Vaginal Progesterone (VP) versus VP plus Intermittent Intramuscular Progesterone (IMP) Use in Frozen/Thawed Blastocyst Transfer Cycles: An Observational Cohort Study

Objective: Comparison of vaginal progesterone (VP) versus VP and intermittent intramuscular progesterone (IMP) use in frozen/thawed blastocyst transfer cycles. Study Design: A single center retrospective analyses of 470 elective FET cycles which were performed between January 2015 and September 2019 were evaluated. Patients were divided into two groups. Control group was consisted of VP (n = 272), the study group was consisted of VP plus IMP (n = 198) users. Results: The number of transfer attempts in control and study groups was 272 and 198, respectively. Age (29.8 ± 4 vs 30.6 ± 4;p = 0.09), BMI (22 ± 2 vs 21.9 ± 3;p = 0.79) and the number of transferred embryos (1.4 ± 0.5 vs 1.4 ± 0.5;p = 0.48) were comparable between groups. Altough, implantation rates (43.7% vs 43.6%;p = 0.9), ectopic pregnancy (0.8% vs 0.3%;p = 0.46) and abortion rates (8.2% vs 4.8%;p = 0.07) were similar. Biochemical pregnancy rate (8.4% vs 3.4% p = 0.01) in control group and ongoing pregnancy rate (OPR) (27.9% vs 38.1%;p = 0.005) in study group were significantly higher. Conclusion: Within the FET cycles in which good quality blastocyst are being transferred additional IMP supplementation to VP may increase OPR while reducing the biochemical pregnancy rate.

Comparison of Efficacy of Two Vitrification Solutions for Mouse Morulae

Objective To study the efficacy of two vitrification solutions for mouse morulae Methods Good morulaes of NIH mice were collected and used to test toxicity of the vitrification solutions EDS40 （40% ethylene glycol, 18% dextran and 0.5 tool sucrose） and EFS40 （40% ethylene glycol, 18% ficoll and 0.5 tool sucrose）. Fine vitrified morulae were packaged in 0.25 mL plastic straws and immersed into liquid nitrogen and cryopreserved for about 2-3 months. Then the straws were heated rapidly, washed in Ham＇s F12 medium and cultured. The viability was determined by morphology and blastocyst formation after being cultured for 48 h. Some embryos were transplanted to recipients after being cultured for 12-14 h. The number of pregnant recipients and young born was counted and analyzed by Chi-squared test. Results The toxicity of EDS40 solution was significantly lower than that of EFS40 （P〈0.05） and the number of embryos developed to the blastocysts after vitrification in EDS40 was significantly higher than in EFS40 （P〈0.05）. The number of zona pellucida and the number of pregnancy and birth integrated after vitrification cryopreservation had no significant difference between EDS40 and EFS40 （P〉0.05）. However, the embryo fineness rates after vitrification in EDS40 was significantly better than in EFS40 （P〈0.01）. Conclusion EDS40 solution has less toxicity and better cryoprotect effect on embryos than EFS 40.

Perinatal outcome and postnatal health in children born from cryopreserved embryos

Frozen-thawed embryo transfer(FET)has been increasingly adopted as an adjunct to in vitro fertilization or intracytoplasmic sperm injection in recent years.It can reduce the risks of ovarian hyperstimulation syndrome and multiple pregnancies,and may even improve pregnancy outcomes in some subgroups such as patients with polycystic ovary syndrome.However,embryo cryopreservation may cause DNA damage,epigenetic changes,and alterations to gene expression profiles,and the potential impacts of cryopreservation on the embryos and on the long-term health of the resulting offspring are receiving increasing attention.Here,we aim to summarize the impact of cryopreservation on the embryos,perinatal outcomes,and long-term health of the offspring,hoping to explore the potential mechanisms and help guide the next steps in designing clinical studies.In this review,we found that there was no apparent difference in most perinatal outcomes between neonates born following FET and fresh embryo transfer,except for higher risks of large-for-gestational age and macrosomia in FET neonates.Studies on the long-term health and development of FET children are currently lacking;however,the limited evidence so far has found no risk of growth retardation,or chronic or malignant diseases.Large,well-designed,prospective studies taking full consideration of the confounding factors,including parental information,lifestyle,and environmental factors,are needed to confirm these conclusions.

Oncofertility:Treatment options from bench to bedside

In recent years,there has been continuous improvement in the treatment and diagnosis of cancer,which has led to a significant improvement in the survival rate of cancer patients.Treatments that include chemotherapy,radiotherapy,surgery,or combined therapy have several side effects that may lead to premature ovarian insufficiency in females or substantial male germ cell loss.Reproductive biologists recommend that all patients who are diagnosed with a malignant tumor must undergo a consultation for fertility protection and preservation.In this review,we discuss the background knowledge,methods,and options for fertility preservation and how these new strategies help oncologists,surgeons,pediatricians,and hematologists,conserve fertility and be aware of the concepts,methods,and importance of fertility guards.This review may aid in the advancement of novel personalized methods for fertility preservation according to patients’conditions.

Female Fertility： Is it Safe to Freeze.

Objective： To evaluate the safety and risk of cryopreservation in female fertility preservation. Data sources： The data analyzed in this review were the English articles from 1980 to 2013 from journal databases, primarily PubMed and Google scholar. The criteria used in the literature search show as tbllowing： （ 1 ） human; embryo; cryopreservation/freezing/vitrification, （2） human; oocyte/immature oocyte; cryopreservation/freezing/vitrification, （3） human; ovarian tissue transplantation; cryopreservation/ freezing/vitrification, （4） human; aneuploidy/DNA damage/epigenetic; cryopreservation/freezing/vitrification, and （5） human; fertility preservation; maternal age. Study selection： The risk ratios based on survival rate, maturation rate, fertilization rate, cleavage rate, implantation rate. pregnancy rate. and clinical risk rate were acquired from relevant meta-analysis studies. These studies included randomized controlled trials or studies with one of tile primary outcome measures covering cryopreservation of human mature oocytes, embryos, and ovarian tissues within the last 7 years （from 2006 to 2013. since the pregnancy rates of oocyte vitrification were significantly increased due to the improved techniques）. The data involving immature oocyte cryopreservation obtained from individual studies was also reviewed by the at, thors. Results： Vitrifications of mature oocytes and embryos obtained better clinical outcomes and did not increase the risks of DNA damage, spindle configuration, embryonic aneuploidy, and genomic imprinting as compared with fresh and slow-freezing procedures, respectively. Conclusions： Both embryo and oocyte vitrifications are safe applications in female fertility preservation.

Fertility Preservation in Cancer Patients

Traditional radiotherapy and chemotherapy often cause irreversible damage to the fertility and endocrine function of cancer patients.The current methods of fertility preservation include freezing the sperms of adult and adolescent males after puberty;freezing the embryos,oocytes,and ovarian tissue of females;and drug intervention and fertility preservation surgery.This article reviews fertility preservation in cancer patients with respect to current methods,indications,and some more recently developed methods that remain under investigation.