R. Azambuja

Successful birth after injection of frozen human oocytes with frozen epididymal spermatozoa

A couple (female 31, male 42 years old) with infertility due to obstructive azoospermy returned to the clinic in order to attempt pregnancy using their frozen oocytes and epididymal sperm cells, which had been cryopreserved at the time of a previous IVF attempt. Two days before the scheduled transfer, eight oocytes were thawed; 5/8 (63%) oocytes survived and 4/5 (80%) oocytes fertilized after intracytoplasmic sperm injection (ICSI) with the previously frozen epididymal spermatozoa. All four fertilized ova cleaved (100%). On day 2 after thawing, four embryos were transferred; three with two cells (grade II) and one with three cells (grade III). Hormonal support for the established pregnancy was maintained with oestradiol and progesterone orally until 12 weeks of gestation, and the patient was delivered by Caesarean section at 40 weeks of gestation; the baby boy weighed 3025 g, and measured 51 cm, with Apgar of 10 in the 1st and 5th min. The cryopreservation and warming protocol used for this study yielded very favourable results, comparing well with reports in the literature. This case report demonstrates that it is possible to obtain high rates of oocyte survival following thawing and high rates of fertilization after ICSI, with viable development of the resulting embryos.

Comparison of embryo quality between sibling embryos originating from frozen or fresh oocytes

Human embryo cryopreservation techniques allow storage of surplus embryos created during assisted reproduction procedures; however, the existence of these same surplus embryos has sparked further debate. What can be their fate once they are no longer desired by their parents, or if the parents are deceased? Thus, the level of interest in the cryopreservation of oocytes has increased, as has the necessity for further scientific study. This study had the objective of comparing embryo quality from 16 women who underwent intracytoplasmic sperm injection, where approximately half of the retrieved oocytes per cycle were inseminated fresh after collection, and the remainder cryopreserved for subsequent fertilization. Normal fertilization rates were not significantly different between the two oocyte-treatment groups. There was no significant difference in the frequency of good quality embryos (morphology grades I and II) on the second day of laboratory evaluation between embryos derived from the two oocyte-treatment groups. It is interesting to note that embryo transfer from fresh oocytes produced no pregnancies, which shows that even embryos derived from frozen oocytes that are fragmented or have a slower cleavage rate are viable embryos, capable of producing healthy babies.

Experience of freezing human oocytes using sodium-depleted media

Human embryo cryopreservation techniques enable the storage of surplus embryos created during assisted reproduction procedures; however, the existence of these same surplus embryos has sparked further debate. What can be their fate once they are no longer desired by their parents or if the parents are deceased? Thus, the level of interest in the cryopreservation of oocytes has increased, as has the necessity for further scientific study. This study had the objective of reporting 10 years of experience of freezing and thawing human oocytes from patients who did not wish to freeze embryos. A total of 159 cycles using frozen–thawed oocytes were performed (mean age 33.7 years). Survival and fertilization rates were 57.4% and 67.2%, respectively. Cleavage rate was 88.4% and the pregnancy rate was 37.7%. Clinical pregnancy was observed in 43 cycles (27.0%) with 14.5% of transferred embryos implanted. These pregnancies delivered 19 boys and 23 girls, two pregnancies are ongoing and nine were miscarriages. The average gestational week was 37.6 weeks and birthweight was 2829.2 g. These data suggest that the use of frozen–thawed oocytes in IVF represents a reasonable alternative for those patients not comfortable with the cryopreservation of supernumerary embryos.

MP35-08 IMPACT OF SEMINAL QUALITY ON THE ANEUPLOIDY EMBRYONIC RATE

INTRODUCTION AND OBJECTIVES: The male factor is implicated in approximately 50% of couples undergoing Assisted Reproductive Technology. It has been known semen alterations could be responsible for chromosomal abnormalities, poor embryonic development and repeated miscarriage.The main objective of this study was to evaluate the possible impact of oligospermia on the aneuploidy embryonic rate, comparing oligo and normospermics patients. METHODS: This study compared 203 oligo and normospermics couples who underwent in vitro fertilization with subsequent embryo biopsy for preimplantation genetic screening (PGS) during the period from July 2014 to October 2016. The female mean age was 38.9. The seminal parameters were evaluated according to WHO 2010. Were biopsied 741 embryos. The biopsies were performed on either day 3 or day 5. The techniques used for the analysis were Array Comparative Genomic Hybridization (aCGH) or Next-Generation Sequencing (NGS). The results were analyzed by the T test (p <0.05). RESULTS: Of the 203 patients, 40 patients (19.7%) were considered oligospermic and obtained 160 biopsied embryos. Of these, 42 (26.2%) were considered euploid embryos. Normospermics patients obtained 581 biopsied embryos, and 151 (25.9%) were considered euploid. Therefore, when considering only the seminal concentration, there is no difference between the aneuploidy embryonic rate. CONCLUSIONS: This study showed no correlation between low seminal concentration and aneuploidy embryonic rate. Although low sperm quality is an indication for PGS, it has not yet been elucidated that there is a decrease in the rate of euploidy during in vitro fertilization as it is expected to occur with the natural conception. Therefore, it is advisable that further studies on the subject be carried out in order to corroborate these primary results.

Managing Fertility Preservation in Childhood Cancer Patients in Brazilian Scenario

The preservation of fertility in young and adolescent population is a matter of great relevance at the present time. For many young children, there are many psychological stress factors that affect them in the context of their lives at the time of illness, and the risk of losing their fertility is a major concern. The ability to preserve fertility can contribute positively to the emotional aspects of the disease and its treatment. In adulthood, reproductive capacity is for most individuals, one of the main determinants of their quality of life [5, 15].