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PP-9 SINGLE BLASTOCYST TRANSFER (SBT) – ACHIEVING EXCELLENCE FOR PATIENTS IN A SMALL CLINICAL SETTING
S8
9th Biennial Conference of ALPHA Scientists in Reproductive Medicine
donation (0.99%), PGD (0.33%) and 0% in IVF. These data were not different from the 0.6% of the general population referred by SEGO. Conclusions: Cryotransfer showed more abortions, but with no statistically significant differences with the other techniques. IVF and IUI showed less malformation rates respect to ICSI and PGD, although in any case these rates are higher than the ones described in literature. PP-8 EVALUATION OF SPERM SELECTION PROCEDURE BASED ON HYALURONIC ACID BINDING ABILITY ON THE IVF SUCCESS OF DONATED OOCYTES FOLLOWING ICSI Susana Cortes, Rocio Nunez-Calonge, Marta Gago, Leonor Ortega, Enrique Olaya, Andres Guijarro, Pedro Caballero. Clinica Tambre, Spain Background and Aim: It has been demonstrated that spermatozoa able to bind hyaluronate (HA) in vitro are those that have completed plasma membrane remodelling, cytoplasmic extrusion and nuclear maturation. SpermSlow™ presents a natural alternative to PVP as it is made principally of HA. The selection principle in SpermSlow™ is based on sperm binding to HA via receptors on the sperm heads. The aim of this study was to compare the efficiency of routine sperm selection method (PVP) with HAselection procedure (SpermSlow™) for fertilization rate, embryo development, implantation and ongoing pregnancy rates. Method: Semen samples were obtained from the 72 couples undergoing ICSI. To avoid female infertility as a bias factor only oocyte donation from donors with proven fertility in previous reproductive cycles were used (n = 72). The percentage of fertilization rate, cleavage, quality of embryos and ongoing pregnancy rate were compared between two procedures: routine sperm selection with PVP (PVP-ICSI group = 36) and HA-binding selection (HA-ICSI group = 36). Between-group differences of normally distributed continuous variables were assessed with parametric statistic (Student’s t-test), and Between-group differences in non-continuous variables were assessed using the c2 method. Results: No significant differences were observed in fecundation rate (83.2 vs. 82.1), embryo cleavage rate (96.4 vs. 97.2) and quality embryo rate (32.9 vs. 26.7). Although the difference is not statistically significant, a clear trend towards a better pregnancy rate per transfer (63.9% vs. 47.2%) was found in the HA-ICSI group. Conclusion: Although we did not observe a statistical significant difference, clinical outcome of HA-ICSI when using the viscous medium Sperm Slow™ showed the positive effect of HA sperm selection on ICSI outcome. Thus, the HA-sperm selecting method may represent at least a physiological alternative for slowing sperm motility prior to ICSI, even though a wider study could confirm these beneficial effects on ICSI outcome.
PP-9 SINGLE BLASTOCYST TRANSFER (SBT) ACHIEVING EXCELLENCE FOR PATIENTS IN A SMALL CLINICAL SETTING Barbara Podsiadly1 , Steven McArthur2 , Penny O’Donnell1 , Robert Woolcott1 . 1 GENEA Newcastle, Australia, 2 GENEA Sydney, Australia Introduction: Advances have been made in laboratory practices including embryo culture, cryopreservation techniques and genetic aspects of ART treatment. All have contributed to increasing implantation and live birth rates. Despite these efforts, high rates of multiple pregnancies and associated risks are still commonly reported. At GENEA Newcastle, we have maintained a strict Single Blastocyst Transfer policy, particularly with patients that are less than 40 years of age. This abstract reviews the clinical outcomes for patients undergoing ART with SBT over the last 4 years. The data shows that high clinical pregnancy outcomes are achievable using single blastocyst transfers on day 5 in combination with a successful blastocyst vitrification program. Method: Clinical data was retrospectively examined between January 2008 and December 2011 (inclusive). This information is annually submitted in de-identified form to the Australian and New Zealand Assisted Reproduction Database (ANZARD). Live birth rates for 2011 are pending with only clinical pregnancies available. The data represents outcomes for all patients less than 40 yeas of age, receiving a single blastocyst transferred day 5. Results: See Table 1. Table 1. Pregnancy outcomes for all patients <40 years of age using fresh and frozen blastocysts 2008
No. of ET’s No. (%) of cycles with 1×ET No. (%) of clinical pregnancies from 1×ET No. (%) of livebirths No. (%) of multiple births (twins)
2009
2010
2011
Fresh SBT
Frozen SBT
Fresh SBT
Frozen SBT
Fresh SBT
Frozen SBT
Fresh SBT
Frozen SBT
318 310 (97.5%) 116 (37.4%)
288 283 (98.0%) 80 (27.7%)
376 360 (95.7%) 131 (36.4%)
332 326 (98.2%) 76 (23.3%)
277 270 (97.5%) 117 (43.3%)
299 293 (98.0%) 81 (27.6%)
269 262 (97.3%) 108 (41.2%)
277 271 (98%) 95 (35.1%)
97 65 108 (31%) (22.6%) (30.0%) 3 (1.0%) 2 (0.7%) 2* (0.5%)
66 (20.0%) Nil*
100 (37.0%) 3** (1.1%)
60 (20.5%) 1* (0.3%)
*At scan, 1 additional twin pregnancy seen but resulted in singleton livebirth (fetal demise). **At scan, 2 additional patients had twin pregnancies but resulted in singleton livebirth (fetal demise).
Conclusion: A review of the data has shown that good pregnancy rates and subsequent live birth rates are achievable with a strict single blastocyst policy. More than 95% of all our transfers are single blastocyst transfers on day 5 for patients less than 40 years and we have maintained this policy with consistent results for over 4 years. Analysis shows Genea Newcastle clinical pregnancy and live birth outcomes, from single embryo transfer, are higher than national average reported to ANZARD.
PP-10 IS REPRODUCTIVE POTENTIAL OF AZOOSPERMIC MEN UNDERGOING INTRACYTOPLASMIC SPERM INJECTION DEPENDENT ON THE TYPE OF AZOOSPERMIA? Genia Ziskind, Hadar Avraham, Samer Khoury, Nathan Lewit, Yoav Paltieli, Joseph Tal, Michal Silberman, Osnat Navon, Ilan Calderon. In Vitro Fertilization Unit, Dept of Obstetrics and Gynecology, Bnai-Zion Medical Center, Technion, Haifa, Israel Background and Aim: Azoospermia, the absence of sperm in ejaculated semen, is the most severe form of male infertility. The objective of this study was to retrospectively evaluate the outcomes of intracytoplasmic
9th Biennial Conference of ALPHA Scientists in Reproductive Medicine
donation (0.99%), PGD (0.33%) and 0% in IVF. These data were not different from the 0.6% of the general population referred by SEGO. Conclusions: Cryotransfer showed more abortions, but with no statistically significant differences with the other techniques. IVF and IUI showed less malformation rates respect to ICSI and PGD, although in any case these rates are higher than the ones described in literature. PP-8 EVALUATION OF SPERM SELECTION PROCEDURE BASED ON HYALURONIC ACID BINDING ABILITY ON THE IVF SUCCESS OF DONATED OOCYTES FOLLOWING ICSI Susana Cortes, Rocio Nunez-Calonge, Marta Gago, Leonor Ortega, Enrique Olaya, Andres Guijarro, Pedro Caballero. Clinica Tambre, Spain Background and Aim: It has been demonstrated that spermatozoa able to bind hyaluronate (HA) in vitro are those that have completed plasma membrane remodelling, cytoplasmic extrusion and nuclear maturation. SpermSlow™ presents a natural alternative to PVP as it is made principally of HA. The selection principle in SpermSlow™ is based on sperm binding to HA via receptors on the sperm heads. The aim of this study was to compare the efficiency of routine sperm selection method (PVP) with HAselection procedure (SpermSlow™) for fertilization rate, embryo development, implantation and ongoing pregnancy rates. Method: Semen samples were obtained from the 72 couples undergoing ICSI. To avoid female infertility as a bias factor only oocyte donation from donors with proven fertility in previous reproductive cycles were used (n = 72). The percentage of fertilization rate, cleavage, quality of embryos and ongoing pregnancy rate were compared between two procedures: routine sperm selection with PVP (PVP-ICSI group = 36) and HA-binding selection (HA-ICSI group = 36). Between-group differences of normally distributed continuous variables were assessed with parametric statistic (Student’s t-test), and Between-group differences in non-continuous variables were assessed using the c2 method. Results: No significant differences were observed in fecundation rate (83.2 vs. 82.1), embryo cleavage rate (96.4 vs. 97.2) and quality embryo rate (32.9 vs. 26.7). Although the difference is not statistically significant, a clear trend towards a better pregnancy rate per transfer (63.9% vs. 47.2%) was found in the HA-ICSI group. Conclusion: Although we did not observe a statistical significant difference, clinical outcome of HA-ICSI when using the viscous medium Sperm Slow™ showed the positive effect of HA sperm selection on ICSI outcome. Thus, the HA-sperm selecting method may represent at least a physiological alternative for slowing sperm motility prior to ICSI, even though a wider study could confirm these beneficial effects on ICSI outcome.
PP-9 SINGLE BLASTOCYST TRANSFER (SBT) ACHIEVING EXCELLENCE FOR PATIENTS IN A SMALL CLINICAL SETTING Barbara Podsiadly1 , Steven McArthur2 , Penny O’Donnell1 , Robert Woolcott1 . 1 GENEA Newcastle, Australia, 2 GENEA Sydney, Australia Introduction: Advances have been made in laboratory practices including embryo culture, cryopreservation techniques and genetic aspects of ART treatment. All have contributed to increasing implantation and live birth rates. Despite these efforts, high rates of multiple pregnancies and associated risks are still commonly reported. At GENEA Newcastle, we have maintained a strict Single Blastocyst Transfer policy, particularly with patients that are less than 40 years of age. This abstract reviews the clinical outcomes for patients undergoing ART with SBT over the last 4 years. The data shows that high clinical pregnancy outcomes are achievable using single blastocyst transfers on day 5 in combination with a successful blastocyst vitrification program. Method: Clinical data was retrospectively examined between January 2008 and December 2011 (inclusive). This information is annually submitted in de-identified form to the Australian and New Zealand Assisted Reproduction Database (ANZARD). Live birth rates for 2011 are pending with only clinical pregnancies available. The data represents outcomes for all patients less than 40 yeas of age, receiving a single blastocyst transferred day 5. Results: See Table 1. Table 1. Pregnancy outcomes for all patients <40 years of age using fresh and frozen blastocysts 2008
No. of ET’s No. (%) of cycles with 1×ET No. (%) of clinical pregnancies from 1×ET No. (%) of livebirths No. (%) of multiple births (twins)
2009
2010
2011
Fresh SBT
Frozen SBT
Fresh SBT
Frozen SBT
Fresh SBT
Frozen SBT
Fresh SBT
Frozen SBT
318 310 (97.5%) 116 (37.4%)
288 283 (98.0%) 80 (27.7%)
376 360 (95.7%) 131 (36.4%)
332 326 (98.2%) 76 (23.3%)
277 270 (97.5%) 117 (43.3%)
299 293 (98.0%) 81 (27.6%)
269 262 (97.3%) 108 (41.2%)
277 271 (98%) 95 (35.1%)
97 65 108 (31%) (22.6%) (30.0%) 3 (1.0%) 2 (0.7%) 2* (0.5%)
66 (20.0%) Nil*
100 (37.0%) 3** (1.1%)
60 (20.5%) 1* (0.3%)
*At scan, 1 additional twin pregnancy seen but resulted in singleton livebirth (fetal demise). **At scan, 2 additional patients had twin pregnancies but resulted in singleton livebirth (fetal demise).
Conclusion: A review of the data has shown that good pregnancy rates and subsequent live birth rates are achievable with a strict single blastocyst policy. More than 95% of all our transfers are single blastocyst transfers on day 5 for patients less than 40 years and we have maintained this policy with consistent results for over 4 years. Analysis shows Genea Newcastle clinical pregnancy and live birth outcomes, from single embryo transfer, are higher than national average reported to ANZARD.
PP-10 IS REPRODUCTIVE POTENTIAL OF AZOOSPERMIC MEN UNDERGOING INTRACYTOPLASMIC SPERM INJECTION DEPENDENT ON THE TYPE OF AZOOSPERMIA? Genia Ziskind, Hadar Avraham, Samer Khoury, Nathan Lewit, Yoav Paltieli, Joseph Tal, Michal Silberman, Osnat Navon, Ilan Calderon. In Vitro Fertilization Unit, Dept of Obstetrics and Gynecology, Bnai-Zion Medical Center, Technion, Haifa, Israel Background and Aim: Azoospermia, the absence of sperm in ejaculated semen, is the most severe form of male infertility. The objective of this study was to retrospectively evaluate the outcomes of intracytoplasmic