title: Artificial shrinkage of blastocoeles using either a micro-needle or a laser pulse prior to the cooling steps of vitrification improves survival rate and pregnancy outcome of vitrified human blastocysts.
abstract: BACKGROUND
  Since we reported the first successful birth from a blastocyst vitrified using a cryoloop technique, our results showed that the survival rate of vitrified blastocysts was negatively correlated with the expansion of the blastocoele. We speculated that a large blastocoele may disturb the efficacy of vitrification. Therefore, we evaluated the effectiveness of artificial shrinkage (AS) of blastocoeles before vitrification, on increasing the survival rate of vitrified blastocysts.
  
  
  METHODS
  Supernumerary expanded blastocysts on day 5 were vitrified after AS, which was performed by puncturing the blastocoele with a micro-needle, or by making a hole in the blastocoele with a laser pulse. After warming, viable blastocysts (confirmed by re-expansion of the blastocoele) were transferred to patients with hormone replacement cycle. We compared these data with those of our previous report where AS was not carried out.
  
  
  RESULTS
  The survival rate was significantly higher (97.2%, 488/502) in this study than that of the previous report (86%). After 266 transferable cycles, 160 patients became pregnant (60.2%), which was significantly higher than our previous results (34.1%, 29/85). The implantation rate was 46.7% (209/448).
  
  
  CONCLUSIONS
  Our results revealed that the survival rate and the pregnancy rate of vitrified expanded and hatching blastocysts can be improved by using AS to collapse the blastocele before vitrification.
authors.affiliation: Hiroshima HART Clinic, Naka-ku, Hiroshima, Japan. info@hiroshima-hart.jp
authors.forename: T
authors.initials: T
authors.lastname: Mukaida
authors.forename: C
authors.initials: C
authors.lastname: Oka
authors.forename: T
authors.initials: T
authors.lastname: Goto
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000502:physiology*; D002470:Cell Survival; D015925:Cryopreservation / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007834:Lasers; D008846:Micromanipulation / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate