ORCID Profile
0000-0001-6276-7010
Current Organisations
Edith Cowan University
,
Bond University
,
Fertility North
,
University of Western Australia
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Publisher: Informa UK Limited
Date: 17-08-2019
DOI: 10.1080/14647273.2017.1366077
Abstract: This study evaluated the effect of sperm selection and intracytoplasmic sperm injection (ICSI) on subsequent fertilization and embryo development using the hyaluronic acid-based SpermSlow™ (HA-ICSI) compared to injection with polyvinylpyrrolidone (PVP-ICSI). A total of 206 metaphase II oocytes were collected from 21 prospectively enrolled ICSI cycles at Fertility North between July 2014 and March 2015. Sibling oocytes were randomized into HA-ICSI and PVP-ICSI (n = 103 per group). Subsequent fertilization outcomes and embryo development in terms of qualitative and quantitative time-lapse measures following three-day culture in the Embryoscope™ were compared. HA-ICSI resulted in significantly lower abnormal fertilization rates (1.9% vs 9.7%, p = 0.017), and a trend towards increased normal fertilization rates (73.8% vs 62.1%, p = 0.073) with increased injection time (2.5 vs 2.1 min, p = 0.001). No differences between HA-ICSI and PVP-ICSI were observed in (a) the proportion of good conventional morphology embryos (50% vs 53.1%, p = 0.712), (b) time-lapse qualitative measures (p > 0.05) and (c) time-lapse quantitative measures (p > 0.05). In conclusion, HA-ICSI improves fertilization outcomes although sperm injection takes longer to complete. Subsequent embryo development up to day 3 is not affected.
Publisher: Asian Pacific Journal of Tropical Medicine Press
Date: 06-2015
Publisher: Oxford University Press (OUP)
Date: 29-06-2022
Publisher: Medknow
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 02-05-2020
Publisher: Oxford University Press (OUP)
Date: 15-08-2023
Abstract: Is spontaneous collapse (SC) by human blastocysts a prognostic factor in IVF treatment? SC in human blastocyst is associated with reduced euploid embryo and pregnancy rates. SC of the human blastocyst is a phenomenon that was revealed relatively recently following the clinical application of time-lapse monitoring in IVF laboratories. The ploidy and clinical prognosis of affected blastocysts are still poorly understood, with inconsistent reports. Systematic reviews and meta-analyses on this topic are currently absent in the literature but its potential as a marker of embryo viability holds great clinical value. In this study, we aimed to comprehensively evaluate the potential of SC as a prognostic factor in regard to ploidy status, and pregnancy, live birth and miscarriage rates. A systematic review and meta-analysis were performed according to PRISMA guidelines, with a protocol registered with PROSPERO (CRD42022373749). A search of MEDLINE, EMBASE, and the Cochrane Library for relevant studies was carried out on 10 October 2022, using key words relevant to ‘blastocyst collapse’ and ‘time-lapse imaging’. Two independent reviewers systematically screened and evaluated each study in terms of participants, exposure, comparator, and outcomes (PECO). The Quality In Prognosis Studies tool was used for quality assessment. Data were extracted according to Cochrane methods. Pregnancy, live birth, ploidy, or miscarriage data were summarized by risk ratios (RRs) or odds ratios and their 95% CIs. All meta-analyses were performed with random-effects models. Following removal of duplicates, a total of 196 records were identified by the initial search. After screening according to PECO, 19 articles were included for further eligibility assessment. For meta-analysis, seven retrospective cohort studies were eventually included. After data pooling, the incidence of blastocyst SC was 37.0% (2516/6801) among seven studies (ranging from 17.4% to 56.2%). SC was associated with significantly lower clinical pregnancy rates (two studies, n = 736 RR = 0.77, 95% CI = 0.62–0.95 I2 = 30%), ongoing pregnancy rates (five studies, n = 2503 RR = 0.66, 95% CI = 0.53–0.83 I2 = 60%), and reduced euploidy rates (three studies, n = 3569 RR = 0.70, 95% CI = 0.59–0.83 I2 = 69%). Nevertheless, live birth rates (two studies, n = 816 RR = 0.76, 95% CI = 0.55–1.04 I2 = 56%) and miscarriage rate (four studies, n = 1358 RR = 1.31, 95% CI = 0.95–1.80 I2 = 0%) did not differ between blastocysts with or without SC. There was, however, significant heterogeneity between the studies included for evaluation of ongoing pregnancy rates (I2 = 60%, P = 0.04), live birth rates (I2 = 56%, P = 0.13), and ploidy rates (I2 = 69%, P = 0.04). Subgroup analyses were conducted according to different definitions of SC, number of collapse events, and whether the transferred blastocyst had undergone preimplantation genetic testing for aneuploidy with inconclusive findings across subgroups. All studies in the meta-analysis were retrospective with varying levels of heterogeneity for different outcomes. Not all studies had accounted for potential confounding factors, therefore only unadjusted data could be used in the main meta-analysis. Studies employed slightly different strategies when defining blastocyst SC. Standardization in the definition for SC is needed to improve comparability between future studies. Our results indicate that blastocyst SC has negative implications for a pregnancy. Such blastocysts should be given a low ranking when selecting from a cohort for intrauterine transfer. Blastocyst SC should be considered as a contributing variable when building blastocyst algorithms to predict pregnancy or live birth. There is no external funding to report. All authors report no conflict of interest. PROSPERO 2022 CRD42022373749
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.RBMO.2022.03.015
Abstract: The last decade has seen an explosion of machine learning applications in healthcare, with mixed and sometimes harmful results despite much promise and associated hype. A significant reason for the reversal in the reported benefit of these applications is the premature implementation of machine learning algorithms in clinical practice. This paper argues the critical need for 'data solidarity' for machine learning for embryo selection. A recent Lancet and Financial Times commission defined data solidarity as 'an approach to the collection, use, and sharing of health data and data for health that safeguards in idual human rights while building a culture of data justice and equity, and ensuring that the value of data is harnessed for public good' (Kickbusch et al., 2021).
Publisher: Informa UK Limited
Date: 16-01-2019
DOI: 10.1080/14647273.2018.1425919
Abstract: This study investigated the efficacy of four published day 3 embryo time-lapse algorithms based on different types of datasets (known implantation data [KID] and single embryo transfer [SET]), and the confounding effect of female age and conventional embryo morphology. Four algorithms were retrospectively applied to three types of datasets generated at Fertility North between February 2013 and December 2014: (a) KID dataset (
Publisher: Medknow
Date: 2020
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.REPBIO.2015.09.001
Abstract: A total of 488 Day 3 human embryos with known implantation data from two independent in vitro fertilization laboratories were included for analysis, with 270 from Fertility North (FN) and 218 from Canberra Fertility Centre (CFC). Implanting embryos grew at different rates between FN and CFC as indicated in hours of the time intervals between pronuclear fading and the 4- (13.9 ± 1.1 vs. 14.9 ± 1.8), 5- (25.7 ± 1.9 vs. 28.4 ± 3.7) and 8-cell stages (29.0 ± 3.2 vs. 32.2 ± 4.6), as well as the durations of 2- (10.8 ± 0.8 vs. 11.6 ± 1.1), 3- (0.4 ± 0.5 vs. 0.9 ± 1.2), and 4-cell stages (11.8 ± 1.4 vs. 13.6 ± 2.9), all p<0.05. The application of a previously published time-lapse algorithm on ICSI embryos from the two participating laboratories failed to reproduce a predictive pattern of implantation outcomes (FN: AUC=0.565, p=0.250 CFC: AUC=0.614, p=0.224). However, for the qualitative measures including poor conventional morphology, direct cleavage, reverse cleavage and 0.05) or non-implanting embryos (30.4% vs. 38.3%, p>0.05) between FN and CFC. Furthermore, implanting embryos favored lower proportions of the above biological events compared to the non-implanting ones in both laboratories (both p<0.01). To conclude, human embryo morphokinetics may vary between laboratories, therefore time-lapse algorithms emphasizing quantitative timing parameters may have reduced inter-laboratory transferability qualitative measures are independent of cell ision timings, with potentially improved inter-laboratory reproducibility.
Publisher: Springer Science and Business Media LLC
Date: 24-02-2021
Publisher: Oxford University Press (OUP)
Date: 06-2023
Publisher: Oxford University Press (OUP)
Date: 07-2021
Publisher: Elsevier BV
Date: 04-2021
Publisher: Oxford University Press (OUP)
Date: 29-06-2022
DOI: 10.1093/HUMREP/DEAC104.008
Abstract: Does transfer of low grade blastocysts results in acceptable live birth rates the birth of healthy babies? While BC/CB/CC blastocysts have a reduced chance of live birth compared with AA/AB/BA/BB blastocysts, the absolute chances are still reasonable. Transfer of poorer quality embryos and blastocysts result in lower live birth rates, though to what extent is unclear, nor if there is an absolute threshold below which live births are very rare or even do not occur. Further, the developmental competence of the inner cell mass (ICM) or trophectoderm (TE) could at least theoretically impact the pregnancy and/or the health of the baby. Many clinics do not transfer or freeze poor quality embryos and blastocysts, and prefer to submit the patient to a further stimulation cycle. We performed a retrospective analysis of 10,978 couples undergoing singleton blastocyst transfers between 2009 and March 2020. We included all single blastocyst transfers for which there was complete data on blastocyst quality, singleton or twin births, birthweight and gestation at delivery, irrespective of blastocyst grading, female age, cause of infertility, ovarian response or endometrial thickness. We recorded live birth rates, birth weight and gestational age. Data from 14 clinics in 3 countries, 8 from China, 5 from New Zealand, and 1 from Australia were included in the final dataset. We compared the impact of blastocyst grading using multiple logistic regression. Blastocyst grading was based on the Gardner classification, in which the first letter denotes the grade of the inner cell mass (A is best), and the second letter the grade of the trophectoderm. Overall, 10,978 single blastocyst cycles resulted in 4,261 live births (38.8%) (4195 singletons and 132 twins). Live birth rates were 47% after transfer of AA blastocysts (n = 2306) 42% after AB/BA (n = 2088) 33% after BC (n = 1973) 25% after CB (n = 715) and 14% after CC (n = 117). There were too few AC (n = 27) or CA (n = 12) blastocysts to include in the analysis. The odds of live birth for BC/CB/CC blastocysts compared with AA/AB/BA blastocysts, vary between 0.8 and 0.9. The live birth rate appears to be more dependent on ICM quality (C grade, n = 844, 23.2%) rather than TE quality (C grade, n = 2117, 32.1%), with the odds of live birth 0.43 and 0.57 respectively compared to A grade ICM or TE. The average birth weight (singleton only) was 3336.9+/-570.3 g (range 3323 to 3386 g), and the average gestation at delivery (singleton only) was 38+6+/-2.0 weeks (range 38+2 to 39+1). There was no significant difference for birth weight or gestational age at delivery between blastocysts of different grades. This was a retrospective study. Grading was based on inner cell mass and trophectoderm and not on degree of expansion, or on day of transfer. It is likely that higher quality blastocysts were transferred first, in a fresh cycle, and poorer quality blastocysts frozen for later transfer. The most important finding is that reasonable live birth rates are obtained in CC-blastocysts. We therefore advocate that CC-blastocysts should be replaced or frozen for later transfer. It is reassuring that there was no impact of blastocyst quality on birth weights or gestational age at the time of delivery. Not applicable
Publisher: Informa UK Limited
Date: 09-04-2019
DOI: 10.1080/14647273.2019.1598586
Abstract: The recent clinical introduction of time-lapse videography into
Publisher: Oxford University Press (OUP)
Date: 29-06-2022
Publisher: Oxford University Press (OUP)
Date: 06-2023
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.REPBIO.2015.03.002
Abstract: Time-lapse videography showed that human early cleavage embryos were quicker following intracytoplasmic sperm injection to reach developmental milestones compared to in vitro fertilization when using insemination as the timing start point (t0), due to differences in the time taken for embryos to reach pronuclear fading (PNF). These differences disappeared when PNF was used as t0. Using a biological rather than procedural t0 will allow a unified assessment strategy to be applied to all cycles irrespective of the insemination method.
Publisher: World Scientific Pub Co Pte Ltd
Date: 30-11-2022
DOI: 10.1142/S2661318223300027
Abstract: Background: It is currently inconclusive whether different intracytoplasmic sperm injection (ICSI) timings post oocyte retrieval (POR) lead to altered chance of clinical pregnancy and live birth following in vitro fertilization (IVF) treatment. This study, therefore, aimed to synthesize literature-based evidence for better clinical guidance regarding ICSI practice. Methods: A systematic review and meta-analysis were performed according to PRISMA guidelines. Studies were searched for in PubMed, MEDLINE, EMBASE, and the Cochrane Library. Outcome endpoints included clinical pregnancy and live birth rates (LBRs). Results: A total of 605 records were retrieved in the initial search. After exclusion, 30 articles were included for further screening for eligibility. For meta-analysis, 1 prospective and 5 retrospective cohort studies were included for pooled analysis, from which clinical pregnancy rates (CPRs) were evaluated in 6 studies while LBRs were evaluated in 3 studies. CPRs were comparable when ICSI was performed at (a) [Formula: see text] hours POR (risk ratio or RR = 1.00, [Formula: see text] confidence interval [CI] 0.94–1.08) vs [Formula: see text] hours, (b) [Formula: see text] hours (RR = 1.01, [Formula: see text] CI 0.88–1.16) vs [Formula: see text] hours, (c) [Formula: see text] hours (RR = 0.99, [Formula: see text] CI 0.93–1.05) vs [Formula: see text] hours, (d) [Formula: see text] hours (RR = 0.98, [Formula: see text] CI 0.93–1.02) vs [Formula: see text] hours, and (e) [Formula: see text] hours (RR = 1.05, [Formula: see text] CI 0.90–1.23) vs [Formula: see text] hours. However, LBR was reduced when ICSI was performed [Formula: see text] hours POR vs [Formula: see text] hours (RR = 0.94, [Formula: see text] CI 0.89–0.99), but such reduction disappeared when comparing [Formula: see text] hours POR (RR = 1.09, [Formula: see text] CI 0.85–1.38) vs [Formula: see text] hours. Conclusions: CPRs remain comparable when ICSI is performed at a range of timings up to 6-hour POR. However, LBR may benefit slightly by scheduling ICSI between 5- and 6-hour POR.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.REPBIO.2014.08.003
Abstract: A total of 341 fertilized and 37 unfertilized oocytes from 63 intracytoplasmic sperm injection (ICSI) treatment cycles were included for retrospective assessment using the Embryoscope time-lapse video system. The second polar body (pb2) extrusion occurred at 2.9±0.1 h (range 0.70-10.15 h) relative to sperm injection. All oocytes reduced in size following sperm injection (p 38 years compared to those <35 years (3.4±0.2 vs. 2.8±0.1, p<0.01) or 35-38 years (3.4±0.2 vs. 2.8±0.1, p 0.05 respectively). A shorter time of first cleavage ision relative to either sperm injection or pb2 extrusion is associated with both top grade (AUC=0.596 or 0.601, p=0.006 or 0.004) and usable embryos (AUC=0.638 or 0.632, p=0.000 respectively) on Day 3. In summary, (i) pb2 of human oocytes extrudes at various times following sperm injection, (ii) the timing of pb2 extrusion is significantly delayed when female age >38 years, but not related to subsequent embryo development, (iii) all human oocytes reduce in size following sperm injection, (iv) completion of pb2 extrusion in the fertilized oocytes is a pivotal event in terminating shrinkage of the vitellus, and (v) time to first cleavage ision either from sperm injection or pb2 extrusion is a significant predictive marker for embryo quality on Day 3.
Publisher: Oxford University Press (OUP)
Date: 07-2021
Publisher: World Scientific Pub Co Pte Ltd
Date: 03-2023
DOI: 10.1142/S2661318223500081
Abstract: Objective: This study aims to investigate the impact of slow embryo development on the subsequent live birth rate and birthweight outcomes following a fresh day 5 transfer. Study design: This retrospective multicenter cohort study included 1,213 consecutive patients undergoing autologous oocyte in vitro fertilization (IVF) treatment at four associated private clinics during 2016–2019. Only fresh single day 5 transfers were included for analysis. Results: No implantation was achieved by embryos that failed to reach the early blastocyst stage on day 5 ([Formula: see text]). After adjusting for potential confounding factors, multivariate logistic regression (expressed as adjusted odds ratio or aOR and [Formula: see text] confidence interval) showed a significantly reduced live birth rate in early blastocysts ([Formula: see text]) in reference to those at the expanding (aOR = 0.584, [Formula: see text], [Formula: see text], [Formula: see text]), expanded (aOR = 0.322, [Formula: see text], [Formula: see text], [Formula: see text]), or hatching/hatched stages (aOR = 0.255, [Formula: see text], [Formula: see text], [Formula: see text]). However, early blastocysts led to similar birthweights ([Formula: see text], [Formula: see text]) in comparison to those at the expanding ([Formula: see text], [Formula: see text], [Formula: see text]), expanded ([Formula: see text], [Formula: see text], [Formula: see text]), or hatching/hatched stages ([Formula: see text], [Formula: see text], [Formula: see text]). This was further confirmed by linear regression analysis using either birthweight or [Formula: see text] score (gestation-adjusted birthweight). Conclusion: Slow day 5 development is associated with reduced live birth rate when transferred fresh, however, subsequent birthweight is not impacted once pregnancy is initiated.
Publisher: Oxford University Press (OUP)
Date: 24-10-2023
Publisher: Oxford University Press (OUP)
Date: 06-2023
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.RBMO.2022.01.017
Abstract: Does variation in day 5 assessment timing confound live birth prediction using snapshot blastocyst morphology and is it possible to develop a numerical prediction algorithm? Retrospective multicentre cohort study including 4851 autologous oocyte single day 5 fresh embryo transfers performed at 11 Monash IVF clinics between 2016 and 2020. Repeat cycles of the same patients were excluded to avoid clustering effects in regression analysis. Hours post insemination (HPI) at day 5 assessment (115.9 ± 2.6 h) significantly correlated with blastocyst developmental stage (r = 0.118, P < 0.001). Independent association (expressed as adjusted odds ratio [aOR] and 95% confidence interval [CI]) was identified between live birth and HPI (aOR 0.950, 95% CI 0.925-0.976, P < 0.001) after accounting for blastocyst morphology and a range of patient/cycle characteristics. Algorithms were constructed using four significant live birth predictors: HPI at day 5 assessment, blastocyst developmental stage (aOR 1.347, 95% CI 1.217-1.491, P < 0.001), morphological grade (aOR 1.314, 95% 1.197-1.443, P < 0.001) and maternal age (aOR 0.922, 95% CI 0.907-0.936, P < 0.001). Receiver operating characteristic (ROC) analysis showed consistent predicting performance of algorithms via five-fold cross-validation, with similar area under the ROC curve (AUC 0.718, 0.715, 0.720, 0.712, 0.726, P < 0.001, respectively, in development subsets and AUC 0.718, 0.731, 0.709, 0.741, 0.684, P < 0.001, respectively, in validation subsets). A score (ranging from 0.1 to 4.7) calculator based on the final algorithm was subsequently created. Day 5 assessment timing is a confounding factor for live birth prediction using snapshot blastocyst morphology. A numerical algorithm incorporating day 5 assessment HPI, blastocyst morphology and maternal age can be developed for live birth prediction.
Publisher: Oxford University Press (OUP)
Date: 06-2023
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.FERTNSTERT.2014.07.1235
Abstract: To investigate the prevalence and potential causes of reverse cleavage (RC) by human early-cleavage embryos and its associations with embryonic development and implantation after transfer. Clinical retrospective cohort study. Private fertility treatment center. A total of 126 consecutive in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment cycles, with 353 IVF and 436 ICSI embryos cultured in the Embryoscope until day 3. None. Embryo assessment on day 3, incidence of abnormal ision, embryo morphokinetic parameters, and fetal heart beat. RC, referring to either blastomere fusion or failed cytokinesis, occurred up to three times per in idual embryo in 27.4% of embryos during the first three cleavage cycles. A higher incidence was associated with GnRH antagonist cycles compared with agonist cycles (odds ratio [OR] 1.683), or with ICSI compared with IVF (OR 1.600). After ICSI, sperm progressive motility was associated with RC (area under the receiver operating characteristic curve: 0.573). Compared with RC-negative embryos, a lower proportion of RC-positive embryos reached 6-cell stage or beyond by day 3 (47.7% vs. 71.7%), and were more likely to have multinucleation at the 4-cell stage (10.1% vs. 5.0%). Embryos showing RC had significantly poorer performance in both conventional grading and morphokinetic parameters, and they implanted less (0/22 vs. 29/131) than those not showing RC. RC significantly compromised embryo development, culminating in poor implantation potential. For each embryo, it can occur on more than one occasion at any stage during the first 3 days of culture. It is associated with factors affecting both oocyte and sperm.
Publisher: Asian Pacific Journal of Tropical Medicine Press
Date: 09-2012
Location: China
No related grants have been discovered for Yanhe Liu.