrome. In conclusion, this study detected, for the first time, the antioxidant activity of FF from patients undergoing an IVF and the FF exhibited strong antioxidant activity.
No preview · Article · Jun 2014 · International journal of clinical and experimental pathology
[Show abstract][Hide abstract] ABSTRACT: Background
Dehydroepiandrosterone (DHEA) is now widely used as an adjuvant to IVF treatment protocols in poor responders. However, clinical evidence for DHEA on improvement of ovarian response and IVF outcome is still limited, the validity of the results of the earlier studies, especially the varied inclusion criteria, is a subject of debate. Recently, the ESHRE Working Group developed a new definition, the Bologna criteria. The aim of the current study was to investigate the potential effect of DHEA treatment on in vitro fertilization (IVF) outcome of poor ovarian responders that fulfill the Bologna criteria.
This study investigated 386 poor ovarian responders that fulfill the Bologna criteria. Patients underwent IVF-ET treatment with the GnRH antagonist protocol. The study group contained 189 patients, who received 75 mg of DHEA daily (25 mg three times daily) before the IVF cycle. The control group was composed of 197 patients who received infertility treatment, but did not receive DHEA. The IVF outcome parameters in each group were compared.
The study and control groups did not show statistically significant differences in terms of patient demographics characteristics, mean numbers of oocytes retrieved, mature oocytes, fertilization rate, cleavage rate, or embryo availability. While the DHEA group demonstrated significantly higher implantation rates (18.7% vs. 10.1%; P<0.01) and ongoing PRs (26.7% vs. 15.8%; P<0.05) as compared with the control.
DHEA pre-treatment does not significantly increase oocyte yield. However, the ongoing PRs in this subgroup of women are significantly higher after DHEA administration, suggesting that DHEA may increase IVF results by improving oocyte and embryo quality.
[Show abstract][Hide abstract] ABSTRACT: Are other HOX genes, in addition to HOXA10, involved in endometrial receptivity?
The highly expressed HOXA9, HOXA11 and HOXD10 genes also appear to be involved in endometrial receptivity.
Within the HOX family of homeobox transcription factor genes are the leading candidates for the regulation of embryonic implantation. A crucial role of HOXA10 in endometrial receptivity has been well established.
To identify HOX candidate genes, we performed data mining on all 39 human HOX genes in the 'Human body index' gene expression database of normal human tissue. The temporal and spatial expression pattern of four highly expressed HOX genes in the human endometrium was determined. To further investigate the function of these Hox genes, we used a robust in vivo mouse model in which we blocked maternal Hox gene expression.
Analysis of a gene expression profile set in the public domain consisting of 504 samples representing 95 different normal human tissues, showed that in addition to HOXA10, also HOXA9, HOXA11, HOXB6 and HOXD10 mRNA showed increased expression in the human endometrium (16 samples). The temporal and spatial expression pattern of these four HOX genes throughout the menstrual cycle was determined in the endometrium from 27 female patients eligible for IVF-embryo transfer with a normal cycle by quantitative real-time PCR (qRT-PCR), western blot and immunohistochemistry. The role of maternal Hoxa9, Hoxa11 and Hoxd10 was assessed in a mouse implantation model by expression knockdown using RNA interference. Forty mice were transfected with Hoxa9-, Hoxa11- or Hoxd10-specific small hairpin RNA (shRNA) constructs or a vector control by injection into the uterine horn at Day 2 after vaginal plug detection (Day 1) (160 mice in total). The effects were examined by qRT-PCR and western blot at Day 4 and litter sizes counted at Day 9 of pregnancy.
HOXA10, HOXA9, HOXA11 and HOXD10 all showed increased expression during the mid-secretory phase of the menstrual cycle (P < 0.01). Knockdown of Hoxa9, Hoxa11 and Hoxd10 in the murine uterus resulted in significantly reduced average implantation rates (P < 0.01) and, with regard to four Hox target genes, also correlated with a significantly increased empty spiracles homolog 2 (Emx2) and insulin-like growth factor binding protein-1 (Igfbp1), and decreased integrin β3 (Itgb3) and leukemia inhibitory factor (Lif), expression (P < 0.01).
Menstrual cycle stage was not confirmed by serum hormone analysis. We verified the absence of significant differences in stage-specific expression of the reference genes used in our study (ACTB/Actb and GAPDH/Gapdh) and therefore possible limitations of this approach were minimized. In addition, the translatability of our data from a mouse model to patients needs to be investigated further.
We provide evidence that three other HOX genes in addition to HOXA10 are involved in endometrial receptivity, and that part of their function is asserted through several known HOX target genes, suggesting the presence of a central HOX signal transduction pathway.
This project was funded by the National Natural Science Foundation of China. The authors declare no conflict of interest.
Full-text · Article · Feb 2014 · Human Reproduction
[Show abstract][Hide abstract] ABSTRACT: Despite the fact that both gonadotropin-releasing hormone (GnRH) agonist and antagonist protocol are effective in suppressing the incidence of premature luteinizing hormone (LH) surges through reversibly blocking the secretion of pituitary gonadotropins, the exact impact of these two distinctive protocols on the clinical setting of patients for in vitro fertilization and embryo transfer (IVF-ET) treatment, however, remained controversial. We thus in the present report conducted a retrospective study to compare the impact of GnRH agonist and antagonist protocol on the same patients during controlled ovarian stimulation cycles. A total of 81 patients undergoing 105 agonist and 88 antagonist protocol were analyzed. We failed to detect a significant difference between two protocols for the difference in duration of ovarian stimulation, number of recombinant FSH (Gonal-F) ampoules used, number of oocytes retrieved, serum levels for estradiol (E2) and progestone (P), thickness of endometrium, and the zygote- and blastocyst-development rate. It is seemly that high quality embryo rate was higher in the antagonist protocol, but the data did not reach a statistical significance. Nevertheless, Implantation rate and clinical pregnancy rate were significantly higher in the antagonist protocol (10.64% and 30.26%, respectively) than that of the agonist protocol (5.26% and 15.82%, respectively). Our data also suggest that the GnRH antagonist protocol is likely to have the advantage for improving the outcome of pregnancy in those patients with a history of multiple failures for the IVF-ET treatment.
No preview · Article · Sep 2013 · International journal of clinical and experimental pathology
[Show abstract][Hide abstract] ABSTRACT: Surplus embryos available for cryopreservation in fresh cycles are considered as having good potential for future use. However, the optimal stage of embryo cryopreservation remains unclear. In this study, 1190 patients with surplus embryos on day 3 were divided into two groups: cleavage-stage embryo cryopreservation (control group) and blastocyst cryopreservation (blastocyst group). The clinical outcomes of the subsequent warming cycles were evaluated. The proportion of cycles with blastocyst formation was 73.8% in the blastocyst group. Although in the blastocyst group, the cancellation rate of blastocyst transfer was increased due to lack of blastocysts available for cryopreservation, the blastocyst group achieved significantly higher rates of clinical pregnancy/ cycle (43.2% versus 34.9%; P = 0.003), pregnancy/ transfer (59.5% versus 35.4%; P < 0.001) and implantation (46.5% versus 22.2%; P < 0.001) from the first warming cycle compared with the control group. In an embryo-number classified analysis, the clinical pregnancy rate was also higher in the blastocyst group. However, the cumulative pregnancy was similar between the two groups. Blastocyst culture as an embryo selection tool will not improve embryo viability but it will help patients to achieve pregnancy more quickly. Extended culture of surplus embryos to the blastocyst stage for cryopreservation optimizes the clinical outcomes. RBMOnline
[Show abstract][Hide abstract] ABSTRACT: Embryos with a poor morphological score at cleavage stage are usually discarded because they are considered unsuitable for transfer and cryopreservation. This study examined the in vitro blastocyst development after extended culture of these embryos and the clinical outcomes after transfer of these blastocysts in warming cycles. A total of 597 blastocysts (24.7%) were obtained from 2421 embryos with low morphological scores after extended culture. One hundred and sixty blastocysts (6.6%) with optimal morphology were vitrified. Embryo utilization rate was increased from 30.8% to 32.6%. After warming, 61 out of 92 blastocysts (66.3%) survived and were transferred in 44 cycles. The clinical pregnancy rate and the implantation rate were 40.9% (18/44) and 32.8% (20/61) respectively. Thirteen healthy babies were born, and 5 pregnancies aborted spontaneously. Our study suggested that some blastocysts derived from embryos with a poor morphological score can be successfully vitrified and give rise to live births. Selection and vitrification of viable embryos after extended culture of embryos with a poor morphological score may constitute a proposal to avoid embryo wastage.
No preview · Article · Jun 2012 · Journal of Huazhong University of Science and Technology
[Show abstract][Hide abstract] ABSTRACT: To investigate the relationship between serum P levels on the day of hCG administration and pregnancy outcomes in different responders undergoing IVF.
A total of 11,055 women who underwent their first IVF/intracytoplasmic sperm injection cycles and a subgroup of 4,021 women undergoing frozen-embryo transfer (FET) cycles.
Patients underwent IVF-ET with the long GnRH agonist protocol. The ovarian response was classified as high (≥ 20 oocytes; n = 2,023), poor (≤ 4 oocytes; n = 827), or intermediate (remaining cases; n = 8,205) according to the number of oocytes retrieved. Clinical outcomes of IVF-ET and FET cycles were analyzed according to plasma P levels.
Ongoing pregnancy rates (PRs).
Ongoing PRs in fresh cycle were inversely associated with serum P levels on the day of hCG administration for all patients. Different P threshold concentrations were determined according to different ovarian response: We proposed a serum P level of 1.5 ng/mL as the threshold for poor responders, 1.75 ng/mL for intermediate responders, and 2.25 ng/mL for high responders. Our study does not show negative results for elevated P levels on oocyte performance in terms of fertilization, cleavage rate, or PR of FET cycles within different ovarian responses, offering no evidence for a detrimental effect of high P on oocyte quality.
Elevated P levels on the day of hCG administration negatively influence PR regardless of different ovarian responses, although increased P threshold concentration is associated with better ovarian responses. The detrimental effect of P elevation on PR seems to be unrelated to oocyte quality in all responders.
No preview · Article · Apr 2012 · Fertility and sterility
[Show abstract][Hide abstract] ABSTRACT: Modified laparoscopic microsurgical tubal anastomosis is an alternative for microsurgical anastomosis via laparotomy to reverse sterilization in women with renewed child wish. The current study aims to evaluate the fertility outcome after modified laparoscopic microsurgical tubal anastomosis. A retrospective study was performed. Fifty-eight women who underwent modified laparoscopic microsurgical tubal anastomosis were monitored to investigate the fertility outcome and characteristics of this new technology. Of the 58 patients, the cumulative pregnancy rate (PR) in the 42 patients with follow-up data was 23.8% (10/42), 57.1% (24/42), 66.7% (28/42), and 73.8% (31/42) within 6, 12, 24, and 36 months after surgery, respectively. The intrauterine PR was 69.0% (29/42). Two patients (4.8%) had ectopic pregnancies that occurred within 24 months of surgery; three cases ended in spontaneous abortion. The delivery rate was 83.9% (26/31). The length of operating time was 1.2±0.3 h, with a range of 1.0-2.5 h (60-145 min), and the mean time was approximately 75 min. The blood loss was relatively small, between 10 and 50 ml with an average amount of 22 ml. Thus, the modified laparoscopic tubal anastomosis is a highly successful procedure and a viable alternative to open abdominal microsurgical approaches. Compared with the traditional laparoscopic tubal sterilization reversal, this modified approach has three advantages: (1) less invasive approach via a trocar reduction; (2) remodeling of tube is better performing tied together after 3-4 sutures; and (3) faster operating time.
No preview · Article · Sep 2011 · Frontiers of Medicine
[Show abstract][Hide abstract] ABSTRACT: The debate exists whether or not gonadotropin-releasing hormone (GnRH) analogs used in controlled ovarian hyperstimulation (COH) impair endometrial receptivity. Homeobox A11 (Hoxa11), Meis homeobox 1 (Meis1), cadherin 1 (Cdh1), and catenin beta 1 (Ctnnb1) are well known to be involved in successful implantation. In this study, the endometrial expression of Hoxa11, Meis1, Cdh1, and Ctnnb1 during the peri-implantation period was investigated in an in vitro fertilization (IVF) mouse model by real-time RT-PCR and Western blot to evaluate the relationship between Hoxa11, Meis1, Cdh1, and Ctnnb1 expression and the impact of the COH on endometrial receptivity. The mimic COH protocols included GnRH agonist plus human menopausal gonadotropin (HMG) (GnRH agonist group), GnRH antagonist plus HMG (GnRH antagonist group), and HMG alone (HMG group). The expression levels of Hoxa11, Meis1, Cdh1, and Ctnnb1 mRNA and protein were decreased in all of the COH groups. The expression levels of Hoxa11 and Ctnnb1 were the lowest in the GnRH agonist group, and those of Meis1 and Cdh1 were lower in the GnRH analog groups than the HMG group. There were positive correlations between the expression of Hoxa11 and Ctnnb1, as well as the expression of Meis1 and Cdh1 among all the groups. In conclusion, the COH protocols, particularly with GnRH analogs, suppressed Hoxa11, Meis1, Ctnnb1 and Cdh1 expression, in mouse endometrium during the peri-implantation period. Our data reveal a novel molecular mechanism by which the COH protocols might impair endometrial receptivity.
No preview · Article · Aug 2011 · Journal of Huazhong University of Science and Technology
[Show abstract][Hide abstract] ABSTRACT: To define the risk of hepatitis B virus (HBV) transmission through oocytes and embryos from chronic HBV carriers.
Research laboratory in a university hospital.
Thirty-one couples with hepatitis B surface antigen (HBsAg)-negative women and HBsAg-positive men, 41 couples with HBsAg-positive women and HBsAg-negative men, and 39 seronegative couples.
Hepatitis B virus DNA and RNA analyses in oocytes and embryos, and the location of virus particles containing HBsAgs.
Hepatitis B virus DNA was detected in 3 of 18 male HBsAg-positive/female HBsAg-negative couples (and in 13 of 84 embryos) and 3 of 14 male HBsAg-negative/female HBsAg-positive couples (and in 15 of 71 oocytes and embryos). Hepatitis B virus RNA was detected in 9 of 13 male HBsAg-positive/female HBsAg-negative couples (and in 39 of 52 embryos) and 8 of 17 male HBsAg-negative/female HBsAg-positive couples (and in 30 of 63 oocytes and embryos). The HBsAg, which is present in the nuclei and cytoplasm of oocytes and embryos, was detected in 6 of 10 male HBsAg-negative/female HBsAg-positive couples (and in 13 of 20 oocytes and embryos). Hepatitis B virus DNA, HBV RNA, and HBsAg were not found in 135 oocytes and embryos from 39 seronegative couples.
The presence of HBV in oocytes and embryos suggests the possibility of vertical transmission of HBV via the germ line.
No preview · Article · Apr 2011 · Fertility and sterility
[Show abstract][Hide abstract] ABSTRACT: To explore the feasibility and safety of microdrop-vitrification for epididymal spermatozoa obtained by percutaneous epididymal sperm aspiration (PESA) without cryoprotectants.
We treated the epididymal sperm samples from 22 patients by conventional freezing (Group 1) and microdrop-vitrification without cryoprotectants (Group 2), and evaluated the effectiveness of the two methods by comparing their revival rate, retrieval rate and incidence of sperm nuclear DNA fractures.
Motile sperm were found in all but 1 case in Group 1. The revival rates of the frozen sperm were low in both Groups 1 and 2 ([18.16 +/- 9.38]% vs [21.99 +/- 10.95]%, P > 0.05), but statistically significant differences were shown between the two groups in the retrieval rate ([58.39 +/- 12.67]% vs [70.82 +/- 14.94]%, P < 0.01). Before freezing, nuclear DNA fractures existed in the epididymal sperm samples of all the 22 patients, comet sperm were seen after unicellular gel electrophoresis, and the incidence of sperm nuclear DNA fracture was (26.68 +/- 9.45)%. After freezing, no increase was observed in the incidence of sperm nuclear DNA fracture in either Group 1 or 2 ([28.68 +/- 12.54]% vs [27.64 +/- 10.70]%, P > 0.05).
Microdrop can be used as a suitable freezing carrier for a low number of sperm, and cryoprotectant-free vitrification with microdrop may be a simple, safe and effective method for the cryopreservation of a low number of epididymal sperm.
No preview · Article · Dec 2010 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: The protein expression of cystic fibrosis transmembrane conductance regulator (CFTR), a cAMP-activated Cl(-) channel, in ovarian stimulated premature female rat ovary during a cycle of follicle development and corpus luteum formation was investigated. Animals were injected with 10 U pregnant Mare's serum gonadotropin (PMSG) and subsequently 10 U hCG 48 h later. Time-dependent immunohistochemistry and Western blotting experiments were performed before and 24, 48, 72 h after hCG treatment. The immunohistochemistry revealed that administration of PMSG stimulated the CFTR expression in thecal cell layer and granulosa cell layer of mature follicles 48 h post injection, coincident with the PMSG-induced peak in follicular estradiol. However, the expression of CFTR in the granulose lutein cell layer and thecal lutein cell layer was time-dependently reduced following hCG injection, in accordance with the gradually increased progestogen level during luteum corpus formation. Western blotting analysis demonstrated that rat ovarian tissue expressed the special CFTR band at 170 kD. It is concluded that cAMP-dependent Cl(-) channels are involved in regulation of follicle development and luteum formation.
No preview · Article · Nov 2008 · Journal of Huazhong University of Science and Technology
[Show abstract][Hide abstract] ABSTRACT: In order to compare GnRH agonist with antagonist protocol for the same patient during controlled ovarian stimulation cycles, the in vitro fertilization and embryo transfer (IVF-ET) outcome was retrospectively studied in 81 patients undergoing 105 agonist protocols and 88 antagonist protocols. The results showed that there was no statistically significant difference in duration of ovarian stimulation, number of ampoules, oocytes retrieved, serum estradiol (E(2)) and progesterone (P) levels, thickness of endometrium, the zygote-and blastocyst-development rate between GnRH agonist and antagonist protocols (P>0.05). High quality embryo rate was higher in antagonist protocols, but there was no significant difference between two protocols. Implantation rate and clinical pregnant rate were significantly higher in antagonist protocol (15.82% and 30.26%, respectively) than in agonist protocol (5.26% and 10.64% respectively (P<0.05). It was concluded GnRH antagonist protocol probably improved the outcome of pregnancy of older patients with a history of multiple failure of IVF-ET in a GnRH protocol.
No preview · Article · Oct 2008 · Journal of Huazhong University of Science and Technology
[Show abstract][Hide abstract] ABSTRACT: To assess the relationship between pronuclear scoring and day-3 embryo quality and pregnancy outcome and to determine the clinical value of pronuclear stage scoring system in human in vitro fertilization-embryo transfer (IVF-ET) program, a pronuclear scoring system was used to score zygotes 16-20 h after insemination during conventional IVF or intracytoplasmic sperm injection (ICSI). The embryos were classified into groups Z1, Z2, Z3 and Z4. Comparisons were made of the rates of arrested embryos and excellent embryos on day 3. Comparisons of pregnancy outcome were made only in those patients in whom cohorts of similarly Z-scored embryos were transferred. The results showed that there were less arrested embryos and more excellent embryos on day 3 in groups Z1 and Z2 than those in group Z3 and Z4. More embryos arrested and less excellent embryos developed in group Z4 than group Z3. The clinical pregnancy rates resulting from the transfer of single pronuclear score homologous embryo types were similar among groups Z1, Z2 and Z3. Implantation rates of group Z1 were higher (P<0.05) than that of group Z3. These findings suggests that pronuclear scoring can predict developmental ability on day 3 and implantation potential. A evaluation that combines the Z-score and day 3 embryo morphology is useful in the determination of the most viable embryos and the number of embryos for transfer.
No preview · Article · Apr 2008 · Journal of Huazhong University of Science and Technology
[Show abstract][Hide abstract] ABSTRACT: To assess the effects of the nuclear status of day 2 preembryos on day 3 embryo quality and implantation potential and to weigh its clinical value in the human in-vitro fertilization-embryo transfer (IVF-ET) program.
Embryos obtained from 409 fresh conventional IVF-ET/ICSI cycles from July to October 2006 were assessed retrospectively. Day 2 preembryos were classified according to the number of nuclei in each blastomere in 3 groups: grade A with only mononucleated blastomeres, grade B with one or more blastomeres containing no visible nucleus, and grade C with one or more multinucleated blastomeres. Comparisons were made of the rates of arrested embryos and excellent embryos on day 3 as well as of the pregnancy outcome and implantation potential of those in whom cohorts of similar nuclear scoring embryos were transferred.
There were fewer arrested embryos and more excellent embryos on day 3 in grade A than in grade B and C (P < 0.01), and so were there in grade B than in grade C (P < 0.01). Among the 234 cycles in which all the transfer embryos were derived from a similar day 2 nuclear scoring, 51 cycles originated from grade A embryos (group A) and 183 from grade B (group B), with similar clinical pregnancy rates between the two groups, while the implantation rate was higher in group A than in B (P < 0.05).
Day 2 nuclear scoring can be used to predict the devel- opment and implantation potential of embryos. A combined evaluation of day 2 nuclear scoring and day 3 embryo morphology helps identify the most viable embryos and reduce the number of embryos for transfer.
No preview · Article · Jan 2008 · Zhonghua nan ke xue = National journal of andrology
[Show abstract][Hide abstract] ABSTRACT: To determine whether cleavage developmentally retarded embryos have not cleaved during a 24 hour period could develop into blastocysts and produce hESC cell lines.
A total of 120 such embryos were cultured to blastocyst stage by sequential culture. Blastocysts formation rate and quality of blastocyst were detected under microscope. The relation between blastocyst formation rate and blastomere number, the fragment of blastomere and blastomere symmetry were analyzed by stepwise Logistical regression analysis. Inner cell masses (ICMs) were isolated by immunosurgery. Colonies derived from the ICMs were passed every 4 - 7 days and the derivatives were passaged and identified.
A total of 22 blastocysts were obtained from 120 embryos. The blastulation rate was 18.7%. Early blatocyst, blastocyst, full blastocyst, expanded blastocyst, hatching blastocyst and hatched blastocyst accounted for 5.9%, 23.5%, 35.3%, 23.5%, 5.9%, and 5.9% respectively. The grade of ICM and trophoblast was mostly scored C or B. Blastocyst formation rate was related to cell number and blastomere symmetry but not fragment. Immunosurgery resulted in the formation of 7 ICMs and 3 primary colonies, which produced 2 cell lines. The cell lines satisfied the criteria that characterize pluripotent hESC cells. Undifferentiated cells were positive for AKP, SSEA-4, TRA-1-60, and TRA-1-81. It could continue to proliferate in vitro and form embryoid bodies when cultured in suspension. It had capability to form teratoma in SCID mice. Both cell lines had normal karyotypes after 45 and 34 passages respectively.
Our results suggest that a subset of developmentally retarded embryos can form blastocysts and give rise to hESC cell lines.
No preview · Article · Oct 2007 · Zhonghua fu chan ke za zhi
[Show abstract][Hide abstract] ABSTRACT: Retrospective study of the results of ICSI (intracytoplasmic sperm insemination) with frozen sperm obtained by PESA (percutaneous epididymal sperm aspiration) was performed in 27 patients.
With conventional freezing method, sperm from diagnosing PESA and the remaining motile sperm after treating cycle were frozen. After frozen-thawed and ICSI process, fertilization rate, implantation rate, clinical pregnancy rate were compared and other outcomes including pregnant combinations and parameters of newborns of experimental group (which used frozen-thawed sperm) and control group (which used fresh PESA sperm) were analyzed respectively.
One hundred and sixty three and 1 157 oocytes of stage M II were injected respectively in the experimental group (15 cycles) and control group (100 cycles), and fertilization rate of experimental group was prominently higher than that of control group (84.05% vs 73.29%, P < 0.05), while implantation rate and clinical pregnancy rate were of no difference from the control, respectively (23.07% vs 15.73%; 53.33% vs 37.00%, P > 0.05). The differences in newborn's weights between two groups were of no statistical significance (P > 0.05). In the experimental group, eight clinical pregnancies were achieved including 5 live deliveries and 3 ongoing pregnancies, 37 clinical pregnancies including 30 deliveries with only 1 fetal death, 3 ongoing pregnancies and 4 abortions in the control group. Neither vital pregnant combinations nor neonate malformations were found in both groups.
ICSI using frozen-thawed sperm obtained by PESA is an economic effective and safe method to treat azoospermia. Recovering rates of frozen sperm form PESA should be further increased.
No preview · Article · May 2006 · Zhonghua nan ke xue = National journal of andrology