RESUMEN
RESEARCH QUESTION: Does artificial shrinkage before fresh blastocyst transfer improve clinical pregnancy rates in IVF? DESIGN: In this monocentric prospective, randomized, double-blind, controlled pilot study, 150 couples undergoing fresh single-blastocyst transfer were randomized between 20 May 2018 and 22 February 2022. In the artificial shrinkage group (AS group), a single laser pulse was directed to the cellular junction of the trophectoderm on the opposite side of the inner cell mass in each blastocyst. IVF outcomes were clinical pregnancy, multiple pregnancy and live birth rates. Cell-free DNA (cfDNA) concentration was also measured by quantitative real-time PCR in the blastocyst culture medium. RESULTS: In total, 142 couples underwent fresh single-blastocyst transfer: control group, no artificial shrinkage, nâ¯=â¯47; and AS group, artificial shrinkage, nâ¯=â¯95; An intention-to-treat (ITT) analysis was employed. After a reassessment and the exclusion of patients with major protocol deviations, 139 couples underwent fresh single-blastocyst transfer under optimal conditions: control group, nâ¯=â¯47; and AS group, nâ¯=â¯92; a per-protocol analysis was used here. The clinical and laboratory characteristics were not significantly different between the groups. The clinical pregnancy rate was similar in the control and AS groups (ITT: 48.9% versus 49.5%, Pâ¯=â¯0.97; per protocol: 48.94% versus 51.1%, Pâ¯=â¯0.89). The multiple pregnancy rate and the live birth rate were also similar between the groups. No significant differences in gestational age, birthweight or proportion of male/female newborns were observed. The concentration of cfDNA in the blastocyst culture medium was not associated with IVF outcome. CONCLUSIONS: Large-scale randomized controlled trials are required to confirm these preliminary results.
Asunto(s)
Fertilización In Vitro , Índice de Embarazo , Humanos , Femenino , Embarazo , Proyectos Piloto , Adulto , Fertilización In Vitro/métodos , Masculino , Método Doble Ciego , Transferencia de Embrión/métodos , Blastocisto , Estudios Prospectivos , Técnicas de Cultivo de Embriones , Resultado del Embarazo , Tasa de NatalidadRESUMEN
DNA barcoding plays an important role in exploring undescribed biodiversity and is increasingly used to delimit lineages at the species level (see Chap. 4 by Miralles et al.). Although several approaches and programs have been developed to perform species delimitation from datasets of single-locus DNA sequences, such as DNA barcodes, most of these were not initially provided as user-friendly GUI-driven executables. In spite of their differences, most of these tools share the same goal, i.e., inferring de novo a partition of subsets, potentially each representing a distinct species. More recently, a proposed common exchange format for the resulting species partitions (SPART) has been implemented by several of these tools, paving the way toward developing an interoperable digital environment entirely dedicated to integrative and comparative species delimitation. In this chapter, we provide detailed protocols for the use of two bioinformatic tools, one for single locus molecular species delimitation (ASAP) and one for statistical comparison of species partitions resulting from any kind of species delimitation analyses (LIMES).