Hum. Reprod. Advance Access originally published online on August 26, 2006
Human Reproduction 2006 21(12):3246-3252; doi:10.1093/humrep/del285
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Artificial shrinkage of blastocoeles using either a micro-needle or a laser pulse prior to the cooling steps of vitrification improves survival rate and pregnancy outcome of vitrified human blastocysts
1 Hiroshima HART Clinic, Naka-ku, Hiroshima and 2 Tokyo HART Clinic, Shibuya-ku, Tokyo, Japan
3 To whom correspondence should be addressed at: Hiroshima HART Clinic, 5-7-10 Ohtemchi, Naka-ku, Hiroshima, 730-0051, Japan. E-mail: info{at}hiroshima-hart.jp
BACKGROUND: Since we reported the first successful birth from a blastocyst vitrified using a cryoloop technique, our results showed that the survival rate of vitrified blastocysts was negatively correlated with the expansion of the blastocoele. We speculated that a large blastocoele may disturb the efficacy of vitrification. Therefore, we evaluated the effectiveness of artificial shrinkage (AS) of blastocoeles before vitrification, on increasing the survival rate of vitrified blastocysts. METHODS: Supernumerary expanded blastocysts on day 5 were vitrified after AS, which was performed by puncturing the blastocoele with a micro-needle, or by making a hole in the blastocoele with a laser pulse. After warming, viable blastocysts (confirmed by re-expansion of the blastocoele) were transferred to patients with hormone replacement cycle. We compared these data with those of our previous report where AS was not carried out. RESULTS: The survival rate was significantly higher (97.2%, 488/502) in this study than that of the previous report (86%). After 266 transferable cycles, 160 patients became pregnant (60.2%), which was significantly higher than our previous results (34.1%, 29/85). The implantation rate was 46.7% (209/448). CONCLUSIONS: Our results revealed that the survival rate and the pregnancy rate of vitrified expanded and hatching blastocysts can be improved by using AS to collapse the blastocele before vitrification.
Key words: artificial shrinkage/blastocoele/cryoloop/human blastocyst/vitrification
This work was undertaken at Hiroshima HART Clinic and Tokyo HART Clinic. Both clinics are private fertility centres. We did not have Institutional Review Board (IRB) when we started this work in 1999. Drs K. Takahashi, T. Mukaida, T. Goto and C. Oka are members of Japan Society of Obstetrics and Gynecology (JSOG), Japan Society of Fertility and Sterility (JSFS) and Japan Society of Fertilization and Implantation (JSFI). Both clinics have been registered as certified fertility centres by JSOG. Our clinical practices and research works have been performed following the guidelines of JSOG. Our clinical research works have also been performed according to the ethical principles for medicine, that is, the Declaration of Helsinki.
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