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PP-011 - A comparison of ongoing pregnancy rate between frozen embryo transfer following freeze-all cycle and fresh embryo transfer
S6
Abstracts of the 11th Biennial Conference of Alpha, Scientists in Reproductive Medicine
PP-010 [Abstract:0020][Reviewed][Embryology]
Effect of circadian temperature rhythm on human embryo development Ronny Janssens, Neelke De Munck, Greta Verheyen Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium Introduction: Since the onset of IVF, constant incubator settings matching the core body temperature (CBT, 37°C) are used, but the optimal culture temperature for embryos is yet undefined. The circadian rhythm (CR) of the core body temperature is a well-documented physiological phenomenon with a maximum temperature in the early evening and a minimum in the early morning with a maximum deviation of 0.9°C. Recent technical improvements to benchtop incubators allow accurate and stable temperature regulation (temperature gradient of 0.1°C between chambers) and now also can simulate a circadian temperature rhythm. The purpose of this prospective study was to evaluate whether incubation with a simulated circadian temperature rhythm can be used in human IVF and if this improves embryo development. Materials and Method: Sibling oocytes from 50 patients were cultured until day 5/6 at 37.0°C (CBT) in a standard benchtop incubator or in a benchtop incubator simulating a circadian temperature rhythm (CR) with a range of 36.6°C (1 to 6 a.m.) to 37.5°C (11 am to 9 pm). Statistics: the two-tailed Chi square test with Yates correction was used. Results: A total of 674 mature oocytes were randomly distributed for culture at 37.0°C (CBT) or exposed to a CR. No significant difference (p=0.113) in fertilization rate was observed (84.0% in CBT vs 78.9% in CR). On day 3 of development, the number of excellent and good quality embryos did not differ between both groups (78.8% vs. 76.7%; p=0.608). Although no significant difference in embryo quality was obtained on day 5 of development (59.2% vs. 52.3%; p=0.146), a significant higher utilization rate per mature oocyte (42.1% vs 32.6%: p=0.014) was observed in the CBT group. Table 1. Temperature
CBT (37.0°C)
CR (36.6-37.5°C)
337
337
283 (84.0)
266 (78.9)
0.113
Excellent (%)
153 (54.1)
131 (49.2)
0.624
Good (%)
70 (24.7)
73 (27.4)
Moderate (%)
36 (12.7)
39 (14.7)
Poor (%)
24 (8.5)
23 (8.6)
250
241
Excellent (%)
51 (20.4)
39 (16.2)
Good (%)
97 (38.8)
87 (36.1)
Moderate (%)
41 (16.4)
52 (21.6)
Poor (%)
61 (24.4)
63 (26.1)
MII Fertilized (%) D3
D5
Transferred
31
26
Cryopreserved D5
77
47
Cryopreserved D6
34
37
142/337 (42.1)
110/337 (32.6)
Per MII
0.147
0.014
Conclusions: This is the first report of human embryos cultured in a circadian temperature rhythm. Although fertilization and embryo development were similar in the two groups, the utilization rate was lower in the CR cultured embryos. The CR settings used in the current study, do not seem to improve embryo development. Further studies are needed to determine the optimal temperature or CR range for human embryos. Keywords: Circadian rhythm, Embryo culture, Temperature, Incubator
PP-011 [Abstract:0021][Reviewed][Cryopreservation]
A comparison of ongoing pregnancy rate between frozen embryo transfer following freeze-all cycle and fresh embryo transfer Huynh Gia Bao1, Tran Tu Cam1, Ha Thanh Que1, Pham Duong Toan1, Ho Manh Tuong2 1 IVFMD, My Duc General Hospital, HCMC, Vietnam; 2CGRH, School of Medicine, VNU-HCM, Vietnam Introduction: There has been increasing evidence supporting freeze-all strategy in IVF program. We performed this study to compare the ongoing pregnancy rate (OPR) between frozen embryo transfer (FET) following freeze-all cycle and fresh embryo transfer (ET). Materials and Methods: A retrospective cohort study was conducted at IVFMD, My Duc hospital from July 2014 to March 2015. Patients who had (i) IVF cycles ≤2, (ii) at least 1 grade I embryo transferred were included in the study. ET was done on day 2, day 3 or day 5. Primary outcome was OPR. Results: A total of 1007 patients were recruited in the study, in which 269 patients had FET following freeze-all cycle, 738 patients had fresh ET. There was no significant difference with age, BMI, infertility duration, endometrial thickness, the average numbers of embryos transferred and top-quality embryos transferred (32.3 vs 32.4, 20.8 vs 20.9, 4.8 vs 4.5, 11.5 vs 11.8, 2.4 vs 2.4, 1.6 vs 1.7, respectively) between two groups. Data analysis showed that FET resulted in significantly higher implantation rate and OPR (27.9 vs 23.4, 45.4 vs 35.5, respectively). Further, OPR was not significantly different between FET following freeze-all cycle and fresh ET with day 2 ET (31.3 vs 33.0, P>0.05) but the OPR was significantly different compared FET following freeze-all cycle and fresh ET in day 3 ET (45.8 vs 35.1, P=0.01) and day 5 ET (82.3 vs 44.1, P=0.01). Otherwise, ectopic pregnancy rate in FET following freeze-all cycle was significant difference lower (1.3% vs 6.6%, RR=0.20 95% Cl 0.05–0.86). Conclusion: FET following freeze-all cycle on day 3 and day 5 achieves higher OPR compared to fresh ET. Keywords: Fresh embryo transfer, Frozen embryo transfer, Freezeall, Implantation rate, Ongoing pregnancy rate, Ectopic pregnancy rate
PP-012 [Abstract:0023][Reviewed][Genetics]
Genetic polymorphism in the vitamin D receptor gene and 25-hydroxyvitamin D serum levels in East Indian women with polycystic ovary syndrome Dipanshu Sur, Ratnabali Chakravorty Department of Obstetrics & Gynecology; MAGS Medical and Research Center, India Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA.
Abstracts of the 11th Biennial Conference of Alpha, Scientists in Reproductive Medicine
PP-010 [Abstract:0020][Reviewed][Embryology]
Effect of circadian temperature rhythm on human embryo development Ronny Janssens, Neelke De Munck, Greta Verheyen Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium Introduction: Since the onset of IVF, constant incubator settings matching the core body temperature (CBT, 37°C) are used, but the optimal culture temperature for embryos is yet undefined. The circadian rhythm (CR) of the core body temperature is a well-documented physiological phenomenon with a maximum temperature in the early evening and a minimum in the early morning with a maximum deviation of 0.9°C. Recent technical improvements to benchtop incubators allow accurate and stable temperature regulation (temperature gradient of 0.1°C between chambers) and now also can simulate a circadian temperature rhythm. The purpose of this prospective study was to evaluate whether incubation with a simulated circadian temperature rhythm can be used in human IVF and if this improves embryo development. Materials and Method: Sibling oocytes from 50 patients were cultured until day 5/6 at 37.0°C (CBT) in a standard benchtop incubator or in a benchtop incubator simulating a circadian temperature rhythm (CR) with a range of 36.6°C (1 to 6 a.m.) to 37.5°C (11 am to 9 pm). Statistics: the two-tailed Chi square test with Yates correction was used. Results: A total of 674 mature oocytes were randomly distributed for culture at 37.0°C (CBT) or exposed to a CR. No significant difference (p=0.113) in fertilization rate was observed (84.0% in CBT vs 78.9% in CR). On day 3 of development, the number of excellent and good quality embryos did not differ between both groups (78.8% vs. 76.7%; p=0.608). Although no significant difference in embryo quality was obtained on day 5 of development (59.2% vs. 52.3%; p=0.146), a significant higher utilization rate per mature oocyte (42.1% vs 32.6%: p=0.014) was observed in the CBT group. Table 1. Temperature
CBT (37.0°C)
CR (36.6-37.5°C)
337
337
283 (84.0)
266 (78.9)
0.113
Excellent (%)
153 (54.1)
131 (49.2)
0.624
Good (%)
70 (24.7)
73 (27.4)
Moderate (%)
36 (12.7)
39 (14.7)
Poor (%)
24 (8.5)
23 (8.6)
250
241
Excellent (%)
51 (20.4)
39 (16.2)
Good (%)
97 (38.8)
87 (36.1)
Moderate (%)
41 (16.4)
52 (21.6)
Poor (%)
61 (24.4)
63 (26.1)
MII Fertilized (%) D3
D5
Transferred
31
26
Cryopreserved D5
77
47
Cryopreserved D6
34
37
142/337 (42.1)
110/337 (32.6)
Per MII
0.147
0.014
Conclusions: This is the first report of human embryos cultured in a circadian temperature rhythm. Although fertilization and embryo development were similar in the two groups, the utilization rate was lower in the CR cultured embryos. The CR settings used in the current study, do not seem to improve embryo development. Further studies are needed to determine the optimal temperature or CR range for human embryos. Keywords: Circadian rhythm, Embryo culture, Temperature, Incubator
PP-011 [Abstract:0021][Reviewed][Cryopreservation]
A comparison of ongoing pregnancy rate between frozen embryo transfer following freeze-all cycle and fresh embryo transfer Huynh Gia Bao1, Tran Tu Cam1, Ha Thanh Que1, Pham Duong Toan1, Ho Manh Tuong2 1 IVFMD, My Duc General Hospital, HCMC, Vietnam; 2CGRH, School of Medicine, VNU-HCM, Vietnam Introduction: There has been increasing evidence supporting freeze-all strategy in IVF program. We performed this study to compare the ongoing pregnancy rate (OPR) between frozen embryo transfer (FET) following freeze-all cycle and fresh embryo transfer (ET). Materials and Methods: A retrospective cohort study was conducted at IVFMD, My Duc hospital from July 2014 to March 2015. Patients who had (i) IVF cycles ≤2, (ii) at least 1 grade I embryo transferred were included in the study. ET was done on day 2, day 3 or day 5. Primary outcome was OPR. Results: A total of 1007 patients were recruited in the study, in which 269 patients had FET following freeze-all cycle, 738 patients had fresh ET. There was no significant difference with age, BMI, infertility duration, endometrial thickness, the average numbers of embryos transferred and top-quality embryos transferred (32.3 vs 32.4, 20.8 vs 20.9, 4.8 vs 4.5, 11.5 vs 11.8, 2.4 vs 2.4, 1.6 vs 1.7, respectively) between two groups. Data analysis showed that FET resulted in significantly higher implantation rate and OPR (27.9 vs 23.4, 45.4 vs 35.5, respectively). Further, OPR was not significantly different between FET following freeze-all cycle and fresh ET with day 2 ET (31.3 vs 33.0, P>0.05) but the OPR was significantly different compared FET following freeze-all cycle and fresh ET in day 3 ET (45.8 vs 35.1, P=0.01) and day 5 ET (82.3 vs 44.1, P=0.01). Otherwise, ectopic pregnancy rate in FET following freeze-all cycle was significant difference lower (1.3% vs 6.6%, RR=0.20 95% Cl 0.05–0.86). Conclusion: FET following freeze-all cycle on day 3 and day 5 achieves higher OPR compared to fresh ET. Keywords: Fresh embryo transfer, Frozen embryo transfer, Freezeall, Implantation rate, Ongoing pregnancy rate, Ectopic pregnancy rate
PP-012 [Abstract:0023][Reviewed][Genetics]
Genetic polymorphism in the vitamin D receptor gene and 25-hydroxyvitamin D serum levels in East Indian women with polycystic ovary syndrome Dipanshu Sur, Ratnabali Chakravorty Department of Obstetrics & Gynecology; MAGS Medical and Research Center, India Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA.