Examining the temperature of embryo culture in in vitro fertilization A randomized controlled trial comparing traditional core temperature 37°C to a more physiologic cooler temperature 36°C

Capsule:
Prior data suggested that tubal temperatures are lower than the IVF culture temperature of 37C. Paired comparison of human embryo culture at 36C and 37C reveals better outcomes at 37C.

Authors:
Kathleen Hong, M.D., Hokyung Lee, M.S., Eric J. Forman, M.D., Kathleen M. Upham, B.S., Richard T. Scott, Jr., M.D., H.C.L.D.

Volume 102, Issue 3, Pages 767-773

Abstract:

Objective:
To determine whether culture at a more physiologically cooler temperature, as suggested by limited human and animal data, would improve blastulation and pregnancy rates in human clinical IVF.

Design:
Paired randomized controlled trial.

Setting:
Academic.

Patient(s):
Infertile couples (n = 52) with a female partner less than 42 years old with eight or more mature oocytes retrieved.

Intervention(s):
Mature oocytes obtained from a single cohort of oocytes were randomly divided into two groups; one was cultured at 37°C and the other at 36°C from the time of ICSI to the time of embryo transfer or vitrification. Paired embryo transfers were accomplished by transferring one euploid embryo from each group. DNA fingerprinting was used as needed to determine the outcome for each embryo.

Main Outcome Measure(s):
Rate of development of expanded blastocysts suitable for transfer or vitrification (primary outcome), fertilization, aneuploidy, and sustained implantation.

Result(s):
A total of 805 mature oocytes were cultured; 399 at 36°C and 406 at 37°C. Paired analysis demonstrated a higher rate of usable blastocyst formation per zygote at 37°C (48.4%) vs. at 36°C (41.2%). Rates of fertilization, aneuploidy, and sustained implantation were equivalent.

Conclusion(s):
IVF culture at 36°C does not improve clinically relevant parameters of embryo development or sustained implantation rates.

Clinical Trial Registration Number:
NCT01506089.

Impact of lymphoma treatments on spermatogenesis and sperm deoxyribonucleic acid A multicenter prospective study from the CECOS network

Capsule:
Lymphoma treatments had highly damaging effects on spermatogenesis and sperm chromatin quality. Mean pretreatment sperm concentrations were recovered at 12months after doxorubicin, bleomycin, vinblastine, darcarbacine (ABVD) or ABVD + radiotherapy, but at 24 months after doxorubicin, cyclophosphamide, vincristine, prednisone(CHOP) ormechlorethamine, oncovin, procarbazine, prednisone (MOPP) therapies.

Authors:
Louis Bujan, M.D., Ph.D., Marie Walschaerts, Ph.D., Florence Brugnon, M.D., Ph.D., Myriam Daudin, M.D., Isabelle Berthaut, Ph.D., Jacques Auger, M.D., Ph.D., Jacqueline Saias, M.D., Ethel Szerman, Ph.D., Nathalie Moinard, D.Pharm., Nathalie Rives, M.D., Ph.D., Sylvianne Hennebicq, M.D., Ph.D.

Volume 102, Issue 3, Pages 667-674

Abstract:

Objective:
To determine consequences of lymphoma treatments on sperm characteristics and sperm DNA, and to evaluate predictors of sperm recovery.

Design:
Multicenter prospective longitudinal study of patients analyzed before treatment and after 3, 6, 12, and 24 months.

Setting:
University hospitals.

Patient(s):
Seventy-five Hodgkin lymphoma and non-Hodgkin lymphoma patients and a control group of 257 fertile men.

Intervention(s):
Semen analyses, and sperm DNA and chromatin assessments.

Main Outcome Measure(s):
Comparisons of sperm characteristics before and after treatment.

Result(s):
Patients already had altered sperm characteristics before lymphoma treatment, with no identified risk factor. Sperm count, total sperm count, motility, and vitality decreased after treatment, with lowest values at 3 and 6 months. Twelve months after treatment, mean sperm count recovered to pretreatment values after doxorubicin, bleomycin, vinblastine, darcarbacine (ABVD) or ABVD + radiotherapy, but not after doxorubicin, cyclophosphamide, vincristine, prednisone (CHOP) or mechlorethamine, oncovin, procarbazine, prednisone (MOPP) chemotherapies. It was noteworthy that 7% of patients remained azoospermic at 24 months. After 24 months, Kaplan-Meier estimates showed that more than 90% of patients will recover normal sperm count after ABVD or ABVD + radiotherapy vs. 61% for CHOP chemotherapies. In multivariate analyses including diagnosis and treatment protocol, only pretreatment total sperm count was related to recovery. Compared with a control group, lymphoma patients had higher sperm chromatin alterations and DNA fragmentation before any treatment. After treatment, DNA fragmentation assessed by TUNEL assay and sperm chromatin structure assay decreased from 3 and 6 months, respectively, while remaining higher than in the control group during follow-up.

Conclusion(s):
Lymphoma patients had altered sperm DNA and chromatin before treatment. Lymphoma treatment had damaging effects on spermatogenesis. These data on both the recovery period according to treatment modalities and the pre- and post-treatment chromatin status of sperm are useful tools for counseling patients wishing to conceive.

Composition of commercial media used for human embryo culture

Capsule:
There is considerable biologically relevant variation in the compositions of commercially available culture media. This information provides a framework for future analysis of long-term effects of in vitro culture and optimization of culture media.

Authors:
Dean E. Morbeck, Ph.D., Rebecca L. Krisher, Ph.D., Jason R. Herrick, Ph.D., Nikola A. Baumann, Ph.D., Thomas Moyer, Ph.D., Dietrich Matern, M.D., Ph.D.

Volume 102, Issue 3, Pages 759-766

Abstract:

Objective:
To determine the composition of commercially available culture media and test whether differences in composition are biologically relevant in a murine model.

Design:
Experimental laboratory study.

Setting:
University-based laboratory.

Animal(s):
Cryopreserved hybrid mouse one-cell embryos were used in experiments.

Intervention(s):
Amino acid, organic acid, ions, and metal content were determined for two different lots of media from Cook, In Vitro Care, Origio, Sage, Vitrolife, Irvine CSC, and Global. To determine whether differences in the composition of these media are biologically relevant, mouse one-cell embryos were thawed and cultured for 120 hours in each culture media at 5% and 20% oxygen in the presence or absence of protein in an EmbryoScope time-lapse incubator.

Main Outcome Measure(s):
The compositions of seven culture media were analyzed for concentrations of 39 individual amino acids, organic acids, ions, and elements. Blastocyst rates and cell cycle timings were calculated at 96 hours of culture, and the experiments were repeated in triplicate.

Result(s):
Of the 39 analytes, concentrations of glucose, lactate, pyruvate, amino acids, phosphate, calcium, and magnesium were present in variable concentrations, likely reflecting differences in the interpretation of animal studies. Essential trace elements, such as copper and zinc, were not detected. Mouse embryos failed to develop in one culture medium and were differentially affected by oxygen in two other media.

Conclusion(s):
Culture media composition varies widely, with differences in pyruvate, lactate, and amino acids especially notable. Blastocyst development was culture media dependent and showed an interaction with oxygen concentration and presence of protein.

Articles of Special Interest

Examining the temperature of embryo culture in in vitro fertilization A randomized controlled trial comparing traditional core temperature 37°C to a more physiologic cooler temperature 36°C

Thursday, June 5, 2014
Prior data suggested that tubal temperatures are lower than the IVF culture temperature of 37C. Paired comparison of human embryo culture at 36C and 37C reveals better outcomes at 37C.

Impact of lymphoma treatments on spermatogenesis and sperm deoxyribonucleic acid A multicenter prospective study from the CECOS network

Monday, June 2, 2014
Lymphoma treatments had highly damaging effects on spermatogenesis and sperm chromatin quality. Mean pretreatment sperm concentrations were recovered at 12months after doxorubicin, bleomycin, vinblastine, darcarbacine (ABVD) or ABVD + radiotherapy, but at 24 months after doxorubicin, cyclophosphamide, vincristine, prednisone(CHOP) ormechlorethamine, oncovin, procarbazine, prednisone (MOPP) therapies.

Composition of commercial media used for human embryo culture

Tuesday, May 27, 2014
There is considerable biologically relevant variation in the compositions of commercially available culture media. This information provides a framework for future analysis of long-term effects of in vitro culture and optimization of culture media.

Hysterosalpingo foam sonography A less painful procedure for tubal patency testing during fertility workup compared to serial hysterosalpingography A randomized controlled trial

Tuesday, May 27, 2014
Hysterosalpingo-foam sonography (HyFoSy) is a less painful office procedure for tubal patency testing during the fertility work-up compared to hysterosalpingography.