Timothy J. Gelety

By Linda Wu, Jinzhou Qin, Dikai Zhang, Minqi Zhang, Suzhen Lu, Jennifer Howell, Timothy J. Gelety and Bin Wu

Assisted reproductive technology (ART) has been widely used for infertility treatment, but many people have concern about their baby’s health. The objective of this chapter is to provide some detailed data about the effect of ART on human birth babies by analyzing the data from in vitro fertilization (IVF) centers in two countries. All recent records related to a baby’s birth including mother’s age, gestational days, baby’s sex, and birth weight data were collected and analyzed according to fresh or frozen embryo transfer procedure. Normal delivery data without ART were used as control. The result showed that ART patient age is significantly older than non-IVF women; the gestation of fresh and frozen embryo transfer is the same as normal spontaneous conception gestation days, but women pregnant with multiple gestations have shorter gestational period and early birth rate as well as low birth weight; and there is no significant difference in the baby’s weight between ART singleton babies and normal conception babies, but male babies weight is more than female babies, and multiple gestation’s birth weights are significantly lower than singletons, while frozen embryo transfer babies have significantly heavier birth weight than fresh embryo transfer. Also, the frozen embryo transfer technique may significantly decrease premature birth rate. Thus, frozen embryo transfer may be recommended as a health strategy in ART.

Part of the book: Embryology

By Timothy J. Gelety

Oocyte cryopreservation (OC) has progressed rapidly from an experimental procedure with limited success to a clinically accepted procedure, in large part due to significant improvements in the techniques and widespread laboratory adaptation of vitrification. With significant improvements in clinical outcome, elective oocyte cryopreservation has gained in popularity as a means of overcoming diminishing ovarian reserve associated with aging. With clinical pregnancy rates equal to utilizing retrieved oocytes, oocyte cryopreservation is being increasingly utilized as an adjunct to standard IVF and now plays a significant role in egg donation with the establishment of egg banks analogous to sperm banks. Continuing research and clinical experience will be instrumental in defining the role of OC going forward.

Part of the book: IVF Technologies and Infertility

By Bin Wu, Xue Feng, Suzhen Lu and Timothy J. Gelety

Human IVF laboratory often shows many abnormal fertilization eggs, such as no pronucleus (0PN), monopronucleus (1PN), three pronuclei (3PN) or multi-pronuclei (mPN) zygotes and these abnormal eggs are usually not used and typically discarded. Recent researches have showed that further evaluation on these abnormal eggs may provide some hope for aged infertile couples to have babies in their family. Our study showed that 0PN eggs may be rescued by introcytoplasmic sperm injection (ICSI). The 1PN zygotes should be cultured to observe their cleavage and blastocyst formation until Day 3 to Day 6. Selecting normal chromosomal embryo transfer may have healthy baby birth. Although most of 3PN embryos are genetically abnormal chromosomal composition, a small portion of 3PN embryos may develop to blastocyst with normal chromosomal composition. Also, those embryos derived from 3PN, especially by ICSI, have more possibility for self-correction to become normal euploid embryos. The microsurgically removing 1PN from 3PN zygotes may artificially correct this abnormal fertilization. After one PN removal, the formed blastocyst may be screened by the PGT for embryo transfer in rare embryo patients to achieve pregnancy and delivery of a healthy newborn. Based on no obvious difference of ooplasm between normal fertilized 2PN and 3PN zygotes, the cytoplasm of 3PN zygotes may be used to supplement the aged woman poor oocytes to improve embryo quality. Transferring partial cytoplasm from 3PN zygote to the fertilized 2PN zygotes of aged woman may promote the receipt embryo to develop blastocysts. This partial ooplasmic transfer does not change the aging woman genetic composition and the woman embryos still keep her with her husband genetic genes in the cell nucleus. However, the baby born with this technique might appear epigenetics because the mixed mitochondrial DNA would be passed on to all future generations.

Part of the book: New Perspectives in Human Embryology