Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The primary objective is to determine which follicle sizes generate the highest rate of euploid blastocysts.
The primary objective is to determine which follicle sizes generate the highest rate of euploid blastocysts.
Secondary objectives to be analysed between the different follicle sizes:
Most of the studies that looked at the relation between the follicular size and the developmental competence of the corresponding oocyte analysed normal responders with an average age of 35 years and normal BMI levels. However, during the last decades, a clear shift appeared in the patient population that present themselves for a fertility treatment. With many women delaying childbirth, we do not yet know how these advanced maternal age women may benefit from early or late trigger or from different follicular sizes.
Also, the rising prevalence of obesity may impact the follicular growth, which has not been analysed at the individual follicle size before.
For the above described reasons, we believe that the analysis of individual follicles and the developmental competence of the obtained oocyte, may guide us to improve individualized stimulation protocols for different subtypes of infertile patients. To guide us in this individualized process, this initial pilot study will be performed in a population of normal responders and will later be expanded to an infertile population with different characteristics.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| measuring the size of the follicle at time of follicle aspiration | Procedure | While for an OPU out of the study the follicles are aspirated without measuring their sizes, now the follicles will be measured before they are aspirated. The measurement of the follicles is a non- invasive measurement: as the OPU is always performed under vaginal echo-guidance, the follicles are visible on the screen connected to the vaginal echo probe. By measuring two dimensions of the follicle, an average follicle diameter is registered for that follicle |
| Measure | Description | Time Frame |
|---|---|---|
| Blastocyst ploidy outcome according to the follicular size at the OPU | Blastocyst ploidy is determined after biopsy of trophectoderm cells, taken from the blastocyst on day 5, 6 or 7 from development. A biopsy is only possible if an oocyte was retrieved from the follicle that was mature, normally fertilized and developed into a blastocyst of sufficient quality for biopsy). The following outcomes are possible:
| 2 months |
| Measure | Description | Time Frame |
|---|---|---|
| Recovery rate | Number of COCs retrieved/ number of follicles aspirated | 2 months |
| Maturate rate | # of MII oocytes/ # of COCs retrieved |
Not provided
Inclusion Criteria:
Cycles with PGT-A analysis
Exclusion Criteria:
Not provided
it depends on the ability to produce follicles
The study is eligible to all patients undergoing a fertility treatment with PGT-A analysis at the blastocyst stage
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Ibrahim Elkhatib, MSc | IVIRMA Middle East Fertility Clinic | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| IVI Middle East Fertilty Clinic | Abu Dhabi | United Arab Emirates |
Information regarding the size of follicle and the PGT-A results will be shared through the discussion part.
Further information regarding endocrine profile, fertilization and embryo development will be mentioned in the discussion as well, however, this data might be shared upon request after publication.
Personal information such as Name and contact details will not be mentioned or shared.
Undecided
Undecided
Not provided
Not provided
Not provided
Not provided
Not provided
trophectoderm cells
| 2 months |
| Fertilization potential ( normal and abnormal fertilization) | Normal fertilization is assessed by the presence of 2 pronuclei 16-20 hours post insemination. This is normal fertilization. Abnormal fertilization is a deviation from the presence of 2 pronuclei, this can be one or three or more. | 2 months |
| Embryo development up to blastocyst stage | development of an embryo from day 0 to the blastocyst stage includes all developmental stages The embryo will make multiple divisions that will be recorded every day of development. It wll go from 1 cell, to 2 cells, 3 cells etc to be 8 cells on day 3 of development. On day 4, the morula will form and the embryo will start to compact, which is indicated as compacting or compacted. After this stage, we are around day 5 of development, the embryo will start to cavitate, this is the beginning of blastulation. Different stages are observed. Bl1: cavity is less than 50%, bl2: cavity is larger tan 50%, bl3: full blastocyst, bl4; expanded blastocyst, bl5: hatching balstocyst, bl6: hatched blastocyst, bl7: hatching through an artificail opening, bl8: collpased blastocyst. Blastocysts will be scored according to Gardner and Schoolcraft (1999). | 2 months |
| Embryo development in time lapse incubators | assessing all specific time points | 2 months |
| Chromosomal status of biopsied embryos | Blastocysts of sufficient quality will undergo trophectoderm biopsy. These 4-8 cells that are taken from the embryo are genitically tested for their chromosomal copy number. This will give an indication on the genetic status of the embryo. The embryo will be euploid if 23 pairs of intact chromosomes are present. If not, they are aneuploid. | 2 months |
| mtDNA copy number | Mitoscore values is the ratio of the mitochondrial DNA over the nuclear DNA. This is presented as a value and has been linked to the implantation potential of the embryo. There is no unit. | 2 months |
| Miscarriage rate after single euploid embryo transfer | loss of a pregnancy with hcg levels above 1000 IU after transfer | 2 months |
| pregnancy rate after euploid embryo transfer | presence of bhCG above 15IU 12 days after transfer | 2 months |
| biochemical pregnancy rate | characterized only by the presence of bhCG above 15 IU, no presence of gestational sac | 2 months |
| clinical pregnancy rate | hCG > 15 Iu/ml and ultrasound confirmation of a gestational sac | 2 months |
| implantation rate | • Implantation rate calculated by the number of gestational sacs observed at echographic screening at 6 weeks of pregnancy divided by the number of embryos transferred, multiplied by 100. | 2 months |
| ectopic pregnancy rate | where the embryo attached outside the uterus | 2 months |