Optimization of a single-embryo transfer in patients with good ovarian reserve

Due to refinements of assisted reproductive technology, the number of multiple pregnancies has increased substantially. Time-lapse microscopy (TLM) is a tool for selecting quality embryos for transfer. This study aimed to assess the outcomes of single-embryo transfer of autologous oocytes performed on day 5 of embryo incubation in a TLM-equipped system in patients with good ovarian reserve. The study was carried out in 208 infertile women with good ovarian reserve (over 8 oocytes retrieved). Single-embryo transfer following incubation in a TLM-equipped incubator was performed in 95 patients, who formed the main group; the control group consisted of 113 patients undergoing single-embryo transfer following a traditional culture and embryo selection procedure. We assessed the quality of transferred embryos, the rates of clinical pregnancy and pregnancy loss. Two subgroups were identified in each group of the participants: the 5SET subgroup (nonelective single-embryo transfer), which included 45 patients from the main group and 67 controls, and the 5eSET subgroup (elective single-embryo transfer), which consisted of 50 main group patients and 46 controls. The groups did not differ in terms of age, infertility factors and infertility duration. The quality of transferred embryos was excellent or good in all main group patients (100%); in the control group, the quality of transferred embryos was excellent or good in 93.8% of cases (p = 0.037). Clinical pregnancies were achieved in 64.2% of women in the main group and in 60.2% of controls (p = 0.65). Delivery rates were 54% and 51.1% in the 5eSET and 5SET subgroups of the main group, respectively (p = 0.940). For the control group, delivery rates were 54.4% and 34.3% in the 5eSET and 5SET subgroups, respectively (p = 0.052, Fisher exact test). Elective single-embryo transfer (5eSET) and the use of TLM increased the chance of pregnancy 2.17-fold (p = 0.01).

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Experience of using time-lapse microscopy in IVF and ICSI programs

Medical alphabet ◽

10.33667/2078-5631-2020-16-47-50 ◽

2020 ◽

pp. 47-50

Author(s):

N. V. Saraeva ◽

N. V. Spiridonova ◽

M. T. Tugushev ◽

O. V. Shurygina ◽

A. I. Sinitsyna

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Selection Procedure ◽

Time Lapse ◽

Single Embryo Transfer ◽

Main Group ◽

Clinical Pregnancy ◽

Control Group ◽

Time Lapse Microscopy

In order to increase the pregnancy rate in the assisted reproductive technology, the selection of one embryo with the highest implantation potential it is very important. Time-lapse microscopy (TLM) is a tool for selecting quality embryos for transfer. This study aimed to assess the benefits of single-embryo transfer of autologous oocytes performed on day 5 of embryo incubation in a TLM-equipped system in IVF and ICSI programs. Single-embryo transfer following incubation in a TLM-equipped incubator was performed in 282 patients, who formed the main group; the control group consisted of 461 patients undergoing single-embryo transfer following a traditional culture and embryo selection procedure. We assessed the quality of transferred embryos, the rates of clinical pregnancy and delivery. The groups did not differ in the ratio of IVF and ICSI cycles, average age, and infertility factor. The proportion of excellent quality embryos for transfer was 77.0% in the main group and 65.1% in the control group (p = 0.001). In the subgroup with receiving eight and less oocytes we noted the tendency of receiving more quality embryos in the main group (р = 0.052). In the subgroup of nine and more oocytes the quality of the transferred embryos did not differ between two groups. The clinical pregnancy rate was 60.2% in the main group and 52.9% in the control group (p = 0.057). The delivery rate was 45.0% in the main group and 39.9% in the control group (p > 0.050).

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Time-lapse imaging of inner cell mass splitting with monochorionic triamniotic triplets after elective single embryo transfer: a case report

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2018.12.017 ◽

2019 ◽

Vol 38 (4) ◽

pp. 491-496 ◽

Cited By ~ 2

Author(s):

Karina Sutherland ◽

Joanne Leitch ◽

Helen Lyall ◽

Bryan J Woodward

Keyword(s):

Case Report ◽

Embryo Transfer ◽

Inner Cell Mass ◽

Cell Mass ◽

Time Lapse ◽

Mass Splitting ◽

Single Embryo Transfer ◽

Elective Single Embryo Transfer ◽

Time Lapse Imaging

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Assessment of the embryo quality in the procedure of in vitro fertilization

Medicinski pregled ◽

10.2298/mpns1608241b ◽

2016 ◽

Vol 69 (7-8) ◽

pp. 241-246

Author(s):

Artur Bjelica ◽

Srna Subanovic

Keyword(s):

Success Rate ◽

Embryo Transfer ◽

Genetic Screening ◽

Embryo Quality ◽

Genetic Diagnosis ◽

Preimplantation Genetic Screening ◽

Single Embryo Transfer ◽

Elective Single Embryo Transfer ◽

Non Invasive

Introduction. Since reproductive technologies are becoming increasingly popular among the couples with infertility problem, and having in mind that the success rate is still low, the clinicians tend to transfer more embryos in order to increase the probability of success. However, such a strategy increases the risk of multiple pregnancy, which brings about numerous risks to the health of both the mother and children. Therefore, an elective single-embryo transfer is set as imperative, which, on the other hand, would not be possible without selection and evaluation of the quality of embryos. Assessment of Embryo Quality. Embryos can be selected by various methods, from non-invasive to invasive methods. In non-invasive methods, the embryos are selected by their morphology or by the techniques based on the analysis of molecular components - analyses of the level of proteomes or metabolomes. A more detailed monitoring of the kinetics of the embryo development can be related to the introduction of time-lapse imaging and monitoring systems into laboratory practice. The invasive methods encompass the techniques such as preimplantation genetic diagnosis and preimplantation genetic screening. In preimplantation genetic diagnosis, the assisted reproduction technologies cycle is approached for the genetic reasons, whereas preimplantation genetic screening is used to enhance the success rate of the assisted reproduction cycles. Conclusion. In this paper we have shown that the application of elective single-embryo transfer requires the selection and assessment of the quality of embryos by the methods that have been developed in the last four decades, and still need further improvements.

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