Ten Instituto Bernabeu research projects arouse the interest of the European Society of Human Reproduction and Embryology, ESHRE, in its first virtual congress
The most important European congress on infertility and reproductive medicine is taking place this year on the computers, tablets and smartphones of more than 6,700 participants as, for the first time in its history and for safety reasons due to the coronavirus crisis, the event is virtual. Every year, several works of Instituto Bernabeu are among the ones selected by its expert committee to be presented in this scientific meeting. It is also the case of 2020, since there are ten research projects that awoke the interest of this scientific society. From the 5th until the 8th of July Instituto Bernabeu presents studies in the field of reproductive biology, molecular biology, genetics and embryology… during this annual meeting.
Dr. Juan Carlos Castillo, gynaecologist of Instituto Bernabeu, will present his research on the use of a natural hormone for ovarian stimulation in egg donors.
Ovarian stimulation is a routine process in reproductive medicine to obtain a greater number of oocytes and thus optimize fertility treatment. To improve the quality of life of egg donors, Instituto Bernabeu has investigated and found a new way to carry out the treatment through a natural hormone administered orally, thus avoiding the injections of medication. This finding has been recognized by the European Society of Human Reproduction and Embryology (ESHRE) and was chosen to be presented via a video-conference in its 36th congress, which this year and for the first time in its history, will be held online.
“Natural micronized progesterone versus a GnRH antagonist in egg-donation cycles. An extended experience”
J. Castillo; J. Guerrero; R. Delgado; B. Moliner; L. Luque; J. Ten; A. Fuentes; A. Bernabeu; J. Ll. Aparicio; R. Bernabeu
Nine other studies of our reproductive medicine clinic will be presented at the international congress.
2. Investigation whether the vaginal microbiome can predict the outcome of in vitro fertilization in cases with or without recurrent implantation failures.
The research project led by Dr. Andrea Bernabeu sought to determine whether certain vaginal and endometrial bacteria are related to success or not of in vitro fertilization in patients with and without implantation failure. The research concludes that the pattern of vaginal and endometrial microbiome has a direct relationship with the pregnancy rate and is different between patients who suffer and those who don’t from implantation failure.
The pattern of vaginal/endometrial microbiome as a predictor for outcome of in vitro fertilization (IVF) in patients with or without repetitive implantation failure: a pilot study.
A. Bernabeu, B. Lledó, M.C. Díaz, F. Lozano, A. Rodríguez-Arnedo, R. Bernabeu
3. New scientific finding on embryo genetics
Instituto Bernabeu presents at ESHRE work developed in the laboratory of molecular biology and genetics in which was observed that more than a half of the alterations in the fragments of a chromosome (58.2%) are located in the telomeres, the ends of the chromosome. A high percentage of these, so-called, segmental alterations are found in embryos considered to be of poor quality (classified as C or D embryos) and young women were found to be at greater risk of presenting these abnormalities. When the percentage of cells with segmental alterations is lower than 50%, the embryo is classified as mosaic and it has possibilities of success as embryos without anomalies and give rise to birth of children free of chromosomal alterations.
Analysis of segmental aneuploidy and mosaicism in the human blastocysts. Is there any difference in pregnancy rates?
José A. Ortiz, Belén Lledó, Ruth Morales, Eva García-Hernández, Jorge Ten, Ll. Aparicio, Andrea Bernabeu, Rafael Bernabeu
4. Study links genetic changes with chromosome abnormalities in the embryo and with the probability of on-going pregnancy
One of the works of our reproductive medicine clinic has focused on studying the genetic changes in a variant of the MTHFR gene, which participates in the metabolism of folic acid, essential for reproduction and pregnancy. Other research relates variants of this gene with alterations in the embryo and problems with gestation. Instituto Bernabeu has discovered, after studying different chromosomal abnormalities in the embryos, that the variants C677CT and A1298C of MTHFR gene do not affect the rate of chromosomal abnormalities in the embryo nor the pregnancy rate.
Do maternal and embryo MTHFR gene polymorphisms have any influence on embryo chromosomal abnormalities and the ongoing pregnancy rate?
García-Hernández E., Morales R., Codina H., Cascales A., Lledó B., Ortiz JA., Ten J., Ll. Aparicio J., Bernabeu A., Bernabeu R.
5. Comparative analysis of the most accurate technique for the chromosomal study of the embryo.
This study carried out by the Genetic Unit Chief at Instituto Bernabeu, Dr. Belén Lledó, consisted of evaluating the accuracy of the non-invasive study of the embryo, niPGT-A, using two different techniques of chromosome analysis. The niPGT-A avoids performing the embryo biopsy during the process of preimplantation genetic diagnosis by analyzing the free DNA in the culture medium where the embryo develops in vitro. It is a way of minimizing a possible impact on the embryo’s ability to implant, given the high level of human specialization and equipment required for embryo biopsy. Researchers have found similar results for PGT-A and niPGT-A techniques, although the effectiveness of the non-invasive test may be influenced by DNA contamination and embryonic mosaicism. To improve its reliability, experts suggest optimizing embryo culture conditions and medium recovery.
Consistent results of non-invasive pre-implantation genetic testing for aneuploidy (niPGT-A) of human embryos using two different techniques for chromosomal analysis.
B. Lledo, R. Morales, J.A. Ortiz, A. Rodriguez-Arnedo, J. Ten, J.C. Castillo, A. Bernabeu, J. Ll. Aparicio, R.Bernabeu.
6. Research linking the outcome of β-HCG test with the prognosis of pregnancy
This study has been carried out at Instituto Bernabeu Albacete taking as sample 196 patients with positive β-hCG (the pregnancy hormone). In this project, the relation between the initial value of this hormone with the later evolution of the pregnancy and birth of the baby was compared, concluding that β-hCG can be used as a prognostic marker in the treatments of assisted reproduction.
Serum beta human chorionicgonadotropin(β-hCG) levels 13 to 14 days after embryotransfer (ET) and the predictability of pregnancy outcome in IVF cycles.
Lydia Luque, N. Ruiz, Á. Linares, J. Bartolomé, J.A. Ortíz, R. Bernabeu
7. Diagnostic finding of low ovarian reserve linked to Interleukin-10 levels
This research has managed to correlate the level of cytokines with the diagnosis of low ovarian reserve and ovarian response. The researchers at Instituto Bernabeu consider that interleukin-10 (IL-10) may be useful as a biomarker to predict ovarian response. The study reveals that interleukin-10 levels are lower in patients with low reserve and ovarian response compared to patients with normal reserve and response. Therefore, knowledge about IL-10 levels can allow us to personalize the treatment and improve the results.
Poor ovarian reserve and response are associated with interleukin 10 levels in women undergoing in-vitro fertilization.
A. Fabregat, M. Hortal, B. Lledó, J.A. Ortiz, A. Bernabeu, J. Ll. Aparicio, R. Bernabeu
8. Which type of biopsy damages the embryo the least and has the highest rate of success?
The biopsy of the embryo consists of the genetic analysis of its cells which allows it to be classified as chromosomally normal, abnormal or mosaic. To do this, 5 to 10 cells are extracted from the future placenta – the, so called, trophoectoderm. The study has assessed the genetic and reproductive outcome of the embryos by studying two ways of performing the biopsy, pulling, which is associated with greater use of laser and flicking, which requires fewer pulses. The study concludes that exceeding 4 pulses of the laser can increase the rate of mosaicism and a simple mosaic embryos rate that implant practically equally to chromosomally normal embryos.
Is mosaicism rate and characteristics influenced by the method of trophectoderm-biopsy technique employed in PGT-A cycles? Genetic results and reproductive outcome after pulling versus flicking
Herrero L., Aparicio M., Cascales L., Ortiz JA., Castillo JC. García-Ajofrín C, Ten J. Bernabeu R.
9. Can blastocyst morphology predict chromosomal alterations in the embryo?
In this research the experts of Instituto Bernabeu have noticed a correlation between aneuploidies and the expansion of the blastocyst as well as the quality of the trofoectoderm. They point out that a deficient morphology and slow development of blastocysts in older patients have higher risk of aneuploidies (chromosomal alterations).
Can we predict aneuploidy or mosaicism considering blastocyst morphology?
Rodríguez A., Herrero L., Cascales L., Ortiz JA., Bernabeu A, Ll. Aparicio J., Llaneza A.,Ten J., Bernabeu R
10. Research links progesterone to uterine contractility and its effect on patients with embryo implantation failure
Patients with repeated implantation failure are a challenge and a concern in assisted reproduction treatments. The study found that patients with low progesterone levels tend to have more uterine contractions. Therefore, the researchers emphasize that knowing both the contractions and the progesterone levels can help in the personalization and the success of the treatment.
4D ultrasonographic evaluation of uterine peristalsis correlates with progesterone levels in patients with repetitive implantation failure
Moliner B, Ll. Aparicio J, Bernabeu A, Castillo JC, Fuentes A, Sellers F, Bernabeu R.