By Lucinda L. Veeck, Nikica Zaninovic
Should you had a responsible strategy for settling on the healthiest and such a lot potential conceptus from a cohort of becoming preembryos, changing greater than a unmarried one to be able to in achieving strong being pregnant premiums will be moot. someday within the not-so-distant destiny, this can be a truth. Taking a step in the direction of that destiny, An Atlas of Human Blastocysts vividly illustrates the common and strange morphology of mammalian blastocysts. The atlas demonstrates that prolonged tradition of blastocysts is now possible within the laboratory and issues us towards the day whilst it is going to be attainable to choose from a few fit hatched blastocysts.
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Shoukir Y, Campana A, Farley T, Sakkas D. Early cleavage of in-vitro fertilized human embryos to the 2-cell stage: a novel indicator of embryo quality and viability. Hum Reprod 1997; 12:1531–6 75. Cohen J, Inge KL, Suzman M, Wiker SR, Wright G. Videocinematography of fresh and cryopreserved embryos: a retrospective analysis of embryonic morphology and implantation. Fertil Steril 1989; 51:820–7 76. Morgan K, Wiemer K, Steuerwald N, Hoffman D, Maxson W, Godke R. Use of videocinematography to assess morphological qualities of conventionally cultured and cocultured embryos.
Our own data do not support reducing transfer numbers in this particular population. After examining replacement outcomes during 6 years for 1876 cycles involving women over age 40, we find a significantly higher clinical pregnancy rate per transfer when four or more preembryos are replaced as compared to three (43% vs. 0001), as well as a significant difference in the incidence of multiple pregnancy per transfer (11% vs. 6%). One could argue that, since the policy exists to replace more than three preembryos in older women whenever possible, those receiving three represent women with poor ovarian response or limited oocyte reserve; this is quite true and should be overlooked when weighing the comparisons.
As a direct consequence of the inhibitory nature of glucose under certain culture conditions, there has been a trend to remove glucose from embryo culture media53,58. However, it is important to consider that glucose is actually present in the female reproductive tract4, and that the oocyte and embryo possess a carrier mechanism for glucose entry into the cell42–45. Therefore, the inhibitory action of glucose in simple culture media should at best be considered as an in vitro-induced artifact. Importantly, the impairment of metabolic function in the embryo by glucose is not evident when specific Metabolic requirements during preimplantation development 41 amino acids50 and the chelator ethylenediaminetetraacetic acid (EDTA) are present in the culture medium3.