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3 Gamete and embryo selection in oocyte donation programs
S96
9th Annual Meeting, Mediterranean Society for Reproductive Medicine
reproductive procedure or to different characteristics of the 2 populations (fertile and infertile). Surgical risks: The surgical risks are correlated to the time of oocyte pick up, the only surgical procedure during an IVF cycle. Literature data indicates a risk of lesions of the pelvic organs less than 0.1%. 3 Gamete and embryo selection in oocyte donation programs O. Barash, V. Zukin Clinic of reproductive medicine “Nadiya”, Kyiv, Ukraine During 2006 2010 years we conducted much research by analyzing our data on gamete and embryo selection for different factors from over 700 donor cycles performed in IVF clinic Nadiya. IMSI can significantly improve treatment outcome in cases with severe teratozoospermia:blastocyst formation rate was significantly higher (48.13±2.7) than in control (40.15±2.3), cycle cancellation rate decreased from 16.81±2.2 to 9.30±1.3, pregnancy rate was on 8.7% higher (IMSI group 54.35±4.2, control 45.65±3.3). Genetic analysis of donor oocytes (FISH on I and II polar bodies, 5 chromosomes) showed that 53.4±2.3 percent of all donor eggs had minor or major chromosomal abnormalities. Morphology of the embryos is one of the most reliable and complex criteria for embryo selection, which was used on routine basis. The most significant correlation rate was found between number of high quality blastocysts (3AA, 4AA) and pregnancy rate correlation rate 0.79. Our results confirm that for now an absolute criterion is not found, so in everyday clinical practice we should use combination of methods. Pre-fertilization analysis of gametes, multiple-factor scoring, photographing, cultivation embryos to the blastocyst stage and genetic analysis are the basis of choosing best embryo for transfer in oocyte donation programs to achieve best result possible. 4 Oocyte vitrification usefulness in an egg donation program F. Bronet1 , L. Herrero1 , A. Cobo2 IVI Madrid, 2 IVI Valencia, Spain
1
Egg donation is a well-established practice in mostly IVF clinics. To achieve successful outcome rate in egg donation program both receptive endometrium and a well synchronized replacement of embryos are required. We can have both with an egg cryopreservation program. Oocytes can be cryopreserved through either slow-freezing or fast freezing techniques. Slow freezing methods show poor results and seem to be of an inconsistent efficiency. The reliability of oocyte cryopreservation has just been confirmed recently. Vitrification appears like a useful tool. Ovum vitrification allows us to work with a cryobank of oocytes and a good synchronization between the endometrium and embryo can be done. Several authors have confirmed the effectiveness of the technique and some studies show outcome rates as higher as fresh oocytes rates. Another item that we must have into account is safety.
We can be sure that donor can be tested to avoid the transmission of infectious disease. 5 Gonadotropins and ART: treatment of the male partner A.E. Calogero, D. Valenti, R.A. Condorelli, S. La Vignera Section of Endocrinology, Andrology and Internal Medicine, Di.M.I.P.S., University of Catania, Italy Introduction: The efficacy of FSH administration to patients with oligozoospermia and normal serum FSH levels is controversial. Results: Some studies have reported that FSH is effective in improving sperm parameters and ultrastructure (chromatin, head, acrosome, etc.), and/or the pregnancy rate. Treatment with purified FSH in patients with severe oligozoospermia increased fertilization and pregnancy rates, but the difference was not statistically different. Recombinant FSH administration resulted in a significant increase of the pregnancy rate. These results have not always been confirmed. Indeed, no effects of FSH treatment on sperm parameters have been reported. However, Foresta and colleagues showed that patients without maturation arrest at the testicular cytology benefit of treatment with FSH in terms of improvement of the sperm parameters. Conclusions: The usefulness of FSH treatment of infertile patients with oligozoospermia and normal serum FSH levels has yet to be established. Some evidence on its effectiveness should encourage the design of prospective, randomized, doubleblind, placebo-controlled studies to obtain objective and reproducible data, necessary to establish the role and the effectiveness of FSH administration to oligozoospermic infertile patients. 6 ART management ovarian monitoring I. C´ edrin-Durnerin Reproductive medicine unit, Jean Verdier Hospital, Paris XIII University, France Ovarian stimulation is commonly used to treat infertility by ART. The aim of stimulation is either to restore a normal ovulation in ovulatory disorders, or to surpass the FSH threshold in normo-ovulatory women in order to recruit about two follicles for IUI or the entire follicular cohort to enable multiple oocyte retrieval for IVF/CSI. Prior to stimulation, a complete assessment of infertility factors within the couple is required. A precise evaluation of ovulatory status and ovarian reserve is mandatory to choose the most adequate treatment. Indeed, individualized ovarian stimulation has to be undertaken to fit the best compromise between increasing pregnancy rates and limiting risks of multiple pregnancy and ovarian hyperstimulation. The amount of FSH required to achieve this goal varies widely among women. Conventional daily doses of FSH in women aged <35 years range from 50 to 100 IU in IUI protocols and 150 to 225 IU in IVF/ICSI protocols but close monitoring and dose adjustment are necessary
9th Annual Meeting, Mediterranean Society for Reproductive Medicine
reproductive procedure or to different characteristics of the 2 populations (fertile and infertile). Surgical risks: The surgical risks are correlated to the time of oocyte pick up, the only surgical procedure during an IVF cycle. Literature data indicates a risk of lesions of the pelvic organs less than 0.1%. 3 Gamete and embryo selection in oocyte donation programs O. Barash, V. Zukin Clinic of reproductive medicine “Nadiya”, Kyiv, Ukraine During 2006 2010 years we conducted much research by analyzing our data on gamete and embryo selection for different factors from over 700 donor cycles performed in IVF clinic Nadiya. IMSI can significantly improve treatment outcome in cases with severe teratozoospermia:blastocyst formation rate was significantly higher (48.13±2.7) than in control (40.15±2.3), cycle cancellation rate decreased from 16.81±2.2 to 9.30±1.3, pregnancy rate was on 8.7% higher (IMSI group 54.35±4.2, control 45.65±3.3). Genetic analysis of donor oocytes (FISH on I and II polar bodies, 5 chromosomes) showed that 53.4±2.3 percent of all donor eggs had minor or major chromosomal abnormalities. Morphology of the embryos is one of the most reliable and complex criteria for embryo selection, which was used on routine basis. The most significant correlation rate was found between number of high quality blastocysts (3AA, 4AA) and pregnancy rate correlation rate 0.79. Our results confirm that for now an absolute criterion is not found, so in everyday clinical practice we should use combination of methods. Pre-fertilization analysis of gametes, multiple-factor scoring, photographing, cultivation embryos to the blastocyst stage and genetic analysis are the basis of choosing best embryo for transfer in oocyte donation programs to achieve best result possible. 4 Oocyte vitrification usefulness in an egg donation program F. Bronet1 , L. Herrero1 , A. Cobo2 IVI Madrid, 2 IVI Valencia, Spain
1
Egg donation is a well-established practice in mostly IVF clinics. To achieve successful outcome rate in egg donation program both receptive endometrium and a well synchronized replacement of embryos are required. We can have both with an egg cryopreservation program. Oocytes can be cryopreserved through either slow-freezing or fast freezing techniques. Slow freezing methods show poor results and seem to be of an inconsistent efficiency. The reliability of oocyte cryopreservation has just been confirmed recently. Vitrification appears like a useful tool. Ovum vitrification allows us to work with a cryobank of oocytes and a good synchronization between the endometrium and embryo can be done. Several authors have confirmed the effectiveness of the technique and some studies show outcome rates as higher as fresh oocytes rates. Another item that we must have into account is safety.
We can be sure that donor can be tested to avoid the transmission of infectious disease. 5 Gonadotropins and ART: treatment of the male partner A.E. Calogero, D. Valenti, R.A. Condorelli, S. La Vignera Section of Endocrinology, Andrology and Internal Medicine, Di.M.I.P.S., University of Catania, Italy Introduction: The efficacy of FSH administration to patients with oligozoospermia and normal serum FSH levels is controversial. Results: Some studies have reported that FSH is effective in improving sperm parameters and ultrastructure (chromatin, head, acrosome, etc.), and/or the pregnancy rate. Treatment with purified FSH in patients with severe oligozoospermia increased fertilization and pregnancy rates, but the difference was not statistically different. Recombinant FSH administration resulted in a significant increase of the pregnancy rate. These results have not always been confirmed. Indeed, no effects of FSH treatment on sperm parameters have been reported. However, Foresta and colleagues showed that patients without maturation arrest at the testicular cytology benefit of treatment with FSH in terms of improvement of the sperm parameters. Conclusions: The usefulness of FSH treatment of infertile patients with oligozoospermia and normal serum FSH levels has yet to be established. Some evidence on its effectiveness should encourage the design of prospective, randomized, doubleblind, placebo-controlled studies to obtain objective and reproducible data, necessary to establish the role and the effectiveness of FSH administration to oligozoospermic infertile patients. 6 ART management ovarian monitoring I. C´ edrin-Durnerin Reproductive medicine unit, Jean Verdier Hospital, Paris XIII University, France Ovarian stimulation is commonly used to treat infertility by ART. The aim of stimulation is either to restore a normal ovulation in ovulatory disorders, or to surpass the FSH threshold in normo-ovulatory women in order to recruit about two follicles for IUI or the entire follicular cohort to enable multiple oocyte retrieval for IVF/CSI. Prior to stimulation, a complete assessment of infertility factors within the couple is required. A precise evaluation of ovulatory status and ovarian reserve is mandatory to choose the most adequate treatment. Indeed, individualized ovarian stimulation has to be undertaken to fit the best compromise between increasing pregnancy rates and limiting risks of multiple pregnancy and ovarian hyperstimulation. The amount of FSH required to achieve this goal varies widely among women. Conventional daily doses of FSH in women aged <35 years range from 50 to 100 IU in IUI protocols and 150 to 225 IU in IVF/ICSI protocols but close monitoring and dose adjustment are necessary