Biphasic (5–2%) oxygen concentration strategy significantly improves the usable blastocyst and cumulative live birth rates in in vitro fertilization

Brouillet, Sophie; Baron, Chloé; Barry, Florent; Andreeva, Aneta; Haouzi, D.; Gala, Anna; Ferrières-Hoa, Alice; Loup, V.; Anahoryl, Tal; Ranisavljevic, Noémie; Gaspari, Laura; Hamamah, S.

doi:10.1038/s41598-021-01782-6

Cited by 13 publications

(19 citation statements)

References 41 publications

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“…In hypoxic environments, O 2 tension promotes the development of mouse blastocysts and reduces apoptosis by regulating HIF-2α, thereby increasing the expression of antioxidant enzymes, such as MnSOD, PRDX5, and vascular endothelial growth factor (VEGF) 44 . In bovine and mouse preimplantation embryos, biphasic O 2 (7-2% or 5-2%) changes the expression of genes involved in embryonic metabolism 9,45,46 47 . Generally, biphasic O 2 (5-2%) cultures are associated with considerably increased cumulative live birth and total blastocyst and usable blastocyst formation rates 47 .…”

Section: Discussionmentioning

confidence: 99%

“…In bovine and mouse preimplantation embryos, biphasic O 2 (7-2% or 5-2%) changes the expression of genes involved in embryonic metabolism 9,45,46 47 . Generally, biphasic O 2 (5-2%) cultures are associated with considerably increased cumulative live birth and total blastocyst and usable blastocyst formation rates 47 . Under biphasic O 2 conditions, changing the relative abundance of anabolic amino acids and metabolites involved in redox homeostasis and the differential expression level of MUC1 in TE cells may improve the development of human embryos 6 .…”

Section: Discussionmentioning

confidence: 99%

“…Under biphasic O 2 conditions, changing the relative abundance of anabolic amino acids and metabolites involved in redox homeostasis and the differential expression level of MUC1 in TE cells may improve the development of human embryos 6 . Moreover, whole transcriptome analysis of blastocysts revealed that 707 RNAs are differentially expressed depending on the strategy of O 2 supplementation 47 .…”

Section: Discussionmentioning

confidence: 99%

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Biphasic oxygen tension promotes the formation of transferable blastocysts in patients without euploid embryos in previous monophasic oxygen cycles

Chen

Lee

Huang

et al. 2023

Preprint

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This study evaluated whether the concentration of biphasic O2 (5–2%) promotes the formation of qualified blastocysts (QBs) and euploid blastocysts and increases the probability of cycles with transferable blastocysts. Total 90 patients (180 cycles) without euploid blastocysts in previous monophasic O2 (5%) cycles were enrolled for an additional cycle of biphasic O2 (5–2%). In the biphasic O2 (5–2%) tension group, the rate of QB (35.8%, 225/628) were significantly higher than those in the monophasic O2 (5%) group ( 23.5%, 137/582; p < 0.001). In addition, the number of euploid blastocysts (0.5 ± 0.8) and the percentage of cycles with transferable blastocysts were significantly higher in the biphasic O2 (5–2%) group (57.8%, 52/90) than in the monophasic O2 (5%) group (0 and 35.6%, 32/90, respectively; p = 0.003). Multivariable regression analysis also indicated that the QB rate and the probability of cycles with transferable blastocysts correlated with O2 tension (OR: 1.535, 95% CI: 1.325–1.777, and OR: 3.191, 95% CI: 1.638–5.679, respectively; p < 0.001). Biphasic O2 culture can be used as an alternative strategy to increase the number of euploid QBs and the probability of cycles with transferable blastocysts in patients with a poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Biphasic oxygen tension promotes the formation of transferable blastocysts in patients without euploid embryos in previous monophasic oxygen cycles

Chen

Lee

Huang

et al. 2023

Preprint

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“…Culture under 2% O 2 tension led to a higher blastulation rate (40.2 versus 22.5%) and a higher utilization rate (36.8 versus 21.3%) [ 10 ]. A recent study showed that the total and usable blastocyst rates (44.4 versus 54.8% and 21.8 versus 32.8%, respectively) were significantly higher under 2% O 2 tension from day 3 onwards [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Ultralow Oxygen Tension (2%) Is Beneficial for Blastocyst Formation of In Vitro Human Low-Quality Embryo Culture

Xue

Shi

2022

BioMed Research International

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Objectives. To investigate whether a reduction in the O2 tension from 5 to 2% during extended culture from day 3 onwards was beneficial to human blastocyst development in vitro. Methods. We firstly identified 139 patients who had no low-quality embryos on day 3, and all the embryos were prolonged to culture on day 5 or 6. We mainly analyzed 188 patients receiving IVF/ICSI-ET for the first time, and no high-quality embryos were obtained on day 3 from January 2018 to December 2019. After transferred with one or two low-quality embryos, extended culture was performed under low O2 (5%) or ultralow O2 (2%) tension for surplus embryos. 296 embryos from 106 patients were continued to culture under 5% O2 tension, and 214 embryos from 82 patients were continued to culture under 2% O2 tension. Main outcomes compared were blastulation and high-quality blastulation rates. Results. We observed no significant differences in the blastulation and high-quality blastulation rates for high-quality cleavage-stage embryos between 2% and 5% O2 groups ( p > 0.05 ). For low-quality cleavage-stage embryos, we observed that the 2% O2 group showed a significantly higher blastulation (39.72 versus 31.08%; p = 0.043 ) rate than that in the 5% O2 group. The high-quality blastocyst formation rate (10.75 versus 8.45%; p = 0.380 ) was comparable between the 2% and 5% O2 groups. The blastulation rate reached 44.86% by culturing blastocysts an additional day under 2% O2 tension which was significantly higher than that (32.09%) under 5% O2 tension ( p < 0.05 ). Conclusion. A reduction in O2 tension from 5 to 2% after day 3 might be beneficial to the patients with no high-quality embryos. Extended culture to day 7 under 2% O2 tension increased the number of available blastocysts per IVF/ICSI cycle and was worth recommending especially for patients with few blastocysts.

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“…Conventional IVF (cIVF) or intra cytoplasmic sperm injection (ICSI) technique were used as appropriate. IVF procedure was performed in our unit as previously described ( 22 ). At D3, embryo morphology was graded using a standard system including number, size and uniformity of blastomeres, degree of fragmentation and the presence of multinucleated blastomeres.…”

Section: Methodsmentioning

confidence: 99%

“Short agonist stop” protocol, an ovarian stimulation for poor responders in in vitro fertilization (IVF): A pilot study

et al. 2022

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IntroductionPoor responder patients remain a challenge in assisted reproductive technologies. The “short agonist stop” (SAS) stimulation protocol uses a double stimulation (flare up effect with the gonadotropin-releasing hormone (GnRH) agonist (GnRH-a) then gonadotropins) associated with a less strenuous blockage (discontinuation of GnRH-a) to favor follicular recruitment in order to obtain a better ovarian response. This study aims to compare the number of oocytes obtained after a SAS stimulation protocol with those obtained after the previous stimulation protocol, in the same women, with poor ovarian response (POR) diagnosed according to the POSEIDON criteria.DesignThis therapeutic observational retrospective cohort from 2018 to 2022, with a case-control evaluation compared with the same patients’ previous performance, included women with POR undergoing IVF with SAS stimulation protocol. The primary outcome was the number of total oocytes recovered and secondary outcomes were the numbers of mature oocytes, total embryos observed at day 2 and usable cleaved embryos and blastocysts (day 5/6).Results63 patients with SAS and previous cycles were included. In the SAS group, the mean number of oocytes was significantly higher: 7.3 vs 5.7, p=0.018 in comparison with the previous attempt. So was the number of mature oocytes (5.8 vs 4.1, p=0.032) and the total mean number of embryos obtained at day 2 (4.1 versus 2.7, p=0.016). The SAS stimulation generated 84 usable embryos: 57 cleaved embryos and 27 blastocysts. The mean number of usable embryos was similar in both groups (1.64 vs 1.31, respectively, p=0.178). In total, out of 63 patients, after the SAS protocol, and subsequent embryo transfers (fresh and frozen, n=54), 9 patients had ongoing pregnancies and no miscarriage occurred. The cumulative ongoing pregnancy rate (cOPR) after the SAS protocol was 14.3% (9/63) per oocyte pick-up and 16.7% (9/54) per transfer.ConclusionSAS stimulation is a short and original protocol strengthening the therapeutic arsenal of poor responders, that may offer promising results for those patients with low prognosis and previous failed IVF. Results must be confirmed with a randomized controlled trial.

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Biphasic (5–2%) oxygen concentration strategy significantly improves the usable blastocyst and cumulative live birth rates in in vitro fertilization

Cited by 13 publications

References 41 publications

Biphasic oxygen tension promotes the formation of transferable blastocysts in patients without euploid embryos in previous monophasic oxygen cycles

Biphasic oxygen tension promotes the formation of transferable blastocysts in patients without euploid embryos in previous monophasic oxygen cycles

Ultralow Oxygen Tension (2%) Is Beneficial for Blastocyst Formation of In Vitro Human Low-Quality Embryo Culture

“Short agonist stop” protocol, an ovarian stimulation for poor responders in in vitro fertilization (IVF): A pilot study

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