Pregnancies after in vitro fertilization and transfer of human blastocysts

Bolton, Virginia N.; Wren, Marie; Parsons, John

doi:10.1016/s0015-0282(16)54257-5

Cited by 128 publications

(38 citation statements)

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“…It has been proposed that the ability of a particular culture medium to give rise to a high percentage of blastocysts does not necessarily mean that such blastocysts are viable or that they have the developmental competence to implant and sustain a pregnancy [13]. Earlier efforts to culture human embryos to the blastocyst stage in less sophisticated media resulted in acceptable blastocyst formation rates but very low pregnancy rates [5][6][7][8], indicating that human embryos are capable of developing in diverse culture media, not all of which appear to generate viable embryos with a capacity to implant and result in a pregnancy. The adaptability of human embryos to varying culture conditions has prompted investigation and discussions regarding possible downstream long-term effects of single versus sequential culture on pregnancy outcome and offspring phenotype [43][44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

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Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Sfontouris

Martins

Nastri

et al. 2016

J Assist Reprod Genet

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Purpose The purpose of this study was to undertake a review of the available evidence comparing the use of a single medium versus sequential media for embryo culture to the blastocyst stage in clinical IVF. Methods We searched the Cochrane Central, PubMed, Scopus, ClinicalTrials.gov, Current Controlled Trials and WHO International Clinical Trials Registry Platform to identify randomized controlled trials comparing single versus sequential media for blastocyst culture and ongoing pregnancy rate. Included studies randomized either oocytes/zygotes or women. Eligible oocyte/zygote studies were analyzed to assess the risk difference (RD) and 95 % confidence intervals (CI) between the two media systems; eligible woman-based studies were analyzed to assess the risk ratio (RR) and 95 % CI for clinical pregnancy rate. Results No differences were observed between single and sequential media for either ongoing pregnancy per randomized woman (relative risk (RR) = 0.9, 95 % CI = 0.7 to 1.3, two studies including 246 women, I 2 = 0 %) or clinical pregnancy per randomized woman (RR = 1.0, 95 % CI = 0.7 to 1.4, one study including 100 women); or miscarriage per clinical pregnancy: RR = 1.3, 95 % CI = 0.4 to 4.3, two studies including 246 participants, I 2 = 0 %). Single media use was associated with an increase blastocyst formation per randomized oocyte/ zygote (relative distribution (RD) = +0.06, 95 % CI = +0.01 to Declaration of Authors' Roles Conception and design (CR, LR, WPM, IAS, and NR-F); search strategy (WPM, IAS); data extraction (WPM, PAN, IGRV, CON), analysis, and interpretation (all authors); writing the article (all authors). All authors had full access to all the data in the study and approved the final manuscript.Capsule In conclusion, there is insufficient evidence to recommend either sequential or single-step media as being superior for the culture of embryos to days 5/6 blastocyst stage. +0.12, ten studies including 7455 oocytes/zygotes, I 2 = 83 %) but not top/high blastocyst formation (RD = +0.05, 95 % CI = −0.01 to +0.11, five studies including 3879 oocytes/zygotes, I 2 = 93 %). The overall quality of the evidence was very low for all these four outcomes. Electronic supplementary materialConclusions Although using a single medium for extended culture has some practical advantages and blastocyst formation rates appear to be higher, there is insufficient evidence to recommend either sequential or single-step media as being superior for the culture of embryos to days 5/6. Future studies comparing these two media systems in well-designed trials should be performed.

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Section: Discussionmentioning

confidence: 99%

“…Initial attempts of culturing human embryos to the blastocyst stage in a simple single-step media (Earle's balanced salt solution, T6 medium or MEM) resulted in disappointingly low implantation and pregnancy rates [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Sfontouris

Martins

Nastri

et al. 2016

J Assist Reprod Genet

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“…One of the most widely used supplements for in vitro culture of bovine embryos is serum. Furthermore, until the early 1990s, most human embryos produced by IVF were cultured in media supplemented with 10-20% maternal serum (47); however, implantation rates remained poor (19). We know that the use of serum albumin as the protein source yields very good embryo development and quality; however, even today most of the in vitro-produced bovine embryos are cultured with serum, and some of the most prominent laboratories in the world use maternal of fetal cord serum in their human culture system.…”

Section: Discussionmentioning

confidence: 99%

“…Embryo IVC with serum produces more blastocysts than culture without serum. However, implantation rates of embryos cultured in the presence of FCS remains very poor (19,5), and the long-term effect of associated-early abnormalities is not known.…”

mentioning

confidence: 99%

Long-term effect of in vitro culture of mouse embryos with serum on mRNA expression of imprinting genes, development, and behavior

Fernández‐González

Moreira

Bilbao

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

357

271

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The long-term developmental and behavioral consequences of mammalian embryo culture are unknown. By altering the culture medium with the addition of FCS, we wanted to determine whether mouse embryos cultured under suboptimal conditions develop aberrant mRNA expression of imprinting genes at the blastocyst stage and whether fetal development, growth, and behavior of adult mice are affected. One-cell embryos obtained from superovulated female B6CBAF1 mice were cultured for 4 days in K ؉ -modified simplex optimized medium in the presence of either 10% FCS or 1 g͞liter BSA. After embryo transfer, born animals were submitted to several developmental and behavior tests. The mRNA expression of some imprinting genes was significantly affected in blastocysts cultured in the presence of FCS. Two of the eight measures of preweaning development and some specific measures of neuromotor development, such as the walking activity, were delayed in the group originated with FCS. After 34 weeks, the weight of female mice cultured in vitro in the presence of FCS was significantly higher than controls. In addition, the locomotion activity of mice was altered at 5 and 15 months. Anatomopathological and histological analysis of animals at 20 months of age showed some large organs and an increase in pathologies. We have found that mice derived from embryos cultured with FCS exhibited specific behavioral alterations in anxiety and displayed deficiencies in implicit memories. Our data indicate that long-term programming of postnatal development, growth, and physiology can be affected irreversibly during the preimplantation period of embryo development by suboptimal in vitro culture.embryo culture ͉ organ weight ͉ postnatal defects

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“…However, with advancements in embryo culture media, use of extended culture and transfer of blastocysts on day 5 became possible [2,3]. These additional days in culture aid in the deselection of poorly developing embryos as aneuploid, and other defective embryos are less likely to reach the blastocyst stage [4,5].…”

Section: Introductionmentioning

confidence: 99%

Is the presence of an uncleaved embryo on day 3 a useful predictor of outcomes following day 5 transfer?

Men

Bormann

Walsh

et al. 2015

J Assist Reprod Genet

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Purpose This study aimed to determine whether the presence of an uncleaved embryo on day 3 is predictive of cycle outcome after day 5 transfer (D5 ET). Methods In vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles from January 2013 to November 2014 with D5 ET were analyzed for the presence of at least one uncleaved embryo on day 3 (D3). Each index cycle (n= 70) was compared with two matched control cycles without uncleaved embryos. The main outcome measures included embryo quality, implantation rate, and clinical pregnancy rate. Results Fifty-nine of 3896 total embryos in this study were uncleaved on D3 (1.5 %). Cycles with uncleaved embryos had more oocytes retrieved (20.6 vs. 17.5), lower proportions of good quality embryos on D3 (52.4 vs. 66.1 %), and fewer usable embryos (transferred or frozen) on D5 (42.4 vs. 50.8 %). However, there were no significant differences in the incidence of cycles with a positive hCG, or in the rates of implantation, clinical pregnancy, or live birth. Conclusions Although an uncleaved embryo on D3 is associated with reduced conversion of sibling embryos to the blastocyst stage on D5, overall quality of those embryos forming blastocysts is not markedly decreased and clinical outcomes are not compromised.

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Pregnancies after in vitro fertilization and transfer of human blastocysts

Cited by 128 publications

References 3 publications

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Long-term effect of in vitro culture of mouse embryos with serum on mRNA expression of imprinting genes, development, and behavior

Is the presence of an uncleaved embryo on day 3 a useful predictor of outcomes following day 5 transfer?

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