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Basile N.,IVI Madrid | Meseguer M.,University of Valencia
Expert Review of Obstetrics and Gynecology | Year: 2012

Current methods of embryo evaluation rely mainly on static observations of the embryo's morphology. These observations are inevitably restricted to specific times and, considering that the development of the embryo is a dynamic process, several critical stages in between observations may go unnoticed. These methods are also very subjective, and variations between embryologists may affect critical decisions that will, in turn, affect the overall success of the IVF clinics. On the other hand, an increased number of multiple pregnancies calls for a reduction in the number of embryos transferred, making the selection procedure even more challenging for the embryologist. Therefore, new markers that may aid the selection of embryos with higher implantation probabilities are needed. This review details what is known about time-lapse imaging, its application in embryology and the possible use of this technology as a novel selection tool. © 2012 Expert Reviews Ltd. Source

Fatemi H.M.,IVI | Garcia-Velasco J.,IVI Madrid
Fertility and Sterility | Year: 2015

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious, and potentially lethal, complications of controlled ovarian stimulation (COS). Induction of final oocyte maturation with a bolus of gonadotropin-releasing hormone (GnRH) agonist (GnRHa), instead of the criterion standard hCG, in patients undergoing ovarian stimulation significantly reduces the risk of OHSS and could be considered to be more physiologic. A bolus of GnRHa used in this context also acts as a luteolytic agent. From a clinical point of view, the most significant benefit of GnRHa trigger is its ability to induce quick and reversible luteolysis and thus reducing the risk of OHSS development. This paper describes the pathophysiology of OHSS, focusing specifically on the luteolytic benefits of using GnRHa to decrease OHSS and the possible corpus luteum rescue modalities available. Source

Castillo J.C.,FIV Valencia | Juan G.-V.,IVI Madrid | Humaidan P.,University of Southern Denmark
Journal of Assisted Reproduction and Genetics | Year: 2012

Purpose This study aimed to explore the incidence of empty follicle syndrome (EFS) in oocyte donors who had final oocyte maturation triggered with GnRHa and to compare the incidence of EFS in this group of patients with IVF patients who had final oocyte maturation with hCG. Methods Data including 2034 oocyte donation cycles and 1433 IVF cycles performed between years 2009 and 2010 was retrospectively analyzed to identify cases of EFS in each group. Results The incidence of EFS in the two groups did not differ significantly, 3.5% versus 3.1%, (n.s.). Conclusions This large retrospective analysis indicates that the incidence of EFS is not increased after GnRHa triggering as compared to hCG triggering. © 2012 Springer Science+Business Media, LLC. Source

Ortega I.,IVI Madrid | Duleba A.J.,University of California at San Diego
Annals of the New York Academy of Sciences | Year: 2015

Resveratrol, a natural polyphenol found in grapes, berries, and medicinal plants, exhibits antioxidant and anti-inflammatory activities and has been proposed to be a longevity-prolonging agent. There is also growing evidence that resveratrol has cardioprotective properties and beneficial effects on both glucose and lipid metabolism. Recently, several studies have examined the use of resveratrol as a therapeutic agent to treat numerous pathological and metabolic disorders. Herein, we present insights into the mechanisms of action, biological effects, and current evidence of actions of resveratrol on the ovary. In vitro, resveratrol inhibits proliferation and androgen production by theca-interstitial cells. Resveratrol also exerts a cytostatic, but not cytotoxic, effect on granulosa cells, while decreasing aromatization and vascular endothelial growth factor expression. In vivo, resveratrol treatment reduced the size of adipocytes and improved estrus cyclicity in the previously acyclic rat model of polycystic ovary syndrome (PCOS). In addition, resveratrol increased the ovarian follicular reserve and prolonged the ovarian life span in rats. Taken together, resveratrol emerges as a potential therapeutic agent to treat conditions associated with androgen excess, such as PCOS. The efficacy of resveratrol in the treatment of gynecological conditions requires further investigation. © 2015 New York Academy of Sciences. Source

Basile N.,IVI Madrid | Caiazzo M.,IVI Madrid | Meseguer M.,IVI Valencia
Current Opinion in Obstetrics and Gynecology | Year: 2015

Purpose of review Time lapse technology represents a new tool in the in-vitro fertilization (IVF) laboratory. It can aid the embryologist in the detection of objective and quantifiable markers associated with embryo viability and implantation. The purpose of this review is to explain how embryo morphokinetics can be used as an adjunct to standard morphological assessment and to evaluate its potential value to improve IVF outcomes. Recent findings Several algorithms have been developed. Some utilize early kinetic markers, whereas others rely more on later stages of embryo development. Even though over a handful of randomized control trials are in progress, at this point, only one has been published demonstrating a significant increase in implantation rates and ongoing pregnancy rates when selecting embryos on the basis of a combination of morphological assessment and morphokinetics. Summary We believe that standard morphological assessment should remain the gold standard to initiate embryo evaluation; however, if possible, it can be complemented with the use of morphokinetics. This new approach will allow the embryologist to perform a more accurate and objective embryo selection and therefore reduce the number of embryos transferred while maintaining or even improving clinical results. © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

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