The integration of blastocyst transfer for all patients.

Purpose To investigate the difference in sex ratio in our centre after day 5 embryo transfer among neonates delivered after fresh in vitro fertilization (IVF), fresh intra cytoplasmatic sperminjection (ICSI) and frozen embryo replacement (FER) compared to expected sex ratio in normal population. Methods Retrospective data after IVF/ICSI/FER therapy from 1995 -2007 and data from the literature on similar subjects. Results Among a total of 420 births after day 5 transfer, there were 225 male and 195 female babies. However, after ICSI alone 30 were female and 21 male. Adding all available data from the literature on gender ratio after long term culture, the ratio of male births to total births (0.545) was significantly (p=0.004) different from the expected ratio (0.515) Conclusions It appears that significantly more males are born than expected after day 5 transfer in IVF. However, a subgroup analysis in our data comparing IVF, ICSI and FER revealed more females born after ICSI and FER, suggesting that further research is needed in this area.

Section: Discussionmentioning

confidence: 99%

Blastocyst transfer and gender: IVF versus ICSI

Hentemann

Briskemyr

Bertheussen

2009

“…Meanwhile, the transfer of blastocysts is suggested to be physiologically more associated with a better synchronization of the uterus and endometrium. Additionally, the extended culture allows a kind of natural pre-selection as not all embryos on day 2 or 3 reach the blastocyst stage and selecting them by an embryologist on the basis of morphological grading at the blastocyst stage has higher predictive value for implantation [1][2][3]. Moreover, embryos selected for transfer on day 5 are suggested to be at lower risk of aneuploidy-although chromosomal Capsule Time-lapse imaging allows the detailed recording of embryonal morphokinetics until the day of transfer.…”

Section: Introductionmentioning

confidence: 99%

The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging—a retrospective observational study

Neyer

Zintz

Stecher

et al. 2015

Purpose Various time-lapse studies have postulated embryo selection criteria based on early morphokinetic markers. However, late paternal effects are mostly not visible before embryonic genome activation. The primary objective of this retrospective study was to investigate whether those early morphokinetic algorithms investigated by time-lapse imaging are reliable enough to allow for the accurate selection of those embryos that develop into blastocysts, while of course taking into account the correlation with the type of injected spermatozoa. Methods During a period of 18 months, a total of 461 MII oocytes from 43 couples with severe male factor infertility and previous Bexternal^IVF failures after cleavage-stage embryo transfer (ET) were fertilized by intracytoplasmic morphologically selected sperm injection (IMSI). Thereof, 373 embryos were monitored in a time-lapse incubator until ET on day 5. Blastocyst outcome in combination with three previously postulated MKc (cc2: t3-t2, 5-12 h; t3, 35-40 h; t5, 48-56 h) and the morphology of the selected sperm were analyzed. Results A significant increase in the rate of blastocysts (54.0 vs. 36.3 %; P<0.01) and top blastocysts (25.3 vs. 10.8 %; P<0.001) was observed in the group of those meeting all three morphokinetic criteria (MKc3). However, MKc3 were only met in 23.3 % of all embryos. Moreover, TBR was influenced by the type of injected spermatozoa. In both groups, TBR decreased dramatically (MKc3, 35.0 vs. 17.0 %; MKc<3, 14.2 vs. 8.4 %) when class II/III sperm instead of class I were injected. Conclusion Early morphokinetic parameters might give some predictive information but fail to serve as a feasible selective tool for the prediction of blastocyst development given the influence of the type of spermatozoa injected.

“…This approach should make possible the transfer of a single blastocyst, thereby maintaining high pregnancy rates while controlling the incidence of multiple gestations [6][7][8]. The integration of Values are means ± SD TQE top quality embryo blastocyst culture for all patients might virtually eliminate the incidence of high-order multiple pregnancies due to decrease in the number of embryos transferred [24]. Before starting infertility treatment in any given unit, patients need to be clearly informed about their chances of having a live baby according to their own situation.…”

Section: Discussionmentioning

confidence: 99%

Top quality embryos at day 2: a prerequisite for single blastocyst transfer? An observational cohort study in women under 36

Guérif

Lemseffer

Blanchard

et al. 2009

Purpose While extended culture has been considerably improved, some questions remain regarding the application of Single Blastocyst Transfer (SBT). Methods An observational cohort study was undertaken with 456 women under 36 years old and assigned to SBT on a voluntary basis. The main outcome was the cumulative delivery rate per couple according to the number of Top Quality Embryos (TQE) on day 2 (Group 1= ≥2 TQE, Group 2= 1 TQE and Group 3= 0 TQE). Results Rate of transfer and mean number of frozen blastocyts were higher in Group 1 compared to Group 3. As a consequence, the cumulative delivery rate per couple was higher in Group 1 (47.9%) compared to Group 3 (34.9%). Conclusions Single blastocyst transfer combining fresh and frozen cycles, might be a worthwhile strategy irrespective of embryo quality on day 2 providing good delivery rates while keeping the rate of multiple deliveries low.