T.H. Taylor

The effects of different laser pulse lengths on the embryo biopsy procedure and embryo development to the blastocyst stage.

PurposeA laser is commonly used to remove a blastomere from an embryo for genetic testing. The laser uses intense heat which could possibly disrupt embryo development. It is the goal of this study to test the effects of different laser pulse lengths (and consequently heat) on the embryo biopsy procedure and embryo development.MethodsEach embryo biopsy was performed randomly utilizing laser pulse lengths of 0.604mS (group I), 0.708mS (group II), and 1.010mS (group III).ResultsFor groups I, II, and III, 83, 86, and 71 embryos were biopsied, respectively. There was no difference in day 5 embryo quality or lysed blastomeres between groups. Average number of blastomeres biopsied between group I (1.0 ± 0.0), II (1.0 ± 0.2), and III (1.1 ± 0.2) was significant (0.0001).ConclusionOur data demonstrates that laser pulse length does not influence the embryo biopsy procedure or embryo development.

Comparison of ICSI and conventional IVF in patients with increased oocyte immaturity

Using sibling oocytes, the objective of this study was to compare the intracytoplasmic sperm injection (ICSI) fertilization rates to those achieved with conventional IVF in patients with high rates of oocyte immaturity. This study was observational in nature, and included 91 patients who were treated using split insemination techniques. The fertilization rates for the ICSI group and the IVF group were 41.1 +/- 15.0% and 53.2 +/- 19.8%, respectively (P <: 0.0001). There was no significant difference in day-3 embryo quality between the two groups. There was a significantly higher number of embryos frozen in the IVF group than in the ICSI group: 357 (84.8%) and 297 (76.7%), respectively (P = 0.037). Furthermore, the number of embryos either transferred or frozen was significantly higher in the IVF group than the ICSI group: 459 of 1173 (39.1%) and 385 of 1268 (30.4%), respectively (P < 0.0001). These data indicate that conventional IVF results in a higher fertilization rate than ICSI. Furthermore, IVF provided more embryos available for transfer or cryopreservation when compared with ICSI, thereby optimizing the patients cycle.

The utility of embryo banking in order to increase the number of embryos available for preimplantation genetic screening in advanced maternal age patients

PurposeTo determine if embryo banking with PGS is more optimal than proceeding with PGS regardless of embryo number.MethodsPatients were divided into 2 groups, group 1 were those that banked embryos and proceeded through another round of IVF prior to PGS, and group 2 underwent PGS regardless of embryo number. Group 2 was divided into group 2A (patients with >10 embryos) and group 2B (patients who had <10 embryos).ResultsThere was no difference in embryos biopsied, normal embryos, number transferred, and pregnancy rate between group 1 and 2. A significant number of patients did not have a transfer in group 2B (6/11) compared to group 1 (3/19) (P = 0.0419). There was no significance between pregnancy rates per transfer between group 1 (6/16) and group 2B (2/5).ConclusionOur data suggests that banking will increase the odds of going to transfer but there was no increase in pregnancy rates.

Effect of denuding on polar body position in in-vitro matured oocytes

The aim of this study was to determine whether the denuding procedure causes the polar body to move within the perivitelline space. Only those patients undergoing IVF who had unused in-vitro matured (IVM) oocytes were included in this study. IVM oocytes were initially viewed under a non-invasive, polarized light microscope. A laser was used to mark the location of the polar body on the zona. Oocytes were subjected to the denuding procedure with a 150 microm, 135 microm and 125 mum diameter pipette. After each pipetting, the oocytes were viewed again to determine whether the polar body had moved. After denuding, the oocyte was left to culture overnight and viewed 24 h later. After denuding with the 150 microm, 135 microm and 125 microm pipettes and after 24 h in culture, the average angle between the spindle and polar body was 15.4 +/- 10.4 degrees , 16.1 +/- 10.1 degrees , 20.9 +/- 11.7 degrees , and 26.7 +/- 18.2 degrees , respectively (P = 0.0021). Slight changes in angles were noted between denuding with the different diameter pipettes. The largest changes in angles were seen after 24 h in culture.

Pregnancy after rebiopsy and vitrification of blastocysts following allele dropout after day 3 biopsy

OBJECTIVE To report a clinical pregnancy after rebiopsy and vitrification of blastocysts following allele dropout (ADO) of biopsied day 3 embryos. DESIGN Case report. SETTING Private center. PATIENT(S) Thirty-year-old woman and her 33-year-old husband who carries the single-gene condition paraganglioma. INTERVENTION(S) In vitro fertilization with day 3 embryo biopsy-ET-blastocyst biopsy and vitrification-subsequent frozen ET cycle. MAIN OUTCOME MEASURE(S) Results from preimplantation genetic diagnosis and pregnancy results after fresh and frozen ETs. RESULT(S) Nineteen oocytes were retrieved of which 13 were mature and 12 fertilized. Eleven embryos were biopsied on day 3: two were normal, five were affected, and four exhibited ADO. The two normal blastocysts were transferred, and three of the ADO blastocysts were biopsied and sent for reanalysis. The biopsied blastocysts were vitrified. No pregnancy resulted from the fresh ET. One of the biopsied blastocysts was normal, one received no result, and one exhibited ADO. A singleton clinical pregnancy resulted from a subsequent frozen ET of the thawed biopsied normal blastocyst. CONCLUSION(S) Rebiopsy and vitrification of blastocysts could be used in cases of ADO or lack of results after day 3 embryo biopsy.