Pregnancy and live birth following the transfer of vitrified–warmed blastocysts derived from zona- and corona-cell-free oocytes reproduction

A 28-year-old patient presented for preimplantation genetic screening (PGS) for family balancing utilizing previously vitrified blastocysts and day-2 embryos. To synchronize endometrial development with the embryos to be transferred, five embryos vitrified on day 2 were warmed 3days prior to scheduled transfer. Three of them developed to 8-, 8- and 7-cell stages, respectively, and were biopsied the next day, during which three vitrified blastocysts were warmed and the two surviving blastocysts underwent trophectoderm biopsy. The five biopsied embryos were subjected to two-probe fluorescence in-situ hybridization for chromosomes X and Y. As there were still 2days before the scheduled embryo transfer following biopsy, the two biopsied blastocysts were re-vitrified. One blastocyst and two of the embryos vitrified on day 2 were normal for sex chromosomes; of these, one of the day-2 vitrified embryos was arrested and the other did not favour the patient's wish. The re-vitrified blastocyst, which was normal for sex chromosomes, was therefore warmed and transferred, resulting in delivery of one healthy boy. As far as is known, this is the first-reported live birth developed from a re-vitrified blastocyst that had been previously vitrified, warmed and undergone trophectoderm biopsy.

Minimal ovarian stimulation (Mini-IVF™) for IVF utilizing vitrification and cryopreserved embryo transfer

Gentle ovarian stimulation protocols, such as 'mini-IVF', have several potential advantages over conventional IVF protocols, including less medication and fewer injections, producing fewer eggs, but eggs of higher quality. The particular 'mild' stimulation protocol called 'mini-IVF' is described. This protocol requires a reliable and cheap method for embryo cryopreservation such as vitrification, because of the negative impact of clomiphene citrate on the endometrium and since cryopreserved embryo transfers with this protocol have yielded much higher pregnancy rates than fresh transfers. In this series, patients were not denied treatment based on their day-3 FSH value or ovarian reserve. Yet very acceptable pregnancy rates were achieved (20% for fresh embryo transfers and 41% for cryopreserved embryo transfers). These results strengthen the argument for a mini-IVF protocol and vitrification as an alternative to standard conventional IVF stimulation protocols. Now a randomized control trial with cryopreserved single-embryo transfer is required.

Gentle ovarian stimulation protocols have several potential advantages over conventional IVF protocols, including less medication and fewer injections, producing fewer eggs, but eggs of higher quality. 'Mini-IVF' is safe, patient friendly and physiologically more natural. It may be more cost effective if results are comparable to conventional protocols. Vitrification of embryos allows the transfer of warmed embryos in subsequent cycles when the endometrium is more receptive. In this series, patients were not denied treatment based on their day-3 FSH value or ovarian reserve. Yet very acceptable pregnancy rates were achieved (20% for fresh embryo transfers and 41% for cryopreserved embryo transfers). These results strengthen the argument for gentle stimulation protocols and vitrification in preference to standard conventional IVF stimulation protocols. Now a randomized control trial with cryopreserved single-embryo transfer is required.

Comparison of blastocyst formation between standard and clomiphene citrate (CC) stimulated in vitro fertilization (IVF) cycles" - ASRM, Oct. 2005

Poster Presentation for the American Society For Reproductive Medicine (ASRM), October 17-19, 2005, Montreal, Quebec

[P-447] Comparison of blastocyst formation between standard and clomiphene citrate (CC) stimulated in vitro fertilization (IVF) cycles.

J. Zhang, Q. Zhan, T. Okimura, K. Kato, S. Silber, O. Kato. New Hope Fertility Center, New York, NY; Center for IVF, 1st Affiliated Hospital of Zhong Shan University, Guangzhou, China; Kato Ladies Clinic, Tokyo, Japan; St Louis Fertility Center, St Louis, MO

Dr. Zhang submitted the following paper to the American Society of Reproductive Medicine (ASRM) conference in October 2005 in Montreal, Quebec. For those interested in the pure science elements of minimum stimulation, this explains the basis for our advanced procedure in some detail.

Dr. Sherman Silber says he can extend a woman's fertility by decades. He just needs to freeze her eggs or even a piece of her ovarian tissue.

By Chad Garrison, The Riverfront Times, Oct. 4, 2007

Ovarian Tissue Transfer involves removing the ovary of one woman, microsurgically dissecting the tissue and subsequently transplanting it into another woman. This procedure is often considered a donor procedure, whereby an infertile woman receives the ovarian tissue of a fertile woman. In this case, it is a preferable alternative to egg donation because ovarian tissue has potentially thousands of eggs and the tissue continues to function as a normal healthy ovary in the recipient's body long after transfer, so it offers recipients multiple chances at pregnancy as compared with the single chance offered by egg donation.

Ovarian Tissue Transfer also occurs when a woman has elected to freeze her own ovarian reserve and then have it transferred back when she is ready to have a child. That is, instead of freezing individual eggs, the patient has the entire ovarian reserve frozen. This procedure is preferable to egg freezing because one egg-freezing cycle generally preserves 1-5 quality eggs, whereas Ovarian Tissue Transfer freezes tens, to hundreds, to thousands of eggs, depending on the woman.