title: Births after vitrification at morula and blastocyst stages: effect of artificial reduction of the blastocoelic cavity before vitrification.
abstract: BACKGROUND
  In 1996, with the introduction of sequential media, we set up a programme of cryopreservation of supernumerary morulae (day 4) and blastocysts (day 5) using a vitrification procedure. Our results showed that the efficiency of the vitrification method was dependent on the stage of embryo development and was negatively correlated with the expansion of the blastocoele. We postulated that a large blastocoele might disturb cryopreservative potential due to ice crystal formation during the cooling step. We analysed therefore the effectiveness of reducing before vitrification the volume of the blastocoelic cavity.
  
  
  METHODS
  Day 4 and day 5 embryos were vitrified in 40% ethylene glycol-18% Ficoll and 0.3 mol/l sucrose before plunging the straws directly into liquid nitrogen. Artificial shrinkage of the blastocyst was achieved after pushing a needle into the blastocoele cavity until it contracted.
  
  
  RESULTS
  The survival rate post-thawing of day 4 and intact day 5 embryos was correlated with the volume of the blastocoele. In the control group only 20.3% blastocysts or expanded blastocysts survived as compared with 54.5 and 58.5% with morulae and early blastocyst respectively. After puncturing the blastocoelic cavity, an increase in the survival rate of up to 70.6% was noted. The pregnancy rates were improved after the artificial shrinkage procedure (20.5%) compared with the control intact blastocyst group (4.5%) (not significant). After reduction of the blastocoelic cavity, a significant increase in the implantation rate per vitrified blastocyst was observed (12.0 versus 1.4% P < 0.01).
  
  
  CONCLUSIONS
  Our results showed that survival rates in cryopreserved expanded blastocysts could be improved by reducing the fluid content. This was presumably because mechanical damage caused by ice crystal formation was avoided. These observations should be considered when establishing a strategy and a protocol for cryopreservation of day 5 embryos.
authors.affiliation: Schoysman Infertility Management Foundation, Vaartstraat 42, 1800 Vilvoorde, Belgium. pierrevdz@hotmail.com
authors.forename: Pierre
authors.initials: P
authors.lastname: Vanderzwalmen
authors.forename: G
authors.initials: G
authors.lastname: Bertin
authors.forename: Ch
authors.initials: Ch
authors.lastname: Debauche
authors.forename: V
authors.initials: V
authors.lastname: Standaert
authors.forename: E
authors.initials: E
authors.lastname: van Roosendaal
authors.forename: M
authors.initials: M
authors.lastname: Vandervorst
authors.forename: N
authors.initials: N
authors.lastname: Bollen
authors.forename: H
authors.initials: H
authors.lastname: Zech
authors.forename: T
authors.initials: T
authors.lastname: Mukaida
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.forename: R
authors.initials: R
authors.lastname: Schoysman
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000502:physiology*; D001826:Body Fluids / Q000378:metabolism; D015925:Cryopreservation / Q000379:methods*; D046508:Culture Techniques; D004322:Drainage; D010064:Embryo Implantation; D005314:Embryonic and Fetal Development / Q000502:physiology; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008875:Middle Aged; D009028:Morula / Q000502:physiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D016019:Survival Analysis