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Yakut T.,Uludag University | Karkucak M.,Uludag University | Sher G.,Sher Institute for Reproductive Medicine | Sher G.,University of Nevada, Reno | And 2 more authors.
Molecular Biology Reports

A common observation after in vitro matured oocyte is that they yield poorer embryo quality compared to their in vivo counterparts. This study was designed to assess chromosomal status with metaphase comparative genomic hybridization after in vitro maturation (IVM) in unstimulated cycles and compare the resultswith those obtained after in vivo maturation. Patients without any obstetrical or gynecological pathology were admitted into the study.IVMoocytes were collected 36 h post hCG and matured in vitro at 37°C in 5%O 2, 6% CO 2, and 89% air for 36 h. All matured (metaphase II) oocytes were subject to polar body 1 (PB-1) biopsy and vitrified individually. PB-1 sampleswere transferred into 0.25 cc PCR tubes containing 2.5 μl of PBS. PB-1 samples from 12 IVM patients were studied. Twenty-six out of 63 PB-1 samples (41%) were determined as euploid and 37 samples (59%) were aneuploid, whereas these values were 42% euploid and 58%aneuploid in the control group (in vivo matured oocytes). No statistical differences were found between the IVMand the control groups for euploid-aneuploid samples (P = 0.900). More aneuploidy was observed on chromosomes 11, 13, 15, 21, and 22 after IVM. Results show a non-significant rate of abnormal PB-1 formation after IVM compared to in vivo maturation. More aneuploidy was observed in chromosomes 11, 13, 15, 21, and 22 in the IVM group. © Springer Science+Business Media B.V. 2011. Source

Kotze D.,Jones Institute | Kruger T.F.,Stellenbosch University | Lombard C.,Biostatistics Unit | Padayachee T.,Biostatistics Unit | And 3 more authors.
Fertility and Sterility

Objective To determine whether the presence of soluble human leukocyte antigen G (sHLA-G) affects implantation and pregnancy outcomes in vitro. Design A multicenter retrospective study. Setting Six certified in vitro fertilization (IVF) units. Patient(s) Embryos obtained from 2,040 patients from six different IVF clinics. Intervention(s) Soluble HLA-G determination on day-2 embryos after intracytoplasmic sperm injection, with embryos transferred on day 3 using the sHLA-G data. Main Outcome Measure(s) Ongoing pregnancy rate (10- to 12-week ultrasound finding). Result(s) All embryos were individually cultured, and a chemiluminescence enzyme-linked immunosorbent assay was used to detect the presence of sHLA-G in the culture medium surrounding the embryos. Embryos were selected based on a positive sHLA-G result and a graduated embryo scoring (GES) score >70, or on embryo morphology if the test was negative. In all centers, a positive sHLA-G result was associated with an increase in the odds of an ongoing pregnancy. The incidence of an ongoing pregnancy was 2.52 times greater in embryos transferred on day 3 with a positive sHLA-G test result than the incidence of an ongoing pregnancy in embryos with a negative sHLA-G test result. Conclusion(s) Data from this multicenter study confirm that sHLA-G expression is a valuable noninvasive embryo marker to assist in improving pregnancy outcomes, with the theoretical potential to reduce multiple pregnancies. © 2013 by American Society for Reproductive Medicine. Source

Kotze D.J.,Sher Institute for Reproductive Medicine | Kotze D.J.,Stellenbosch University | Hansen P.,Sher Institute for Reproductive Medicine | Keskintepe L.,Sher Institute for Reproductive Medicine | And 4 more authors.
Journal of Assisted Reproduction and Genetics

Purpose: To compare pregnancy and implantation rates when embryos are selected based on a single Day 3 (D 3) morphology score vs. a GES score plus sHLA-G expression. Methods: A prospective randomized study (n=214) undergoing fresh ICSI cycles. Embryos were selected for transfer based on either Day 3 morphology score (Group A) or GES-scoring plus sHLA-G expression (Group B). Results: Clinical [35/107 (33%) vs. 52/107 (49%)] and ongoing pregnancy [20/107 (19%) vs. 52/107 (49%)] rates were significantly different between Group A and Group B (p<0.05). Implantation rates were not significantly different between Group A [52/353 (15%)] and Group B [73/417 (18%)] (p<0.05). The number of pregnancies lost during the first trimester was nearly 12 times higher in Group A [25/52 (48%)]. Conclusion: The miscarriage rate was significantly lower in Group B than Group A and the pregnancy results were superior when embryos were selected based on GES plus sHLA-G expression. © Springer Science+Business Media, LLC 2010. Source

Kennedy C.,University of Missouri | Ahlering P.,Sher Institute for Reproductive Medicine | Rodriguez H.,Sher Institute for Reproductive Medicine | Levy S.,Sher Institute for Reproductive Medicine | Sutovsky P.,University of Missouri
Reproductive BioMedicine Online

The objective of this study was to determine if a relationship exists between sperm parameters, measured by sperm chromatin structure assay (SCSA), and spontaneous abortion and multiple births in couples undergoing assisted reproduction treatment. Retrospective analysis of infertility treatment outcomes and occurrence of spontaneous abortion and multiple births was conducted in 233 couples who underwent treatment by intracytoplasmic sperm injection or intrauterine insemination at the Sher Institute for Reproductive Medicine, between 2001 and 2004. Sperm samples used for treatments were analysed for sperm concentration, sperm motility and two different parameters of SCSA (DNA fragmentation index, DFI, and high DNA stainability, HDS). Pregnancy, spontaneous abortion and multiple birth rates were recorded for all couples. A statistically significant relationship (P < 0.001) was observed between DFI and spontaneous abortion. However, the correlation between HDS and spontaneous abortion was not statistically significant. Significantly lower levels of DFI were observed in men from couples having triplet pregnancies compared with those in the spontaneous abortion group (P ≤ 0.05). It is concluded that the parameters of SCSA correlate significantly with spontaneous abortion and multiple birth and may provide guidance for clinical decision making (number of embryos per transfer) and management of spontaneous abortion-prone cases. © 2010, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. Source

Tortoriello D.V.,Sher Institute for Reproductive Medicine | Dayal M.,Sher Institute for Reproductive Medicine | Beyhan Z.,Sher Institute for Reproductive Medicine | Yakut T.,University of Bursa | And 2 more authors.
Journal of Assisted Reproduction and Genetics

Objective: The objective of this study is to determine mosaicism and its effect on blastocysts; abnormal blastocysts determined by molecular testing were sequentially biopsied and retested. Material and method: We re-biopsied 37 blastocyst-stage abnormal embryos from eight patients, which were reanalyzed to determine the level of concordance between biopsies and inter-laboratory congruence between reputable commercial PGS laboratories. Results: The main outcome measures were intra-embryo variation between sequential embryo biopsies and inter-laboratory variation between two PGS laboratories. The compatibility between both aCGH and NGS was found to be 11 % (3/27). Importantly, 9/27 (33 %) of embryos originally reported to be aneuploid, upon repeat assessment, were found to be euploid. The concurrence for SNP array and NGS was 50 % (3/6), and 17 % (1/6) of these abnormal embryos tested normal upon re-evaluation with NGS. NGS resulted 41 % (11/27) normal results when 27 of CGH abnormal embryos were retested. Concordance between aCGH and NGS was 4 % (1/27) whereas in three instances, gender discrepancy was observed with NGS when aCGH abnormal embryos were reanalyzed. Conclusions: The results of these studies reinforce the prevalence of inconsistencies during PGS evaluation of trophectoderm biopsies possibly due to variations in platform sensitivity and heightening concerns over the clinical tractability of such technology in human ARTs.. © 2016 Springer Science+Business Media New York Source

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