Cryopreservation of Human Gametes and Embryos: Current State and Future Perspectives

Cryopreservation of human gametes and embryos is an important and widely used method in most embryology laboratories. During last years, the practice of single embryo transfer was a greater demand for reliable cryostorage of surplus embryos. Currently, there are two basic principally different methods usable for cryopreservation: slow freezing and vitrification. Vitrification is a very promising method with massive use in embryology. Nowadays, this method is also suitable for cryopreservation of human mature oocytes (one of the most problematic cell in cryobiology). This progress in the field of cryopreservation opens new perspectives in assisted reproduction. Recent effective oocyte vitrification systems have a significant impact on clinical practice. This chapter gives a view of human gametes (sperms, oocytes) and embryos cryopreservation application and possibilities. Indications and methods of cryopreservation and thawing are mentioned

Gestational surrogacy in the Czech Republic

BACKGROUND: Gestational surrogacy, is a treatment option for women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. The aim of our study was to review, evaluate and share our experience and outcomes over the last 13 years of the largest surrogacy program in the Czech republic. METHODS: A total of 75 intended mothers and 82 surrogate mothers participated in this study. A retrospective cohort study was performed. Anonymized data were collected on 130 cycles of gestational surrogate (2004-2017) directly from the Clinic database. RESULTS: We performed 130 in vitro fertilization cycles with gestational surrogacy which involved 73 fresh embryo transfers and 57 frozen embryo transfers. We achieved 57 (43.9%) pregnancies and 42 (32.3%) live births. The rate of multiple pregnancies was only 2.3 %. The most common indication for using was an absent or damaged uterus (65%), followed by medical conditions precluding pregnancy (23%) and repeated in vitro fertilization cycles or pregnancy failure (12%). CONCLUSION: In the 14 years of our experience, we have shown that treatment of young women with specific indications for gestational surrogacy is beneficial, successful and relatively free of complications. However, it is imperative to follow the medical indications for this treatment and specialist recommendations.National Program of Sustainability II (MEYS CR) [LQ1605]; GACRGrant Agency of the Czech Republic [17-07753S

Analysis of ground reaction force in gait during different phases of pregnancy

During pregnancy there are increased biomechanical demands on women affecting gait parameters. The purpose of this study was to analyze changes in vertical ground reaction force (GRF), normalized by body mass, during advancing phases of pregnancy. Nine pregnant subjects participated in this study at three pregnancy stages. To determine in-shoe pressure distribution Pedar Insole System was used (100 Hz). Analysis was done on 200 steps cycles of treadmill walking at the velocity of 0.83 m·s-1. To compare the differences of GRFs in maximal weight acceptance, middle stance and push-off phase and time to reach these forces among three pregnancy stages, repeated-measures ANOVA was performed to obtain partial eta-squared values to measure the effect size (η>.10). To interpret the overall mean differences between the three pregnancy stages Cohen’s d was applied (d>.20). Altered gait pattern during advancing phases of pregnancy demonstrated in the current study by a significant decrease in force of maximal weight acceptance and an increase in main time variables of the step is suggested to be a protective mechanism against overloading the contact area of the foot despite the increase in body mass

Individualized versus conventional ovarian stimulation for in vitro fertilization: a multicenter, randomized, controlled, assessor-blinded, phase 3 noninferiority trial

Objective To compare the efficacy and safety of follitropin delta, a new human recombinant FSH with individualized dosing based on serum antimüllerian hormone (AMH) and body weight, with conventional follitropin alfa dosing for ovarian stimulation in women undergoing IVF. Design Randomized, multicenter, assessor-blinded, noninferiority trial (ESTHER-1). Setting Reproductive medicine clinics. Patient(s) A total of 1,329 women (aged 18â40 years). Intervention(s) Follitropin delta (AMH <15 pmol/L: 12 μg/d; AMH â¥15 pmol/L: 0.10â0.19 μg/kg/d; maximum 12 μg/d), or follitropin alfa (150 IU/d for 5 days, potential subsequent dose adjustments; maximum 450 IU/d). Main Outcomes Measure(s) Ongoing pregnancy and ongoing implantation rates; noninferiority margins â8.0%. Result(s) Ongoing pregnancy (30.7% vs. 31.6%; difference â0.9% [95% confidence interval (CI) â5.9% to 4.1%]), ongoing implantation (35.2% vs. 35.8%; â0.6% [95% CI â6.1% to 4.8%]), and live birth (29.8% vs. 30.7%; â0.9% [95% CI â5.8% to 4.0%]) rates were similar for individualized follitropin delta and conventional follitropin alfa. Individualized follitropin delta resulted in more women with target response (8â14 oocytes) (43.3% vs. 38.4%), fewer poor responses (fewer than four oocytes in patients with AMH <15 pmol/L) (11.8% vs. 17.9%), fewer excessive responses (â¥15 or â¥20 oocytes in patients with AMH â¥15 pmol/L) (27.9% vs. 35.1% and 10.1% vs. 15.6%, respectively), and fewer measures taken to prevent ovarian hyperstimulation syndrome (2.3% vs. 4.5%), despite similar oocyte yield (10.0 ± 5.6 vs. 10.4 ± 6.5) and similar blastocyst numbers (3.3 ± 2.8 vs. 3.5 ± 3.2), and less gonadotropin use (90.0 ± 25.3 vs. 103.7 ± 33.6 μg). Conclusion(s) Optimizing ovarian response in IVF by individualized dosing according to pretreatment patient characteristics results in similar efficacy and improved safety compared with conventional ovarian stimulation. Clinical Trial Registration Number NCT01956110