Timing considerations for removal of early cumulus cells in short-term insemination strategies
Zhiren Liu
A * , Qicai Liu A , Mingting Jiang B , Xingting Chen A , Chen Lin A and Yujia Guo A *
A Center for Reproductive Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350000, People’s Republic of China.
B Institute for Translational Medicine, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China.
Reproduction, Fertility and Development 33(18) 881-885 https://doi.org/10.1071/RD21259
Published online: 2 December 2021
© 2021 The Author(s) (or their employer(s)). Published by CSIRO Publishing
Abstract
Context: The timing of early cumulus cell removal (ECCR) can be changed within a range. The change has an effect on the multiple pronuclei (MPN) rate and the exposure time of oocytes to sperm waste products. The timing of ECCR effects the outcomes of assisted reproductive technology, however, it is still unclear what time is best for ECCR.
Aims: To find the best time for ECCR based on clinical outcomes in order to increase the success rate of assisted reproductive technology.
Methods: A retrospective study was performed. Cycles were categorised into six groups according to the timing of ECCR. The clinical outcomes of these six groups were compared by Kruskal–Wallis test and Pearson X2 test.
Key results: The timing of ECCR had a significant effect on the MPN rate, 0PN without cleavage rate and grade 1–2 embryo rate at Day 3. Among our six time groups of ECCR, the cumulus cell removal ≤4 h post-insemination group had the highest MPN rate and grade 1–2 embryo rate at Day 3, and the 5.5 h < time ≤6 h group had the highest pronuclear formation failure rate. In addition, 2PN rate was not significantly different among the six time groups.
Conclusions: Within the time range of ECCR in our study, selecting an earlier timing to remove the cumulus cells may have a better outcome.
Implications: ECCR is helpful for optimisation of the short-term insemination strategy.
Keywords: assisted reproductive technology, early cumulus cell removal, embryo grade, fertilisation, multiple pronuclei, short-term insemination strategies, timing, total fertilisation failure.
References
Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology (2011). The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Human Reproduction 26, 1270–1283.| The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting.Crossref | GoogleScholarGoogle Scholar | 21502182PubMed |
Coticchio, G, Mignini Renzini, M, Novara, PV, Lain, M, De Ponti, E, Turchi, D, Fadini, R, and Dal Canto, M (2018). Focused time-lapse analysis reveals novel aspects of human fertilization and suggests new parameters of embryo viability. Human Reproduction 33, 23–31.
| Focused time-lapse analysis reveals novel aspects of human fertilization and suggests new parameters of embryo viability.Crossref | GoogleScholarGoogle Scholar | 29149327PubMed |
Dai, J, Leng, LZ, Lu, CF, Gong, F, Zhang, SP, Zheng, W, Lu, GX, and Lin, G (2017). Time-lapse observation and transcriptome analysis of a case with repeated multiple pronuclei after IVF/ICSI. Journal of Assisted Reproduction and Genetics 34, 1189–1197.
| Time-lapse observation and transcriptome analysis of a case with repeated multiple pronuclei after IVF/ICSI.Crossref | GoogleScholarGoogle Scholar | 28643089PubMed |
Dirnfeld, M, Bider, D, Koifman, M, Calderon, I, and Abramovici, H (1999). Shortened exposure of oocytes to spermatozoa improves in-vitro fertilization outcome: a prospective, randomized, controlled study. Human Reproduction 14, 2562–2564.
| Shortened exposure of oocytes to spermatozoa improves in-vitro fertilization outcome: a prospective, randomized, controlled study.Crossref | GoogleScholarGoogle Scholar | 10527987PubMed |
Huang, B, Qian, K, Li, Z, Yue, J, Yang, W, Zhu, G, and Zhang, H (2015). Neonatal outcomes after early rescue intracytoplasmic sperm injection: an analysis of a 5-year period. Fertility and Sterility 103, 1432–1437.E1.
| Neonatal outcomes after early rescue intracytoplasmic sperm injection: an analysis of a 5-year period.Crossref | GoogleScholarGoogle Scholar | 25813286PubMed |
Kattera, S, and Chen, C (2003). Short coincubation of gametes in in vitro fertilization improves implantation and pregnancy rates: a prospective, randomized, controlled study. Fertility and Sterility 80, 1017–1021.
| Short coincubation of gametes in in vitro fertilization improves implantation and pregnancy rates: a prospective, randomized, controlled study.Crossref | GoogleScholarGoogle Scholar | 14556826PubMed |
Kotil, T, Kervancioğlu, ME, Kanten, GE, Tunalı, G, and Solakoğlu, S (2018). Mitochondrial activity and cytoskeleton organization in three pronuclei oocytes after intracytoplasmic sperm injection. Zygote 26, 319–325.
| Mitochondrial activity and cytoskeleton organization in three pronuclei oocytes after intracytoplasmic sperm injection.Crossref | GoogleScholarGoogle Scholar | 30280682PubMed |
Liu, W, Liu, J, Zhang, X, Han, W, Xiong, S, and Huang, G (2014). Short co-incubation of gametes combined with early rescue ICSI: an optimal strategy for complete fertilization failure after IVF. Human Fertility 17, 50–55.
| Short co-incubation of gametes combined with early rescue ICSI: an optimal strategy for complete fertilization failure after IVF.Crossref | GoogleScholarGoogle Scholar | 24313679PubMed |
Llácer, J, Moliner, B, Luque, L, Bernabéu, A, Lledó, B, Castillo, JC, Guerrero, J, Ten, J, and Bernabéu, R (2020). Luteal phase stimulation versus follicular phase stimulation in poor ovarian responders: results of a randomized controlled trial. Reproductive Biology and Endocrinology 18, 9.
| Luteal phase stimulation versus follicular phase stimulation in poor ovarian responders: results of a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 32033610PubMed |
Mutia, K, Wiweko, B, Iffanolida, PA, Febri, RR, Muna, N, Riayati, O, Jasirwan, SO, Yuningsih, T, Mansyur, E, and Hestiantoro, A (2019). The frequency of chromosomal euploidy among 3PN embryos. Journal of Reproduction and Infertility 20, 127–131.
| 31423415PubMed |
World Health Organization (WHO) (2010) ‘WHO laboratory manual for the examination and processing of human semen.’, 5th edn. (WHO: Geneva)
Xiong, S, Han, W, Liu, JX, Zhang, XD, Liu, WW, Liu, H, and Huang, GN (2011). Effects of cumulus cells removal after 6 h co-incubation of gametes on the outcomes of human IVF. Journal of Assisted Reproduction and Genetics 28, 1205–1211.
| Effects of cumulus cells removal after 6 h co-incubation of gametes on the outcomes of human IVF.Crossref | GoogleScholarGoogle Scholar | 21898104PubMed |
Xue, Y, Tong, X, Jiang, L, Zhu, H, Yang, L, and Zhang, S (2013). Effect of cumulus cell removal 4 h post-insemination on fertilization and embryo quality: a prospective randomized sibling-oocyte study. Journal of Assisted Reproduction and Genetics 30, 1049–1053.
| Effect of cumulus cell removal 4 h post-insemination on fertilization and embryo quality: a prospective randomized sibling-oocyte study.Crossref | GoogleScholarGoogle Scholar | 23868532PubMed |
