Good practice recommendations for the use of time-lapse technology†

STUDY QUESTION: What recommendations can be provided on the approach to and use of time-lapse technology (TLT) in an IVF laboratory?SUMMARY ANSWER: The present ESHRE document provides 11 recommendations on how to introduce TLT in the IVF laboratory. WHAT IS KNOWN ALREADY: Studies have been published on the use of TLT in clinical embryology. However, a systematic assessmentof how to approach and introduce this technology is currently missing.STUDY DESIGN, SIZE, DURATION: A working group of members of the Steering Committee of the ESHRE Special Interest Group in Embryology and selected ESHRE members was formed in order to write recommendations on the practical aspects of TLT for the IVF laboratory.PARTICIPANTS/MATERIALS, SETTING, METHODS: The working group included 11 members of different nationalities with internationally recognized experience in clinical embryology and basic science embryology, in addition to TLT. This document is developed according to the manual for development of ESHRE recommendations for good practice. Where possible, the statements are supported by studies retrieved from a PUBMED literature search on ‘time-lapse’ and ART.MAIN RESULTS AND THE ROLE OF CHANCE: A clear clinical benefit of the use of TLT, i.e. an increase in IVF success rates, remains to be proven. Meanwhile, TLT systems are being introduced in IVF laboratories. The working group listed 11 recommendations on what to do before introducing TLT in the lab. These statements include an assessment of the pros and cons of acquiring a TLT system, selection of relevant morphokinetic parameters, selection of an appropriate TLT system with technical and customer support, development of an internal checklist and education of staff. All these aspects are explained further here, based on the current literature and expert opinion.LIMITATIONS, REASONS FOR CAUTION: Owing to the limited evidence available, recommendations are mostly based on clinical and technical expertise. The paper provides technical advice, but leaves any decision on whether or not to use TLT to the individual centres.WIDER IMPLICATIONS OF THE FINDINGS: This document is expected to have a significant impact on future developments of clinical embryology, considering the increasing role and impact of TLT

Epigenetic homogeneity in histone methylation underlies sperm programming for embryonic transcription

Abstract: Sperm contributes genetic and epigenetic information to the embryo to efficiently support development. However, the mechanism underlying such developmental competence remains elusive. Here, we investigated whether all sperm cells have a common epigenetic configuration that primes transcriptional program for embryonic development. Using calibrated ChIP-seq, we show that remodelling of histones during spermiogenesis results in the retention of methylated histone H3 at the same genomic location in most sperm cell. This homogeneously methylated fraction of histone H3 in the sperm genome is maintained during early embryonic replication. Such methylated histone fraction resisting post-fertilisation reprogramming marks developmental genes whose expression is perturbed upon experimental reduction of histone methylation. A similar homogeneously methylated histone H3 fraction is detected in human sperm. Altogether, we uncover a conserved mechanism of paternal epigenetic information transmission to the embryo through the homogeneous retention of methylated histone in a sperm cells population

Automated and manual sperm analysis: united we stand, divided we fall

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L'Hormone anti-Müllerienne (comparaison de deux trousses de dosage et intérêt de son évaluation chez la femme en médecine de la reproduction)

L'Hormone anti-Müllerienne est récemment apparue comme un marqueur prometteur au sein du bilan hormonal dans la prise en charge d'un couple en médecine de la reproduction. Les résultats fournis par les deux kits de dosage existant (DSL® et Immunotech®) montrent un écart important, ce qui peut s'expliquer par l'absence de standard international. Notre étude prospective menée chez 69 femmes suivies pour FIV confirme l'intérêt de l'AMH dans la prédiction de la réponse ovarienne et sa supériorité sur la FSH et l'oestradiol. Seule la trousse Immunotech® permet de déterminer un seuil prédictif pour l'initiation d'une grossesse, situé à 1,40 g/L.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

Transcriptomics analysis and human preimplantation development

International audienceThe study of oocyte and preimplantation embryo biology has been regarded with great curiosity throughout scientific history, but it is not until the development of robust methods for in vitro observation and manipulation of animal gametes that developmental biology has flourished as a discipline. By far the biggest technical challenge in studying transcription in oocytes and early embryo has been the necessity of developing techniques that retain a high level of accuracy when starting from small amount of material. The objective of this narrative review is to summarize the knowledge gained about the embryonic preimplantation period in the human species from tran-scriptomics experiments, and to discuss technical limitations and solutions to the study of transcriptomics in these samples.Significance: In this review we identify key critical issues in performing transcriptomics experiments during the human preimplantation period, and identifying possible ways to overcome them. This, combined with a description of clinical perspectives and the definition of future avenues for research will provide useful for future research

Stimulation ovarienne à fortes doses de gonadotrophines en FIV : étude rétrospective cas-témoin au CHU de Nantes

International audienceOBJECTIVES: While assisted reproductive technology (ART) activity increases throughout the world, most teams have to face with the challenge of ovarian stimulation in poor responders. Despite a huge amount of literature available, no consensus currently exists on the best protocol, molecule or dose to use in these patients. The main objective of this case-control study was to compare ovarian stimulation and IVF outcome in patients at risk of poor ovarian response undergoing antagonist protocol with high doses of gonadotropins (≥450IU/day) versus patients undergoing stimulation at 300IU/day.METHODS: This retrospective monocentric study was conducted in 2013 on antagonist cycles performed with ≥450IU/day. Each cycle was matched with a control antagonist cycle with 300IU/day injection, with strict matching for ART type, age, serum anti-müllerian hormone (AMH) and body mass index (BMI).RESULTS: A total of 82 high dose cycles were matched and compared with 82 control cycles. Both groups were comparable, except for poor responder prevalence and mean IVF rank, which were higher in high dose group than in control group. No significant difference was observed between the groups in terms of number of oocytes, embryos, fertilization rate, implantation and ongoing pregnancy rates.CONCLUSIONS: No ovarian stimulation protocol has demonstrated its superiority in expected poor responders up to now, especially regarding doses of gonadotropins to use. Accordingly, our study did not show any difference between high dose stimulation regimen (≥450IU/day) and conventional stimulation (300IU/day) in terms of IVF cycle outcome.Objectifs. – L’activité d’assistance médicale à la procréation (AMP) est souvent confrontée à la difficulté des stimulations ovariennes chez des patientes mauvaises répondeuses. Malgré une littérature abondante sur le sujet, aucun consensus n’existe sur la stratégie à adopter en termes de protocole, de molécule ou de dose de gonadotrophines chez ces patientes. L’objectif principal de cette étude cas-témoin était de comparer les résultats des stimulations ovariennes en protocoles antagonistes à fortes doses de gonadotrophines (450 UI par jour minimum) à ceux à 300 UI par jour.Méthodes. – Cette étude rétrospective monocentrique menée sur l’année 2013 a porté sur des cycles stimulés à 450 UI/j minimum. Chaque cycle était strictement apparié à un cycle témoin à 300 UI/j selon la technique d’AMP, l’âge, l’hormone anti-müllérienne (AMH) et l’indice de masse corporelle (IMC).Résultats. – Un total de 82 cycles à fortes doses a été apparié avec 82 cycles témoins à 300 UI/j. Les 2 groupes étaient comparables, en dehors du pourcentage attendu de mauvaises répondeuses et du rang moyen de tentative. Aucune différence significative n’a été observée entre les groupes en termes de réponse ovarienne, de nombre d’ovocytes, d’embryons, de taux de fécondation, d’implantation et de grossesse évolutive.Conclusions. – Aucun protocole n’a démontré sa supériorité dans la littérature pour la stimulation des mauvaises répondeuses. Notre étude conclue en l’absence de supériorité d’un traitement de stimulation à fortes doses de gonadotrophines à 450 UI par jour versus 300 UI par jour

Les principes de la Très Haute Fiabilité appliqués en AMP, Rencontres Today & Tomorrow, Paris, 12-13 mars

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Time-lapse imaging systems in IVF laboratories: a French national survey

International audiencePurpose Although the clinical value of time-lapse imaging (TLI) systems in in vitro fertilization (IVF) cycles is still debated, its prevalence worldwide seems to be expanding. The situation of TLI in the USA has been recently surveyed, but these results might not be transposable to other countries with different IVF regulation and funding such as France. This study evaluated the TLI situation in French IVF laboratories.Methods An anonymous online cross-sectional survey was sent by email to 210 embryologists in September and October 2017. Laboratories, demographics, TLI clinical use, purchasing plan, and embryologists' opinions were analyzed using logistic regression to calculate odds ratio.Results Of the 210 lab directors surveyed, 78 responded (37.1%), 43 (55%) working in private IVF laboratories and 35 (45%) in public hospitals. Thirty (38.5%) were TLI users. The odds of TLI possession were not statistically different according to laboratory sector or size. Most embryologists (n = 21, 70%) used TLI for unselected patients. Cost was the main reason given by non-users for not implementing TLI (n = 24, 50%). Most respondents were convinced that TLI is superior to standard morphology (n = 52, 73.2%) and that TLI improves culture conditions (n = 62, 84.9%). However, half (n = 39, 54.9%) indicated that evidence was still lacking to assert TLI clinical usefulness.Conclusion The prevalence of TLI systems and embryologists' opinion in France was slightly different from the American situation. The different regulation and funding policy might account for some differences in terms of TLI use and perception

Can time-lapse parameters predict embryo ploidy? A systematic review

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