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1.
Nat Commun ; 11(1): 4917, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004802

RESUMO

Maternal mRNA clearance is an essential process that occurs during maternal-to-zygotic transition (MZT). However, the dynamics, functional importance, and pathological relevance of maternal mRNA decay in human preimplantation embryos have not yet been analyzed. Here we report the zygotic genome activation (ZGA)-dependent and -independent maternal mRNA clearance processes during human MZT and demonstrate that subgroups of human maternal transcripts are sequentially removed by maternal (M)- and zygotic (Z)-decay pathways before and after ZGA. Key factors regulating M-decay and Z-decay pathways in mouse have similar expression pattern during human MZT, suggesting that YAP1-TEAD4 transcription activators, TUT4/7-mediated mRNA 3'-oligouridylation, and BTG4/CCR4-NOT-induced mRNA deadenylation may also be involved in the regulation of human maternal mRNA stability. Decreased expression of these factors and abnormal accumulation of maternal transcripts are observed in the development-arrested embryos of patients who seek assisted reproduction. Defects of M-decay and Z-decay are detected with high incidence in embryos that are arrested at the zygote and 8-cell stages, respectively. In addition, M-decay is not found to be affected by maternal TUBB8 mutations, although these mutations cause meiotic cell division defects and zygotic arrest, which indicates that mRNA decay is regulated independent of meiotic spindle assembly. Considering the correlations between maternal mRNA decay defects and early developmental arrest of in vitro fertilized human embryos, M-decay and Z-decay pathway activities may contribute to the developmental potential of human preimplantation embryos.


Assuntos
Blastocisto/metabolismo , Desenvolvimento Embrionário/fisiologia , Estabilidade de RNA/fisiologia , RNA Mensageiro Estocado/metabolismo , Fatores de Transcrição/metabolismo , Adulto , Animais , Técnicas de Cultura Embrionária , Feminino , Fertilização In Vitro/métodos , Regulação da Expressão Gênica no Desenvolvimento , Humanos , Masculino , Meiose/genética , Camundongos , Mutação , Oócitos/metabolismo , Cultura Primária de Células , RNA-Seq , Tubulina (Proteína)/genética , Zigoto/metabolismo
2.
Medicine (Baltimore) ; 99(40): e22558, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019467

RESUMO

RATIONALE: During ultrasound prenatal screening, absence of the fetal nasal bone is used as a marker for common aneuploidies in singleton pregnancies. However, its application in multiple pregnancies is less sensitive and more challenging owing to difficulties in obtaining adequate views of the fetal face. PATIENT CONCERNS: A 38-year-old woman with dichorionic-diamniotic (DCDA) pregnancy and a history of in vitro fertilization and embryo transfer was referred to our hospital with the absence of the nasal bone noted on ultrasound images obtained during the second trimester in 1 fetus. DIAGNOSIS: Prenatal sonographic examination revealed the absence of the nasal bone in 1 fetus in the DCDA gestation. Amniocentesis performed on the dual amniotic sacs revealed normal karyotypes for each twin. The absence of the nasal bone was confirmed on a radiograph obtained postnatally in 1 infant. INTERVENTIONS: The mother underwent routine outpatient care according to the gestational age and successfully delivered following lower-segment cesarean section. OUTCOMES: Two live infants were uneventfully delivered. Radiography confirmed the absence of the nasal bone in 1 of the newborns on postnatal day 3. The infants were followed up until 2 years and 9 months of age, which revealed normal appearance and eating and breathing functions. LESSONS: Prenatal diagnosis of the absence of nasal bone in 1 fetus of DCDA pregnancy has rarely been reported. Although a fetus with the absence of the nasal bone in DCDA gestation poses a significant risk of aneuploidy, it is acceptable when the defect is an isolated anomaly after ruling out genetic abnormalities. Appropriate consultation should be provided for these patients.


Assuntos
Fertilização In Vitro/efeitos adversos , Osso Nasal/anormalidades , Diagnóstico Pré-Natal/métodos , Adulto , Amniocentese/métodos , Cesárea/métodos , Transferência Embrionária , Feminino , Feto , Humanos , Osso Nasal/diagnóstico por imagem , Gravidez , Segundo Trimestre da Gravidez , Gravidez Múltipla , Radiografia , Gêmeos Dizigóticos , Ultrassonografia Pré-Natal/métodos
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(8): 960-965, 2020 Aug 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33053539

RESUMO

OBJECTIVES: To investigate the possible factors relevant to fertilization failure in in vitro fertilization-embryo transfer (IVF-ET). METHODS: The medical records of 4 205 infertile patients undergoing IVF-ET treatment at the Reproductive Medicine Center, Xiangya Hospital, Central South University from January 2016 to December 2017 were collected. The patients were divided into a complete fertilization failure group, a low fertilization rate group, and a control group based on fertilization rate. We examined the associations among the 3 groups in terms of female age, duration of infertility, duration of stimulation, gonadotropin (Gn) dosage, follicle-stimulating hormone (FSH) dosage, and total number of retrieved oocytes. According to theincidence factors, the patients were divided into a single female factor group, a single male factor group and a unisex factor group, and the correlation analysis of incidence factor among the 3 groups was performed. The patients were divided into a primary infertility and a secondary infertility in accordance with the type of infertility. We analyzed the correlation of infertility type among the three groups. Risk factors for complete fertilization failure and low fertilization rate in IVF-ET were obtained by stepwise multiple linear regression analysis. RESULTS: Primary infertility, long infertility duration, total number of retrieved oocytes, and unisex factor were associated with completefertilization failure and low fertilization rate in IVF-ET (P<0.05), but female age, duration of stimulation, FSH dosage as well as Gn dosage were not correlated with complete fertilization failure and low fertilization rate in IVF-ET (P>0.05). Stepwise multiple linear regression analysis showed that the incidence factor, type of infertility, and infertility duration were independent influential factors for complete fertilization failure and low fertilization rate. CONCLUSIONS: Complete fertilization failure and low fertilization rate in IVF-ET are related to duration of infertility, total number of retrieved oocytes, cause of onset, and type of infertility, but they are not relevant to female age, duration of stimulation, and Gn and FSH dosage.


Assuntos
Fertilização In Vitro , Infertilidade , Transferência Embrionária , Feminino , Humanos , Masculino , Oócitos , Injeções de Esperma Intracitoplásmicas
4.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(3): 96-105, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-190826

RESUMO

La pandemia por el nuevo virus SARS-CoV-2 ha provocado un proceso de adaptación a la nueva situación por parte de toda de la sociedad y, con ello, los centros de reproducción asistida. Tras la fase aguda de la crisis sanitaria, en la que se redujo de forma drástica la actividad, se han reanudado los ciclos, guiados por las recomendaciones de las sociedades científicas. En este artículo revisamos toda la información publicada respecto al virus y el sistema reproductivo, señalando la presencia de enzima convertidora de angiotensina tipo ii(angiotensin-converting enzyme 2, ACE2) en el sistema reproductivo femenino y masculino, a nivel testicular, ovárico, endometrial y a nivel embrionario. Además, realizamos un análisis comparativo entre las recomendaciones de las sociedades científicas en cuanto al cribado de la infección, las normas de funcionamiento y las medidas generales de laboratorio


The pandemic caused by the new SARS-CoV-2 virus has led to a process of adaptation to the new situation by society as a whole and, therefore, by assisted reproduction centres. After the acute phase of the health crisis, when activity was drastically reduced, cycles have resumed, guided by the recommendations of scientific societies. In this article, a review is presented of all the published information regarding the virus and the reproductive system, pointing out the presence of angiotensin-converting enzyme 2 (ACE2) in the female and male reproductive system, at the testicular, ovarian, endometrial and embryonic levels. In addition, a comparative analysis is carried out between the recommendations of the scientific societies regarding the screening of infection, performance standards, and general laboratory measurements


Assuntos
Humanos , Pandemias , Técnicas Reprodutivas , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Fertilidade , Técnicas de Reprodução Assistida/normas , Fertilização In Vitro , Inseminação Artificial , Infecções por Coronavirus/fisiopatologia , Medicina Reprodutiva/organização & administração , Serviços de Saúde Reprodutiva/normas
5.
Medicine (Baltimore) ; 99(35): e21815, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871903

RESUMO

BACKGROUND: Previous studies have given an inaccurate assessment of the role of acupuncture in in vitro fertilization (IVF). We will use acupuncture doses as an entry point, discussing the dose-related effects of acupuncture therapy in women undergoing IVF. METHODS: This study will search the following database: EMBASE, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), and 4 Chinese databases. All databases will be searched from the date of database establishment to January 31, 2019. In addition, we will search possible studies which were included in previous meta-analyses. The primary outcomes are the clinical pregnancy rate (CPR) and the live birth rate (LBR). The secondary outcomes involved the biochemical pregnancy rate (BPR), the ongoing pregnancy rate (OPR), serum hormone level, the incidence of ovarian hyper-stimulation syndrome (OHSS), the cycle cancellation rates, and adverse events (AEs). After checking and integrating the raw data, we will use a 2-step to conduct the meta-analysis. Firstly, we will assess the effect of acupuncture on in vitro fertilization and embryo transfer (IVF-ET). Secondly, the meta-analysis will be performed for studies with similar total number of treatment sessions to investigate the dose-related effects of acupuncture. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, then a descriptive analysis will be conducted. RESULTS: This study will investigate the relationship between pregnancy outcomes and the doses of acupuncture therapy in women undergoing IVF, and answer whether a higher-doses of acupuncture treatment will contribute to a better outcome of IVF-ET. CONCLUSION: The funding of this meta-analysis may provide convincing evidence for clinicians, benefitting more patients who crave children. INPLASY REGISTRATION NUMBER: INPLASY202070072.


Assuntos
Terapia por Acupuntura , Fertilização In Vitro , Metanálise como Assunto , Revisões Sistemáticas como Assunto , Feminino , Humanos , Nascimento Vivo , Síndrome de Hiperestimulação Ovariana , Gravidez , Taxa de Gravidez , Projetos de Pesquisa
8.
Dtsch Arztebl Int ; 117(24): 422, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32865496
10.
Cochrane Database Syst Rev ; 9: CD005291, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32898291

RESUMO

BACKGROUND: In in vitro fertilisation (IVF) with or without intracytoplasmic sperm injection (ICSI), selection of the most competent embryo(s) for transfer is based on morphological criteria. However, many women do not achieve a pregnancy even after 'good quality' embryo transfer. One of the presumed causes is that such morphologically normal embryos have an abnormal number of chromosomes (aneuploidies). Preimplantation genetic testing for aneuploidies (PGT-A), formerly known as preimplantation genetic screening (PGS), was therefore developed as an alternative method to select embryos for transfer in IVF. In PGT-A, the polar body or one or a few cells of the embryo are obtained by biopsy and tested. Only polar bodies and embryos that show a normal number of chromosomes are transferred. The first generation of PGT-A, using cleavage-stage biopsy and fluorescence in situ hybridisation (FISH) for the genetic analysis, was demonstrated to be ineffective in improving live birth rates. Since then, new PGT-A methodologies have been developed that perform the biopsy procedure at other stages of development and use different methods for genetic analysis. Whether or not PGT-A improves IVF outcomes and is beneficial to patients has remained controversial. OBJECTIVES: To evaluate the effectiveness and safety of PGT-A in women undergoing an IVF treatment. SEARCH METHODS: We searched the Cochrane Gynaecology and Fertility (CGF) Group Trials Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, and two trials registers in September 2019 and checked the references of appropriate papers. SELECTION CRITERIA: All randomised controlled trials (RCTs) reporting data on clinical outcomes in participants undergoing IVF with PGT-A versus IVF without PGT-A were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies for inclusion, assessed risk of bias, and extracted study data. The primary outcome was the cumulative live birth rate (cLBR). Secondary outcomes were live birth rate (LBR) after the first embryo transfer, miscarriage rate, ongoing pregnancy rate, clinical pregnancy rate, multiple pregnancy rate, proportion of women reaching an embryo transfer, and mean number of embryos per transfer. MAIN RESULTS: We included 13 trials involving 2794 women. The quality of the evidence ranged from low to moderate. The main limitations were imprecision, inconsistency, and risk of publication bias. IVF with PGT-A versus IVF without PGT-A with the use of genome-wide analyses Polar body biopsy One trial used polar body biopsy with array comparative genomic hybridisation (aCGH). It is uncertain whether the addition of PGT-A by polar body biopsy increases the cLBR compared to IVF without PGT-A (odds ratio (OR) 1.05, 95% confidence interval (CI) 0.66 to 1.66, 1 RCT, N = 396, low-quality evidence). The evidence suggests that for the observed cLBR of 24% in the control group, the chance of live birth following the results of one IVF cycle with PGT-A is between 17% and 34%. It is uncertain whether the LBR after the first embryo transfer improves with PGT-A by polar body biopsy (OR 1.10, 95% CI 0.68 to 1.79, 1 RCT, N = 396, low-quality evidence). PGT-A with polar body biopsy may reduce miscarriage rate (OR 0.45, 95% CI 0.23 to 0.88, 1 RCT, N = 396, low-quality evidence). No data on ongoing pregnancy rate were available. The effect of PGT-A by polar body biopsy on improving clinical pregnancy rate is uncertain (OR 0.77, 95% CI 0.50 to 1.16, 1 RCT, N = 396, low-quality evidence). Blastocyst stage biopsy One trial used blastocyst stage biopsy with next-generation sequencing. It is uncertain whether IVF with the addition of PGT-A by blastocyst stage biopsy increases cLBR compared to IVF without PGT-A, since no data were available. It is uncertain if LBR after the first embryo transfer improves with PGT-A with blastocyst stage biopsy (OR 0.93, 95% CI 0.69 to 1.27, 1 RCT, N = 661, low-quality evidence). It is uncertain whether PGT-A with blastocyst stage biopsy reduces miscarriage rate (OR 0.89, 95% CI 0.52 to 1.54, 1 RCT, N = 661, low-quality evidence). No data on ongoing pregnancy rate or clinical pregnancy rate were available. IVF with PGT-A versus IVF without PGT-A with the use of FISH for the genetic analysis Eleven trials were included in this comparison. It is uncertain whether IVF with addition of PGT-A increases cLBR (OR 0.59, 95% CI 0.35 to 1.01, 1 RCT, N = 408, low-quality evidence). The evidence suggests that for the observed average cLBR of 29% in the control group, the chance of live birth following the results of one IVF cycle with PGT-A is between 12% and 29%. PGT-A performed with FISH probably reduces live births after the first transfer compared to the control group (OR 0.62, 95% CI 0.43 to 0.91, 10 RCTs, N = 1680, I² = 54%, moderate-quality evidence). The evidence suggests that for the observed average LBR per first transfer of 31% in the control group, the chance of live birth after the first embryo transfer with PGT-A is between 16% and 29%. There is probably little or no difference in miscarriage rate between PGT-A and the control group (OR 1.03, 95%, CI 0.75 to 1.41; 10 RCTs, N = 1680, I² = 16%; moderate-quality evidence). The addition of PGT-A may reduce ongoing pregnancy rate (OR 0.68, 95% CI 0.51 to 0.90, 5 RCTs, N = 1121, I² = 60%, low-quality evidence) and probably reduces clinical pregnancies (OR 0.60, 95% CI 0.45 to 0.81, 5 RCTs, N = 1131; I² = 0%, moderate-quality evidence). AUTHORS' CONCLUSIONS: There is insufficient good-quality evidence of a difference in cumulative live birth rate, live birth rate after the first embryo transfer, or miscarriage rate between IVF with and IVF without PGT-A as currently performed. No data were available on ongoing pregnancy rates. The effect of PGT-A on clinical pregnancy rate is uncertain. Women need to be aware that it is uncertain whether PGT-A with the use of genome-wide analyses is an effective addition to IVF, especially in view of the invasiveness and costs involved in PGT-A. PGT-A using FISH for the genetic analysis is probably harmful. The currently available evidence is insufficient to support PGT-A in routine clinical practice.


Assuntos
Aneuploidia , Fertilização In Vitro , Testes Genéticos/métodos , Diagnóstico Pré-Implantação/métodos , Injeções de Esperma Intracitoplásmicas , Aborto Espontâneo/epidemiologia , Viés , Biópsia , Coeficiente de Natalidade , Blastocisto/patologia , Feminino , Humanos , Nascimento Vivo , Idade Materna , Corpos Polares/patologia , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Anim Sci J ; 91(1): e13451, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32926550

RESUMO

This study assessed the effects of cryoprotectant concentration during equilibration on the efficiency of bovine blastocyst vitrification and the expression of selected developmentally important genes. In vitro produced bovine blastocysts were equilibrated in either 7.5% ethylene glycol (EG) + 7.5% DMSO (Va group) or in 2% EG + 2% DMSO (Vb group) then vitrified on Cryotop® sheets in 16.5% EG + 16.5% DMSO + 0.5M sucrose. After warming, embryos were cultured for 48 hr. Re-expansion, hatching, and the numbers of total and membrane damaged cells were compared among vitrified groups and a control. There was no significant difference between the vitrified groups in survival, cell numbers and the extent of membrane damage. Vitrification increased the number of membrane-damaged cells in both groups, however, in a greater extent in the Vb group. Vitrification increased (p < .05) the expression of the HSP70 gene in Va but not in Vb embryos. The expression of IGF2R, SNRPN, HDAC1, DNMT3B, BAX, OCT4, and IFN-t genes were the same in control and vitrified groups. In conclusion, the concentration of cryoprotectants during equilibration did not affect survival rates; however, normal cell numbers could be maintained only by equilibration in 15% cryoprotectants which was associated with increased HSP70 expression.


Assuntos
Blastocisto , Sobrevivência Celular/efeitos dos fármacos , Criopreservação/métodos , Criopreservação/veterinária , Crioprotetores/farmacologia , Fertilização In Vitro/métodos , Fertilização In Vitro/veterinária , Vitrificação/efeitos dos fármacos , Animais , Bovinos , Células Cultivadas , Relação Dose-Resposta a Droga , Feminino , Expressão Gênica , Proteínas de Choque Térmico HSP70/genética , Proteínas de Choque Térmico HSP70/metabolismo
12.
BMJ ; 370: m2519, 2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32759285

RESUMO

OBJECTIVE: To compare the ongoing pregnancy rate between a freeze-all strategy and a fresh transfer strategy in assisted reproductive technology treatment. DESIGN: Multicentre, randomised controlled superiority trial. SETTING: Outpatient fertility clinics at eight public hospitals in Denmark, Sweden, and Spain. PARTICIPANTS: 460 women aged 18-39 years with regular menstrual cycles starting their first, second, or third treatment cycle of in vitro fertilisation or intracytoplasmic sperm injection. INTERVENTIONS: Women were randomised at baseline on cycle day 2 or 3 to one of two treatment groups: the freeze-all group (elective freezing of all embryos) who received gonadotropin releasing hormone agonist triggering and single frozen-thawed blastocyst transfer in a subsequent modified natural cycle; or the fresh transfer group who received human chorionic gonadotropin triggering and single blastocyst transfer in the fresh cycle. Women in the fresh transfer group with more than 18 follicles larger than 11 mm on the day of triggering had elective freezing of all embryos and postponement of transfer as a safety measure. MAIN OUTCOME MEASURES: The primary outcome was the ongoing pregnancy rate defined as a detectable fetal heart beat after eight weeks of gestation. Secondary outcomes were live birth rate, positive human chorionic gonadotropin rate, time to pregnancy, and pregnancy related, obstetric, and neonatal complications. The primary analysis was performed according to the intention-to-treat principle. RESULTS: Ongoing pregnancy rate did not differ significantly between the freeze-all and fresh transfer groups (27.8% (62/223) v 29.6% (68/230); risk ratio 0.98, 95% confidence interval 0.87 to 1.10, P=0.76). Additionally, no significant difference was found in the live birth rate (27.4% (61/223) for the freeze-all group and 28.7% (66/230) for the fresh transfer group; risk ratio 0.98, 95% confidence interval 0.87 to 1.10, P=0.83). No significant differences between groups were observed for positive human chorionic gonadotropin rate or pregnancy loss, and none of the women had severe ovarian hyperstimulation syndrome; only one hospital admission related to this condition occurred in the fresh transfer group. The risks of pregnancy related, obstetric, and neonatal complications did not differ between the two groups except for a higher mean birth weight after frozen blastocyst transfer and an increased risk of prematurity after fresh blastocyst transfer. Time to pregnancy was longer in the freeze-all group. CONCLUSIONS: In women with regular menstrual cycles, a freeze-all strategy with gonadotropin releasing hormone agonist triggering for final oocyte maturation did not result in higher ongoing pregnancy and live birth rates than a fresh transfer strategy. The findings warrant caution in the indiscriminate application of a freeze-all strategy when no apparent risk of ovarian hyperstimulation syndrome is present. TRIAL REGISTRATION: Clinicaltrials.gov NCT02746562.


Assuntos
Peso ao Nascer , Blastocisto , Criopreservação , Fertilização In Vitro/métodos , Transferência de Embrião Único/métodos , Aborto Espontâneo/epidemiologia , Adulto , Gonadotropina Coriônica/sangue , Feminino , Humanos , Nascimento Vivo , Ciclo Menstrual , Complicações do Trabalho de Parto/epidemiologia , Gravidez , Taxa de Gravidez , Nascimento Prematuro/epidemiologia , Fatores de Tempo
13.
Environ Pollut ; 265(Pt B): 114973, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32806448

RESUMO

Maternal exposure to air pollution is associated with poor reproductive outcomes in in vitro fertilization (IVF). However, the susceptible time windows are still not been known clearly. In the present study, we linked the air pollution data with the information of 9001 women receiving 10,467 transfer cycles from August 2014 to August 2019 in The Second Hospital of Hebei Medical University, Shijiazhuang City, China. Maternal exposure was presented as individual average daily concentrations of PM2.5, PM10, NO2, SO2, CO, and O3, which were predicted by spatiotemporal kriging model based on residential addresses. Exposure windows were divided to five periods according to the process of follicular and embryonic development in IVF. Generalized estimating equation model was used to evaluate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for association between clinical pregnancy and interquartile range increased average daily concentrations of pollutants during each exposure period. The increased PM2.5 (adjusted OR = 0.95, 95% CI: 0.90, 0.99), PM10 (adjusted OR = 0.93, 95% CI: 0.89, 0.98), NO2 (adjusted OR = 0.89, 95% CI: 0.85, 0.94), SO2 (OR = 0.94, 95% CI: 0.90, 0.98), CO (adjusted OR = 0.93, 95% CI: 0.89, 0.97) whereas decreased O3 (OR = 1.08, 95% CI: 1.02, 1.14) during the duration from preantral follicles to antral follicles were the strongest association with decreased probability of clinical pregnancy among the five periods. Especially, women aged 20-29 years old were more susceptible in preantral-antral follicle transition stage. Women aged 36-47 years old were more vulnerable during post-oocyte retrieve period. Our results suggested air pollution exposure during preantral-antral follicle transition stage was a note-worthy challenge to conceive among females receiving IVF.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar , Adulto , China , Feminino , Fertilização In Vitro , Humanos , Exposição Materna , Pessoa de Meia-Idade , Gravidez , Adulto Jovem
14.
PLoS Genet ; 16(8): e1008954, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32785227

RESUMO

The flagellum is essential for sperm motility and fertilization in vivo. The axoneme is the main component of the flagella, extending through its entire length. An axoneme is comprised of two central microtubules surrounded by nine doublets, the nexin-dynein regulatory complex, radial spokes, and dynein arms. Failure to properly assemble components of the axoneme in a sperm flagellum, leads to fertility alterations. To understand this process in detail, we have defined the function of an uncharacterized gene, Cfap97 domain containing 1 (Cfap97d1). This gene is evolutionarily conserved in mammals and multiple other species, including Chlamydomonas. We have used two independently generated Cfap97d1 knockout mouse models to study the gene function in vivo. Cfap97d1 is exclusively expressed in testes starting from post-natal day 20 and continuing throughout adulthood. Deletion of the Cfap97d1 gene in both mouse models leads to sperm motility defects (asthenozoospermia) and male subfertility. In vitro fertilization (IVF) of cumulus-intact oocytes with Cfap97d1 deficient sperm yielded few embryos whereas IVF with zona pellucida-free oocytes resulted in embryo numbers comparable to that of the control. Knockout spermatozoa showed abnormal motility characterized by frequent stalling in the anti-hook position. Uniquely, Cfap97d1 loss caused a phenotype associated with axonemal doublet heterogeneity linked with frequent loss of the fourth doublet in the sperm stored in the epididymis. This study demonstrates that Cfap97d1 is required for sperm flagellum ultra-structure maintenance, thereby playing a critical role in sperm function and male fertility in mice.


Assuntos
Axonema/genética , Proteínas do Citoesqueleto/genética , Dineínas/genética , Infertilidade Masculina/genética , Animais , Chlamydomonas/genética , Cílios/genética , Cílios/patologia , Fertilização In Vitro , Humanos , Infertilidade Masculina/patologia , Masculino , Camundongos , Camundongos Knockout , Motilidade Espermática/genética , Cauda do Espermatozoide/metabolismo , Cauda do Espermatozoide/patologia , Espermatozoides/crescimento & desenvolvimento , Espermatozoides/patologia , Testículo/crescimento & desenvolvimento , Testículo/patologia
15.
Reprod Biomed Online ; 41(3): 428-430, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32753362

RESUMO

RESEARCH QUESTION: Discontinuation of IVF cycles has been part of the radical transformation of healthcare provision to enable reallocation of staff and resources to deal with the COVID-19 pandemic. This study sought to estimate the impact of cessation of treatment on individual prognosis and US population live birth rates. DESIGN: Data from 271,438 ovarian stimulation UK IVF cycles was used to model the effect of age as a continuous, yet non-linear, function on cumulative live birth rate. This model was recalibrated to cumulative live birth rates reported for the 135,673 stimulation cycles undertaken in the USA in 2016, with live birth follow-up to October 2018. The effect of a 1-month, 3-month and 6-month shutdown in IVF treatment was calculated as the effect of the equivalent increase in a woman's age, stratified by age group. RESULTS: The average reduction in cumulative live birth rate would be 0.3% (95% confidence interval [CI] 0.3-0.3), 0.8% (95% CI 0.8-0.8) and 1.6% (95% CI 1.6-1.6) for 1-month, 3-month and 6-month shutdowns. This corresponds to a reduction of 369 (95% CI 360-378), 1098 (95% CI 1071-1123) and 2166 (95% CI 2116-2216) live births in the cohort, respectively. Th e greatest contribution to this reduction was from older mothers. CONCLUSIONS: The study demonstrated that the discontinuation of fertility treatment for even 1 month in the USA could result in 369 fewer women having a live birth, due to the increase in patients' age during the shutdown. As a result of reductions in cumulative live birth rate, more cycles may be required to overcome infertility at individual and population levels.


Assuntos
Betacoronavirus , Coeficiente de Natalidade , Infecções por Coronavirus/epidemiologia , Fertilização In Vitro/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Nascimento Vivo/epidemiologia , Idade Materna , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
16.
Cochrane Database Syst Rev ; 8: CD003416, 2020 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-32827168

RESUMO

BACKGROUND: Transfer of more than one embryo during in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) increases multiple pregnancy rates resulting in an increased risk of maternal and perinatal morbidity. Elective single embryo transfer offers a means of minimising this risk, but this potential gain needs to be balanced against the possibility of jeopardising the overall live birth rate (LBR). OBJECTIVES: To evaluate the effectiveness and safety of different policies for the number of embryos transferred in infertile couples undergoing assisted reproductive technology cycles. SEARCH METHODS: We searched the Cochrane Gynaecology and Fertility Group specialised register of controlled trials, CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform from inception to March 2020. We handsearched reference lists of articles and relevant conference proceedings. We also communicated with experts in the field regarding any additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing different policies for the number of embryos transferred following IVF or ICSI in infertile women. Studies of fresh or frozen and thawed transfer of one to four embryos at cleavage or blastocyst stage were eligible. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed trial eligibility and risk of bias. The primary outcomes were LBR and multiple pregnancy rate. The secondary outcomes were clinical pregnancy and miscarriage rates. We analysed data using risk ratios (RR), Peto odds ratio (Peto OR) and a fixed effect model. MAIN RESULTS: We included 17 RCTs in the review (2505 women). The main limitation was inadequate reporting of study methods and moderate to high risk of performance bias due to lack of blinding. A majority of the studies had low numbers of participants. None of the trials compared repeated single embryo transfer (SET) with multiple embryo transfer. Reported results of multiple embryo transfer below refer to double embryo transfer. Repeated single embryo transfer versus multiple embryo transfer in a single cycle Repeated SET was compared with double embryo transfer (DET) in four studies of cleavage-stage transfer. In these studies the SET group received either two cycles of fresh SET (one study) or one cycle of fresh SET followed by one frozen SET (three studies). The cumulative live birth rate after repeated SET may be little or no different from the rate after one cycle of DET (RR 0.95, 95% CI (confidence interval) 0.82 to 1.10; I² = 0%; 4 studies, 985 participants; low-quality evidence). This suggests that for a woman with a 42% chance of live birth following a single cycle of DET, the repeated SET would yield pregnancy rates between 34% and 46%. The multiple pregnancy rate associated with repeated SET is probably reduced compared to a single cycle of DET (Peto OR 0.13, 95% CI 0.08 to 0.21; I² = 0%; 4 studies, 985 participants; moderate-quality evidence). This suggests that for a woman with a 13% risk of multiple pregnancy following a single cycle of DET, the risk following repeated SET would be between 0% and 3%. The clinical pregnancy rate (RR 0.99, 95% CI 0.87 to 1.12; I² = 47%; 3 studies, 943 participants; low-quality evidence) after repeated SET may be little or no different from the rate after one cycle of DET. There may be little or no difference in the miscarriage rate between the two groups. Single versus multiple embryo transfer in a single cycle A single cycle of SET was compared with a single cycle of DET in 13 studies, 11 comparing cleavage-stage transfers and three comparing blastocyst-stage transfers.One study reported both cleavage and blastocyst stage transfers. Low-quality evidence suggests that the live birth rate per woman may be reduced in women who have SET in comparison with those who have DET (RR 0.67, 95% CI 0.59 to 0.75; I² = 0%; 12 studies, 1904 participants; low-quality evidence). Thus, for a woman with a 46% chance of live birth following a single cycle of DET, the chance following a single cycle of SET would be between 27% and 35%. The multiple pregnancy rate per woman is probably lower in those who have SET than those who have DET (Peto OR 0.16, 95% CI 0.12 to 0.22; I² = 0%; 13 studies, 1952 participants; moderate-quality evidence). This suggests that for a woman with a 15% risk of multiple pregnancy following a single cycle of DET, the risk following a single cycle of SET would be between 2% and 4%. Low-quality evidence suggests that the clinical pregnancy rate may be lower in women who have SET than in those who have DET (RR 0.70, 95% CI 0.64 to 0.77; I² = 0%; 10 studies, 1860 participants; low-quality evidence). There may be little or no difference in the miscarriage rate between the two groups. AUTHORS' CONCLUSIONS: Although DET achieves higher live birth and clinical pregnancy rates per fresh cycle, the evidence suggests that the difference in effectiveness may be substantially offset when elective SET is followed by a further transfer of a single embryo in fresh or frozen cycle, while simultaneously reducing multiple pregnancies, at least among women with a good prognosis. The quality of evidence was low to moderate primarily due to inadequate reporting of study methods and absence of masking those delivering, as well as receiving the interventions.


Assuntos
Transferência Embrionária/efeitos adversos , Transferência Embrionária/métodos , Fertilização In Vitro , Taxa de Gravidez , Aborto Espontâneo/epidemiologia , Blastocisto , Fase de Clivagem do Zigoto/transplante , Feminino , Humanos , Nascimento Vivo/epidemiologia , Gravidez , Gravidez Múltipla/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transferência de Embrião Único , Injeções de Esperma Intracitoplásmicas
17.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(6): 651-656, 2020 Jun 06.
Artigo em Chinês | MEDLINE | ID: mdl-32842281

RESUMO

Objective: To investigate the association between estradiol on the day of human chorionic gonadotropin (HCG) administration and birth outcomes among singleton live births following fresh embryo transfers. Methods: Based on the clinical reproduction medicine management system of the First Affiliated Hospital of Nanjing Medical University, this retrospective cohort study collected data of fresh embryo transfer cycles during January 2013 and December 2016, including pregnant women's age, body mass index (BMI), type and cause of infertility, assisted reproductive therapy indicators (fertilization mode, ovulation stimulation protocol, estradiol levels on HCG administration day), adverse birth outcomes[small for gestational age (SGA), premature and low birth weight (LBW)], etc.. A total of 2 060 women with singleton pregnancy (2 061 fresh embryo transfer cycles) were enrolled. Multivariate logistic regression was used to analyze the association between estradiol on HCG administration day and singletons' adverse birth outcomes. Results: The age and BMI of the 2 060 pregnant women were (29.63±3.92) years old and (22.29±2.86) kg/m2. Incidences of SGA, premature and LBW were 9.8% (201/2 061), 6.9% (143/2 061) and 3.5% (73/2 061), respectively. After adjusting for confounders, the risk of LBW in 4 000-4 499 pg/ml group was significantly elevated when compared to estradiol<1 500 pg/ml group [OR (95%CI): 4.42 (1.13-17.24)]. A protective effect of premature was observed in estradiol≥4 500 pg/ml group [OR (95%CI): 0.50 (0.25-0.97)]. Conclusion: The high level of estradiol on HCG administration day might be a risk factor for LBW, but a protective factor for premature.


Assuntos
Estradiol , Fertilização In Vitro , Adulto , Gonadotropina Coriônica , Transferência Embrionária , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos
18.
PLoS One ; 15(8): e0237766, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822364

RESUMO

Semen contains epithelial cells that can be cultured in vitro. For somatic cell nuclear transfer applications, it is essential to know whether clone(s) produced from semen-derived epithelial cells (SedECs) are healthy and reproductively competent. In this study, the semen and fertility profile of a cloned bull (C1) that was produced from a SedEC were compared with its donor (D1) and with two cloned bulls (C2, C3) that were produced from commonly used skin-derived fibroblast cells (SkdFCs). We observed variations in some fresh semen parameters (ejaculated volume and mass motility), frozen-thawed sperm parameters (plasma membrane integrity, and computer-assisted semen analysis (CASA) indices), but values are within the normal expected range. There was no difference in sperm concentration of ejaculated semen and frozen-thawed semen parameters which include sperm motility, percentage of live and normal morphology sperm, and distance traveled through oestrus mucus. Following in vitro fertilization (IVF) experiments, zygotes from C1 had higher (P < 0.05) cleavage rates (81%) than C2, C3, and D1 (71%, 67%, and 75%, respectively); however, blastocyst development per cleaved embryo and quality of produced blastocysts did not differ. The conception rate of C1 was 46% (7/15) and C2 was 50% (8/15) following artificial insemination with frozen-thawed semen. Established pregnancies resulted in births of 7 and 6 progenies sired by C1 and C2, respectively, and all calves show no signs of phenotypical abnormalities. These results showed that semen from a cloned bull derived from SedECs is equivalent to semen from its donor bull and bulls cloned from SkdFCs.


Assuntos
Búfalos/fisiologia , Clonagem de Organismos/veterinária , Células Epiteliais/citologia , Sêmen/citologia , Animais , Criopreservação/veterinária , Feminino , Fertilidade , Fertilização , Fertilização In Vitro/veterinária , Inseminação Artificial/veterinária , Masculino , Análise do Sêmen/veterinária , Motilidade Espermática
19.
Ecotoxicol Environ Saf ; 204: 110965, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32798747

RESUMO

Toxic and essential trace elements are associated with human fertility. However, limited studies have been conducted on the relationship between trace elements and in vitro fertilization (IVF) outcomes in the Chinese population. In this exploratory study, 103 couples who underwent IVF/intracytoplasmic sperm injection (ICSI) treatment in our reproductive center were recruited. Serum and follicular fluid (FF) samples and seminal plasma samples were collected from the female and male partners, respectively, on the day of oocyte retrieval. Concentrations of chromium (Cr), nickel (Ni), arsenic (As), selenium (Se), cadmium (Cd), and lead (Pb) in the specimens were measured by inductively coupled plasma-mass spectrometry. Generalized linear models were used to evaluate the associations of toxic and essential trace element levels with the intermediate parameters and outcomes of IVF at both the sex-specific and couple levels. The Cr level in the serum of the female partners was inversely associated with the count of mature oocytes retrieved (p for trend = 0.033). In terms of embryo development, As concentrations in female serum and FF were inversely associated with the probabilities to obtain good-quality cleavage embryos (p for trend < 0.01). There were significant correlations between follicular Se concentrations and seminal As concentrations and higher quality cleavage embryos (p for trend < 0.01). Moreover, a positive correlation was observed between the female serum Se concentrations and blastocyst formation (p for trend = 0.031). In contrast, a higher follicular Se level was negatively correlated with embryo development at the blastocyst stage (p for trend < 0.01). Regarding the clinical outcomes, a positive association of Se levels in seminal plasma and a negative association of follicular Cd levels was observed with the probabilities of pregnancy (p for trend = 0.006 and 0.035, respectively) and live birth (p for trend = 0.014 and 0.027, respectively). The results indicate that exposure to toxic elements (Cr, As and Cd) is associated with intermediate parameters and outcomes of IVF. Furthermore, male Se exposure may be related to better pregnancy outcomes.


Assuntos
Poluentes Ambientais/metabolismo , Líquido Folicular/química , Sêmen/química , Soro/química , Oligoelementos/metabolismo , Adulto , Poluentes Ambientais/sangue , Feminino , Fertilização In Vitro , Humanos , Masculino , Oligoelementos/sangue , Adulto Jovem
20.
Niger Postgrad Med J ; 27(3): 171-176, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687115

RESUMO

Background: Gonadotrophin-Releasing Hormone agonist (GnRHa) - long and short acting - is used for pituitary down regulation prior to ovarian stimulation in in vitro fertilisation (IVF) treatment. However, there are controversies in the literature as to their effectiveness, dose of gonadotrophin needed subsequently for ovarian stimulation and the clinical outcome. Objective: The objective of the study was to compare the efficacy of single-dose long-acting GnRHa - goserelin - and daily dose short-acting GnRHa - buserelin - for pituitary down regulation and their clinical outcome in IVF treatment. Materials and Methods: : This prospective comparative study was undertaken at the IVF centre in National Hospital Abuja, a public tertiary hospital in Nigeria. A total of 114 IVF patients were consecutively allocated into either long-acting GnRHa - goserelin - 3.6 mg single dose (Group A) or short-acting GnRHa - buserelin - 0.5 mg daily (Group B) both starting on day 21 of the cycle preceding the IVF treatment. The effects on pituitary down regulation and treatment outcomes were compared. Results: Time taken (days) to achieve down regulation (22.6 ± 4.3 vs. 26.1 ± 8.0; P = 0.084) and the mean number of human menopausal gonadotrophin (HMG) doses used (57.7 ± 13.7 vs. 54.2 ± 16.7; P = 0.222) were similar in the two groups. Although the number of oocytes retrieved (9.9 ± 6.7 vs. 7.2 ± 5.0; P = 0.02) and fertilised (6.2 ± 4.4 vs. 4.6 ± 3.5; P = 0.04) were significantly higher in Group A, there was no statistically significant difference in the number of embryos (4.4 ± 2.6 vs. 4.0 ± 3.0; P = 0.850) and clinical pregnancy rate at 6 weeks (49.2% vs. 43.6%; odds ratio 1.249; confidence interval = 0.579-2.612; P = 0.578) in both the groups. While group B had a significantly higher number of hospital visits (P = 0.0001) as well as a higher number of injections (P = 0.0001), the mean cost of GnRHa and gonadotrophin used was significantly higher in Group A (P = 0.043). Conclusion: Single-dose long-acting GnRHa is as effective as daily dose short-acting GnRHa for pituitary desensitisation prior to controlled ovarian stimulation in IVF cycles.


Assuntos
Fertilização In Vitro , Hormônio Liberador de Gonadotropina/administração & dosagem , Hormônio Liberador de Gonadotropina/agonistas , Indução da Ovulação/métodos , Adulto , Regulação para Baixo , Feminino , Hormônio Foliculoestimulante/uso terapêutico , Humanos , Nigéria , Gravidez , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
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