Abstract
Research question
Do morphokinetic profiles and treatment outcomes differ between embryos developed
from vitrified or fresh oocytes?
Design
Retrospective multicentre analysis using data from eight CARE Fertility clinics across
the UK between 2012 and 2019. Patients receiving treatment using embryos developed
from vitrified oocytes (n = 118 women, n = 748 oocytes), providing 557 zygotes during this time period, were recruited and
matched with patients undergoing treatment with embryos developed from fresh oocytes
(n = 123 women, n = 1110 oocytes), providing 539 zygotes in the same time frame. Time-lapse microscopy
was used to assess morphokinetic profiles, including early cleavage divisions (2-
through to 8-cell), post-cleavage stages including time to start of compaction, time
to morula, time to start of blastulation and time to full blastocyst. Duration of
key stages such as the compaction stage were also calculated. Treatment outcomes were
compared between the two groups (live birth rate, clinical pregnancy rate and implantation
rate).
Results
A significant delay of 2–3 h across all early cleavage divisions (2- through to 8-cell)
and time to start of compaction occurred in the vitrified group versus fresh controls
(all P ≤ 0.01). The compaction stage was significantly shorter in vitrified oocytes (19.02 ± 0.5 h)
compared with fresh controls (22.45 ± 0.6 h, P < 0.001). There was no difference in the time that fresh and vitrified embryos reached
the blastocyst stage (108.03 ± 0.7 versus 107.78 ± 0.6 h). There was no significant
difference in treatment outcomes between the two groups.
Conclusion
Vitrification is a useful technique for extending female fertility with no effects
on IVF treatment outcome.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Reproductive BioMedicine OnlineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Alterations in mitochondrial membrane potential during preimplantation stages of mouse and human embryo development.Mol. Hum. Reprod. 2004; 10: 23-32
- Morphokinetic analysis of human embryo development and its relationship to the female age: a retrospective time-lapse imaging study.Cell. Mol. Biol. (Noisy-le-grand). 2017; 63: 84-92
- Is morphokinetic the analysis answer?.Reprod. Biomed. Online. 2013; 27: 654-663
- Maternal body mass index affects embryo morphokinetics: a time-lapse study.J. Assist. Reprod. Genet. 2019; 36: 1109-1116
- Similar morphokinetic patterns in embryos derived from obese and normoweight infertile women: a time-lapse study.Hum. Reprod. 2013; 28: 794-800
- The influence of body mass index on pregnancy outcome following single-embryo transfer.J. Assist. Reprod. Genet. 2018; 35: 1295-1300
- Meiotic spindle assembly and chromosome segregation in oocytes.J. Cell. Biol. 2016; 215: 611-619
- A simplified model for mitochondrial ATP production.J. Theor. Biol. 2006; 243: 575-586
- The impact of endometriosis on early embryo morphokinetics: a case-control study.Syst. Biol. Reprod. Med. 2019; 65: 250-257
- ACE consensus meeting report: oocyte and embryo cyropreservation Sheffield. 17.05.11.Hum. Fertil. 2012; 15: 69-74
- Genetics: Analysis and Principles.Addison-Wesley, Reading, MA1999
- Calcium, ATP, and ROS: a mitochondrial love-hate triangle.Am. J. Physiol. Cell. Physiol. 2004; 287: C817-C833
- Structure and function of gelsolin.Results Probl. Cell. Differ. 2001; 32: 201-211
- Modelling a risk classification of aneuploidy in human embryos using non-invasive morphokinetics.Reprod. Biomed. Online. 2013; 26: 477-485
- Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS.Reprod. Biomed. Online. 2013; 27: 140-146
- Consequences of metaphase II oocyte cryopreservation on mRNA content.Cryobiology. 2011; 62: 130-134
- Effect of vitrification on mitochondrial membrane potential in human metaphase II oocytes.J. Assist. Reprod. Genet. 2012; 29: 1045-1050
- Proposed guidelines on the nomenclature and annotation of dynamic human embryo monitoring by a time-lapse user group.Hum. Reprod. 2014; 29: 2650-2660
- Efficiency and efficacy of vitrification in 35654 sibling oocytes from donation cycles.Hum. Reprod. 2020; 35: 2262-2271
- Clinical application of oocyte vitrification: a systematic review and meta-analysis of randomized controlled trials.Fertil. Steril. 2011; 96: 277-285
- Vitrification may increase the rate of chromosome misalignment in the metaphase II spindle of human mature oocytes.Reprod. Biomed. Online. 2009; 19: 29-34
- Timing of cell division in human cleavage-stage embryos is linked with blastocyst formation and quality.Reprod. Biomed. Online. 2012; 25: 371-381
- Measurement of ATP in single oocytes: impact of maturation and cumulus cells on levels and consumption.J. Cell. Physiol. 2014; 229: 353-361
- In-vitro development of embryos derived from vitrified-warmed oocytes is delayed compared with embryos derived from fresh oocytes: a time-lapse sibling oocyte study.Reprod. Biomed. Online. 2020; 40: 82-90
- Fertility options in transgender people.Int. Rev. Psychiatry. 2016; 28: 112-119
- Mitochondria and Ca(2+)in cell physiology and pathophysiology.Cell. Calcium. 2000; 28: 339-348
- Human oocyte cryopreservation: comparison between slow and ultrarapid methods.Reprod. Biomed. Online. 2009; 19: 171-180
- Revealing the secret life of pre-implantation embryos by time-lapse monitoring: a review.Int. J. Reprod. Biomed. 2017; 15: 257-264
- Morphometric analysis of human oocytes using time lapse: does it predict embryo developmental outcomes?.Hum. Fertil. (Camb). 2019; 22: 171-176
- Evolution of embryo selection for IVF from subjective morphology assessment to objective time-lapse algorithms improves chance of live birth.Reprod. Biomed. Online. 2020; 40: 61-70
- Comparison of embryo morphokinetics after in vitro fertilization-intracytoplasmic sperm injection in smoking and nonsmoking women.Fertil Steril. 2013; 99: 1944-1950
- Five years’ experience using oocyte vitrification to preserve fertility for medical and nonmedical indications.Fertil. Steril. 2013; 99: 1994-1999
- Slow cooling of human oocytes: ultrastructural injuries and apoptotic status.Fertil. Steril. 2009; 91: 1023-1034
- Vitrification of human in-vitro matured oocytes: effects on mitochondrial ultrastructure and oxygen consumption.Fertil. Reprod. 2019; 1: 131-135
- Selection of high-potential embryos by culture in poly(dimethylsiloxane) microwells and time-lapse imaging.Fertil. Steril. 2012; 97: 332-337
- Effect of reactive oxygen species produced by spermatozoa and leukocytes on sperm functions in non-leukocytospermic patients.Fertil. Steril. 2005; 83: 635-642
- Selection of high potential embryos using time-lapse imaging: the era of morphokinetics.Fertil. Steril. 2013; 99: 1030-1034
- Comparison of spindle and chromosome configuration in in vitro- and in vivo-matured mouse oocytes after vitrification.Fertil. Steril. 2008; 90: 1424-1432
- Prediction of human blastocyst development from morulas with delayed and/or incomplete compaction.Fertil. Steril. 2011; 96: 1473-1478.e2
- Analysis of compaction initiation in human embryos by using time-lapse cinematography.J. Assist. Reprod. Genet. 2014; 31: 421-426
- Cryopreservation of metaphase II human oocytes effects mitochondrial membrane potential: implications for developmental competence.Hum. Reprod. 2004; 19: 1861-1866
- Handbook of the Assisted Reproduction Laboratory.CRC Press, London2000
- Which patients pursue fertility preservation treatments? A multicentre analysis of the predictors of fertility preservation in women with breast cancer.Fertil. Steril. 2012; 97: 671-676
- Postponement and childlessness – evidence from two British cohorts.Demographic. Res. 2008; 19: 1935-1968
- Embryo selection: the role of time-lapse monitoring.Reprod. Biol. Endocrinol. 2014; 12: 124
- Development of a new clinically applicable device for embryo evaluation which measures embryo oxygen consumption.Hum. Reprod. 2016; 31: 2321-2330
- Effect of female underweight on embryo morphokinetic using time-lapse.Hum. Reprod. 2013; 28 (P-085)
- Human embryos from overweight and obese women display phenotypic and metabolic abnormalities.Hum. Reprod. 2015; 30: 122-132
- Vitrification of in vitro matured oocytes: effects on meiotic spindle configuration and mitochondrial function.Int. J. Clin. Exp. Pathol. 2014; 7: 1159-1165
- Effect of vitrification and thawing on human oocyte ATP concentration.Fertil. Steril. 2011; 95: 1839-1841
- Vitrification versus slow freezing of oocytes: effects on morphologic appearance, meiotic spindle configuration, and DNA damage.Fertil. Steril. 2011; 95: 374-377
- Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials.BMJ. 2010; 341: c6945
- The use of morphokinetics as a predictor of embryo implantation.Hum. Reprod. 2011; 20: 2658-2671
- Slow freezing and vitrification differentially modify the gene expression profile of human metaphase II oocytes.Hum. Reprod. 2012; 27: 2160-2168
- Smoking during pregnancy according to obstetric complications and parity: results of the EUROPOP study.Eur. J. Epidemiol. 2007; 22: 715-721
- Endometriosis and infertility: epidemiology and evidence-based treatments.Ann. N. Y. Acad. Sci. 2008; 1127: 92-100
- Number of embryos for transfer following in vitro fertilisation or intra-cytoplasmic sperm injection.Cochrane. Database. Syst. Rev. 2013; CD003416
- Time-lapse culture with morphokinetic embryo selection improves pregnancy and live birth chances and reduces early pregnancy loss: a meta-analysis.Reprod. Biomed. Online. 2017; 35: 511-520
- A prospective study of pregnancy outcome and biomarkers of oxidative stress in nulliparous obese women.Am. J. Obstet. Gynecol. 2009; 200 (395.e1–9)
- Effects of ovarian endometrioma on embryo quality.Fertil. Steril. 2011; 95: 2700-2702
- The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis.Hum. Reprod. 2012; 27: 2908-2917
- Introduction: Biomarkers of embryo viability: the search for the ‘holy grail’ of embryo selection.Fertil. Steril. 2017; 108: 719-721
- Symposium: innovative techniques in human embryo viability assessment. Human oocyte respiration-rate measurement–potential to improve oocyte and embryo selection?.Reprod. Biomed. Online. 2008; 17: 461-469
- A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome.Asian. J. Androl. 2017; 19: 80-90
- Prospective randomized comparison of human oocyte cryopreservation with slow-rate freezing or vitrification.Fertil. Steril. 2010; 94: 2088-2095
- Important parameters affecting quality of vitrified donor oocytes.Cryobiology. 2021; 100: 110-116
- Womens’ intentions to use fertility preservation to prevent age-related fertility decline.Reprod. Biomed. Online. 2016; 32: 121-131
- BMI-related metabolic composition of the follicular fluid of women undergoing assisted reproductive treatment and the consequences for oocyte and embryo quality.Hum. Reprod. 2012; 27: 3531-3539
- Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women.Hum. Reprod. 2008; 23: 324-328
- Identification of maturation-specific proteins by single-cell proteomics of human oocytes.Mol. Cell. Proteomics. 2016; 15: 2616-2627
- Limited recovery of meiotic spindles in living human oocytes after cooling-rewarming observed using polarized light microscopy.Hum. Reprod. 2001; 16: 2374-2378
- WHO Laboratory Manual for the Examination and Processing of Human Semen.5th edn. World Health Organization, Geneva, Switzerland2010
- Non-invasive imaging of human embryos before embryonic genome activation predicts development to the blastocyst stage.Nat. Biotechnol. 2010; 28: 1115-1121
- Cryopreservation of human failed-matured oocytes followed by in vitro maturation: vitrification is superior to the slow freezing method.Reprod. Biol. Endocrinol. 2011; 9: 156
Biography

Kathryn Montgomery holds an MRes Bioscience from Aberystwyth University, from which her research dissertation was conducted in collaboration with CARE Fertility, Manchester, resulting in this publication. Following the successful completion of her master's degree Kathryn is now an equine semen analysis technician for Stallion AI Services, UK.2
Article info
Publication history
Published online: February 28, 2023
Accepted:
February 21,
2023
Received in revised form:
February 13,
2023
Received:
December 15,
2022
Declaration: The authors report no financial or commercial conflicts of interest.Publication stage
In Press Journal Pre-ProofIdentification
Copyright
Crown Copyright © 2023 Published by Elsevier Ltd on behalf of Reproductive Healthcare Ltd. All rights reserved.