排卵針劑量與囊胚染色體異常率無明顯正相關 (年輕病人囊胚染色體異常率約40% , 高齡約58%)

Hum Reprod. 2018 Aug 20. doi: 10.1093/humrep/dey270. [Epub ahead of print]

Dosage of exogenous gonadotropins is not associated with blastocyst aneuploidy or live-birth rates in PGS cycles in Chinese women.

Wu Q1,2,3, Li H1,2,3, Zhu Y1,2,3, Jiang W1,2,3, Lu J1,2,3, Wei D1,2,3, Yan J1,2,3, Chen ZJ1,2,3,4,5.

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Abstract

STUDY QUESTION:

Is the total dose of exogenous gonadotropins associated with blastocyst aneuploidy or live-birth rates in PGS cycles in Chinese women?

SUMMARY ANSWER:

The total dose of exogenous gonadotropins is not significantly associated with blastocyst aneuploidy or live-birth rates in PGS cycles in Chinese women.

WHAT IS KNOWN ALREADY:

The administration of gonadotropins in ovarian stimulation leads to supraphysiological steroid concentrations compared with those seen during natural cycles. The rate of euploid blastocytes is negatively associated with female age.

STUDY DESIGN, SIZE, DURATION:

This is a retrospective study using anonymised data on PGS cycles performed in China from 2013 to 2017. Data from 1088 PGS cycles and 3219 embryos were analysed by array-comparative genomic hybridization (array-CGH).

PARTICIPANTS/MATERIALS, SETTING, METHODS:

The study included 944 women who underwent PGS cycles with COH. All cycles were analysed by the total dose of exogenous gonadotropins (<1500, 1500-3000 and >3000 IU), patient age (<35 and ≥35 y.o.) and number of oocytes retrieved (1-5, 6-10, 11-15 and >15 oocytes).

MAIN RESULTS AND THE ROLE OF CHANCE:

In the group of younger women (<35 y.o., 537 PGS cycles), the incidence of aneuploidy ranged from 36.9 to 43.4% when data was stratified by gonadotropins dose. After adjusting for confounding factors, the dose of exogenous gonadotropins was not associated with the blastocyst aneuploidy rate. Similar results were shown in the group of women with advanced maternal age (≥35 y.o., 551 PGS cycles), with no difference in the rate of blastocyst aneuploidy among different gonadotropins dose groups (<1500 IU, 58.0%; 1500-3000 IU, 59.8%; and >3000 IU, 59.8%; P = 0.86). The live-birth rates after single cryopreserved blastocyst transfers were also not significantly associated with the gonadotropins dose.

寬鬆四角內褲精蟲品質優於緊身三角內褲

Hum Reprod. 2018 Aug 8. doi: 10.1093/humrep/dey259. [Epub ahead of print]

Type of underwear worn and markers of testicular function among men attending a fertility center.

Mínguez-Alarcón L1, Gaskins AJ2,3, Chiu YH2,3, Messerlian C1, Williams PL3,4, Ford JB1, Souter I5, Hauser R1,3,6, Chavarro JE2,3,7.

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Abstract

STUDY QUESTION:

Is self-reported type of underwear worn associated with markers of testicular function among men at a fertility center?

SUMMARY ANSWER:

Men who reported most frequently wearing boxers had higher sperm concentration and total count, and lower FSH levels, compared to men who did not.

WHAT IS KNOWN ALREADY:

Elevated scrotal temperatures are known to adversely affect testicular function. However, the epidemiologic literature on type of underwear, as a proxy of scrotal temperature, and male testicular function is inconsistent.

STUDY DESIGN, SIZE, DURATION:

This is a cross-sectional study including 656 male partners of couples seeking infertility treatment at a fertility center (2000-2017).

PARTICIPANTS/MATERIALS, SETTING, METHODS:

Self-reported information on type of underwear worn was collected from a take-home questionnaire. Semen samples were analyzed following World Health Organization guidelines. Enzyme immunoassays were used to assess reproductive hormone levels and neutral comet assays for sperm DNA damage. We fit linear regression models to evaluate the association between underwear type and testicular function, adjusting for covariates and accounting for multiple semen samples.

MAIN RESULTS AND THE ROLE OF CHANCE:

Men had a median (interquartile range) age of 35.5 (32.0, 39.3) years and BMI of 26.3 (24.4, 29.9) kg/m2. About half of the men (53%; n = 345) reported usually wearing boxers. Men who reported primarily wearing boxers had a 25% higher sperm concentration (95% CI = 7, 31%), 17% higher total count (95% CI = 0, 28%) and 14% lower serum FSH levels (95% CI = -27, -1%) than men who reported not primarily wearing boxers. Sperm concentration and total count were inversely related to serum FSH. Furthermore, the differences in sperm concentration and total count according to type of underwear were attenuated after adjustment for serum FSH. No associations with other measured 

囊胚期胚胎之blastocoel fluid 無法代表ICM 或TE之實際karyotyping狀況, 相符率僅40%

ICM 或TE之實際karyotyping狀況, 相符率85%

Fertil Steril. 2018 Jun;109(6):1127-1134.e1. doi: 10.1016/j.fertnstert.2018.02.008.

Karyotype of the blastocoel fluid demonstrates low concordance with both trophectoderm and inner cell mass.

Tšuiko O1, Zhigalina DI2, Jatsenko T3, Skryabin NA4, Kanbekova OR5, Artyukhova VG6, Svetlakov AV6, Teearu K7, Trošin A8, Salumets A9, Kurg A7, Lebedev IN10.

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Abstract

OBJECTIVE:

To compare the genomic profiles of blastocoel fluid (BF), inner cell mass (ICM), and trophectoderm (TE) cells derived from the same blastocyst.

DESIGN:

Prospective study.

SETTING:

Academic and in vitro fertilization units.

PATIENT(S):

Sixteen donated cryopreserved embryos at blastocyst stage.

INTERVENTION(S):

BF, TE, and ICM cells were retrieved from each blastocyst for chromosome analysis by means of next-generation sequencing (NGS).

MAIN OUTCOME MEASURE(S):

Aneuploidy screening and assessment of mosaicism in BF, TE and ICM samples with subsequent comparison of genomic profiles between the three blastocyst compartments.

RESULT(S):

Out of 16 blastocysts, 10 BF samples and 14 TE and ICM samples provided reliable NGS data for comprehensive chromosome analysis. Only 40.0% of BF-DNA karyotypes were fully concordant with TE or ICM, compared with 85.7% concordance between TE and ICM. In addition, BF-DNA was burdened with mosaic aneuploidies and the total number of affected chromosomes in BF was significantly higher compared with the TE and ICM.

CONCLUSION(S):

BF-DNA can be successfully amplified and subjected to NGS, but owing to increased discordance with ICM and TE, BF does not adequately represent the status of the rest of the embryo. To overcome biologic and technical challenges associated with BF sampling and processing, blastocentesis would require improvement in both laboratory protocols and aneuploidy calling algorithms. Therefore, TE biopsy remains the most effective way to predict embryonic karyotype, and the use of BF as a single source of DNA for preimplantation genetic screening is not yet advised.