Expression of trophinin and dipeptidyl peptidase IV in endometrial co-culture in the presence of an embryo: A comparative immunocytochemical study.

Recurrent implantation failure leads to a reduced pregnancy rate. The expression patterns of trophinin and dipeptidyl peptidase IV (CD26) indicate the involvement of embryo implantation and early placental development. The purpose of the present study was to evaluate endometrial co­culture cells in the presence of embryo with trophinin and CD26 immunofluorescence staining. Patients with recurrent implantation failure were enrolled in the present study. The patients were aged between 26 and 36 years. Co­cultures were prepared from endometrial biopsies for each patient. Controlled ovarian hyperstimulation was performed on each of the patients. Certain embryos were maintained in a conventional culture environment (n=80), and others in an endometrial co­culture environment (n=25). Following embryo transfer, the co­culture cells were examined under an inverted wide­field fluorescence microscope. The ratio of a successful pregnancy was 0.38 in the present study (n=5/13 pregnancies). The average age of the successful group (28±3.54 years) was younger compared with the unsuccessful (32.67±2.81) group (P≤0.05). The number of trophinin (+) endometrial cells in the presence of an embryo was significantly lower (P=0.046) in the successful group on the first day. No significant difference between the groups was observed in terms of the number of CD26 (+) cells on the first to the fourth days (P≤0.05). Trophinin and CD26 immunostaining is important in the early period of pregnancy, and it will be beneficial in terms of providing the deficit of conventional culture medium in performed studies with the endometrial co­culture medium. The co­culture may be important, particularly in the early period, in patients with recurrent implantation failure in terms of enabling a connection between the cells belonging to the endometrium and the embryo.

Live birth after transfer of a tripronuclear embryo: An intracytoplasmic sperm injection as a combination of microarray and time-lapse technology.

Although around 1-4% of human zygotes have been found to be tripronuclear, there is little information about the subsequent development and chromosomal composition of embryos that derive from these zygotes. Herein, we report a pregnancy and subsequent delivery of a healthy newborn after the transfer of a blastocyst that developed from a tripronuclear zygote that had a euploid microarray result.

Reproducibility of a time-lapse embryo selection model based on morphokinetic data in a sequential culture media setting.

OBJECTIVE: To compare the outcomes of embryos that were given a dynamic score based on a preconstructed embryo scoring model and to analyze whether this model complies with our data. MATERIAL AND METHODS: A total of 910 transferred embryos with known implantation data were retrospectively analyzed in this study. All of the embryos were given a dynamic score based on the preconstructed hierarchical embryo scoring model. RESULTS: The highest pregnancy rate was seen in groups C+ and A- (48.2% for each), and the lowest was observed in Group E (19.7%). When implantation and clinical pregnancy rates were compared between groups, it was found that the highest and statistically significant implantation and clinical pregnancy rates were seen in group C+ (32.7% for each, p=0.000). They were dropped down to 29.4% in Group A-. CONCLUSION: The outcomes of the embryos based on the dynamic score do not comply with the results of the preconstructed model. Each IVF laboratory is unique based on its practice. Therefore, we suggest that each IVF laboratory should determine its own embryo selection criteria based on its own data instead of using a preconstructed model.

Frequency of embryo multinucleation detected by time-lapse system and its impact on pregnancy outcome.

OBJECTIVE: To compare the detection rate of multinucleation with the time-lapse system and conventional control timing proposed by European Society of Human Reproduction and Embryology (ESHRE) consensus and evaluate its impact on pregnancy rates. DESIGN: Retrospective study. SETTING: A private IVF center. PATIENT(S): A total of 686 embryos from 511 intracytoplasmic sperm injection (ICSI) cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): A time-lapse system was used to acquire embryo images until ET; the stored data were reviewed for the presence and persistence of multinucleation. The detection rate of multinucleation was compared with ESHRE/ALPHA consensus-proposed embryo evaluating times (23 ± 1, 26 ± 1, 44 ± 1 hours). Morphokinetic characteristics of multinucleated embryos and the effect of multinucleation on pregnancy rate were researched. RESULT(S): Multinucleation was detected in 159 embryos of 145 ICSI cycles. Using ESHRE/ALPHA consensus embryo evaluating times, only 44 (27.6%) out of 159 multinucleated embryos could be identified. In cycles with multinucleated ETs compared with cycles with no multinucleated embryos, clinical pregnancy rates (respectively, 23.4 vs. 44) and implantation rates (respectively, 23.3 vs. 43.6) were significantly lower. Time to 2-cell, 4-cell, and 6-cell stage was significantly longer in multinucleated embryos. Patient age (odds ratio [OR], 0.95; confidence interval [CI], 0.92-0.98) and presence of multinucleation (OR, 0.37; CI, 0.24-0.56) were the only significant predictors of clinical pregnancy rate. CONCLUSION(S): The time-lapse monitoring system seems to be a valuable tool to identify all cases with multinucleation. We conclude that the detection of multinucleation by time-lapse monitoring is associated with lower implantation and clinical pregnancy rates.

Effect of follicular fluid NO, MDA and GSH levels on in vitro fertilization outcomes.

OBJECTIVE: To investigate the biochemical markers such as nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH), indicators of the oxidative status of the follicle, to predict the outcome of in vitro fertilization. MATERIAL AND METHODS: Follicular aspirates of dominant follicles were collected during oocyte retrieval. Biochemical analyses of NO, MDA and GSH were performed on all aspirates. RESULTS: When the successful and unsuccessful pregnancy groups were compared in terms of NO, MDA and GSH, follicular fluid MDA was significantly higher (p=0.001) and follicular fluid NO level was significantly lower (p=0.039) in the pregnant group. Correlation analysis between oxidative stress and IVF parameters showed that MDA had a positive weak correlation with the number of grade 1 embryos (r=0.271, p=0.033) and fertilization rate (r=0.263, p=0.039). ROC curve analysis found that malondialdehyde has an area under the curve of 0.74 and can predict pregnancy with high sensitivity. CONCLUSION: As malondialdehyde was significantly different in pregnant and non-pregnant women and had a good sensitivity profile in predicting pregnancy, it may be considered a marker for predicting IVF success.

In vitro maturation may prevent the cancellation of in vitro fertilization cycles in poor responder patients: A case report.

In vitro maturation (IVM) is a promising technique that is used for the maturation of immature oocytes in laboratory conditions and preferred for use in patients with a diagnosis of polycystic ovary syndrome (PCOS) as an alternative to conventional in vitro fertilization (IVF) treatment. In this report, we present a case who surprisingly showed insufficient response to gonadotrophin stimulation during IVF treatment and whose cycle was retrieved from cancellation by using the in vitro maturation technique. As a result, we conclude that IVM may be a good option not only for PCOS patients, but also for poor responders.