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Embryo’s Natural Motion (enMotion): a paired randomized controlled trial evaluating a dynamic embryo culture system

      Objective

      To determine if a dynamic embryo culture system affects the reproductive potential of human embryos resulting from in vitro fertilization (IVF).

      Design

      Paired randomized controlled trial (RCT).

      Setting

      IVF center.

      Patient(s)

      IVF patients with normal ovarian reserve eligible for two-embryo transfer.

      Intervention

      IVF care was routine until fertilization was confirmed. Two-pronuclear embryos (2PNs) were then randomized: One-half of each patient’s 2PNs were cultured in dynamic culture and one-half in static culture. Preimplantation genetic testing for embryonic aneuploidy was used to control for aneuploidy and allow for DNA fingerprinting. The best euploid blastocyst from each culture system was selected and patients underwent a frozen two-embryo transfer. If a singleton gestation resulted, DNA-fingerprinting was used to determine which of the two blastocysts implanted. The dynamic platform used was the NSSB-300 (Nepagene).

      Main Outcome Measure(s)

      The primary outcome was the proportion of usable blastocysts obtained. The secondary outcome was sustained implantation rate (SIR).

      Result(s)

      One hundred participants completed oocyte retrieval and blastocyst vitrification for frozen-thawed embryo transfer; 609 dynamic 2PNs and 615 static 2PNs were followed; and 304 blastocysts developed in dynamic culture and 333 blastocysts developed in static culture. In the paired analysis, the rate of usable blastulation was similar between dynamic and static culture (58.3% vs. 57.1%). In addition, there was no difference in the rate of aneuploidy (20.0% vs. 33.3%) or SIR (67.1% vs. 63.1%) between groups.

      Conclusion(s)

      In this paired RCT, dynamic culture did not improve usable blastulation rate or SIR.

      Clinical Trial Registration Number

      NCT02467725
      Movimiento natural del embrión (enMotion): un ensayo controlado aleatorio pareado que evalúa un sistema dinámico de cultivo de embriones

      Objetivo

      determinar si un sistema dinámico de cultivo de embriones afecta el potencial reproductivo de los embriones humanos resultantes de la fertilización in vitro (FIV).

      Diseño

      ensayo controlado aleatorio pareado (ECA).

      Lugar

      centro de FIV.

      Paciente (s)

      pacientes de FIV con reserva ovárica normal elegibles para transferencia de dos embriones.

      Intervención

      el manejo de la FIV fue de rutina hasta que se confirmó la fertilización. Luego, los embriones de dos pronucleos (2PN) se aleatorizaron: la mitad de los 2PN de cada paciente se cultivaron en cultivo dinámico y la otra mitad en cultivo estático. Las pruebas genéticas previas a la implantación para la aneuploidía embrionaria se utilizaron para controlar la aneuploidía y permitir la toma de huellas digitales de ADN. Se seleccionó el mejor blastocisto euploide de cada sistema de cultivo y los pacientes se sometieron a una transferencia congelada de dos embriones. Si se producía una gestación singleton, se utilizaban las huellas digitales de ADN para determinar cuál de los dos blastocistos se implantaba. La plataforma dinámica utilizada fue el NSSB-300 (Nepagene).

      Medida (s) principal (s) de resultado

      El resultado primario fue la proporción de blastocitos utilizables obtenidos. El resultado secundario fue la tasa de implantación sostenida (SIR).

      Resultado (s)

      Cien participantes completaron la recuperación de ovocitos y la vitrificación de blastocistos para la transferencia de embriones congelados y descongelados; Se siguieron 609 2PN dinámicos y 615 2PN estáticos; y 304 blastocistos se desarrollaron en cultivo dinámico y 333 blastocistos se desarrollaron en cultivo estático. En el análisis pareado, la tasa de blastulación utilizable fue similar entre el cultivo dinámico y el estático (58.3% vs. 57.1%). Además, no hubo diferencias en la tasa de aneuploidía (20.0% vs. 33.3%) o SIR (67.1% vs. 63.1%) entre los grupos. Conclusión (es): en este ECA pareado, el cultivo dinámico no mejoró la tasa de blastulación utilizable o SIR.

      Palabras clave

      cultivo dinámico, plataforma de microvibración, competencia embrionaria.

      Key Words

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