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Predictive value of oocyte morphology in human IVF: a systematic review of the literature.

ABSTRACT: BACKGROUND: Non-invasive selection of developmentally competent human oocytes may increase the overall efficiency of human assisted reproduction and is regarded as crucial in countries where legal, social or religious factors restrict the production of supernumerary embryos. The purpose of this study was to summarize the predictive value for IVF success of morphological features of the oocyte that can be obtained by light or polarized microscopic investigations. METHODS: Studies about oocyte morphology and IVF/ICSI outcomes were identified by using a systematic literature search. RESULTS: Fifty relevant articles were identified: 33 analysed a single feature, 9 observed multiple features and investigated the effect of these features individually, 8 summarized the effect of individual features. Investigated structures were the following: meiotic spindle (15 papers), zona pellucida (15 papers), vacuoles or refractile bodies (14 papers), polar body shape (12 papers), oocyte shape (10 papers), dark cytoplasm or diffuse granulation (12 papers), perivitelline space (11 papers), central cytoplasmic granulation (8 papers), cumulus-oocyte complex (6 papers) and cytoplasm viscosity and membrane resistance characteristics (2 papers). None of these features were unanimously evaluated to have prognostic value for further developmental competence of oocytes. CONCLUSIONS: No clear tendency in recent publications to a general increase in predictive value of morphological features was found. These contradicting data underline the importance of more intensive and coordinated research to reach a consensus and fully exploit the predictive potential of morphological examination of human oocytes.

SUBMITTER: Rienzi L

PROVIDER: S-EPMC3001337 | biostudies-literature | 2011 Jan-Feb

REPOSITORIES: biostudies-literature

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Predictive value of oocyte morphology in human IVF: a systematic review of the literature.

Rienzi Laura L Vajta Gábor G Ubaldi Filippo F

Human reproduction update 20100716 1

<h4>Background</h4>Non-invasive selection of developmentally competent human oocytes may increase the overall efficiency of human assisted reproduction and is regarded as crucial in countries where legal, social or religious factors restrict the production of supernumerary embryos. The purpose of this study was to summarize the predictive value for IVF success of morphological features of the oocyte that can be obtained by light or polarized microscopic investigations.<h4>Methods</h4>Studies abo ...[more]

PMID: 20639518

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Project description:BackgroundInfertility affects up to 15% of couples. In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the association between female dietary patterns, a modifiable factor, and IVF outcomes with conflicting results. We performed a systematic literature review to identify female dietary patterns associated with IVF outcomes, evaluate the body of evidence for potential sources of heterogeneity and methodological challenges, and offer suggestions to minimize heterogeneity and bias in future studies.MethodsWe performed systematic literature searches in EMBASE, PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for studies with a publication date up to March 2020. We excluded studies limited to women who were overweight or diagnosed with PCOS. We included studies that evaluated the outcome of pregnancy or live birth. We conducted an initial bias assessment using the SIGN 50 Methodology Checklist 3.ResultsWe reviewed 3280 titles and/or titles and abstracts. Seven prospective cohort studies investigating nine dietary patterns fit the inclusion criteria. Higher adherence to the Mediterranean diet, a 'profertility' diet, or a Dutch 'preconception' diet was associated with pregnancy or live birth after IVF treatment in at least one study. However, causation cannot be assumed. Studies were potentially hindered by methodological challenges (misclassification of the exposure, left truncation, and lack of comprehensive control for confounding) with an associated risk of bias. Studies of the Mediterranean diet were highly heterogenous in findings, study population, and methods. Remaining dietary patterns have only been examined in single and relatively small studies.ConclusionsFuture studies with rigorous and more uniform methodologies are needed to assess the association between female dietary patterns and IVF outcomes. At the clinical level, findings from this review do not support recommending any single dietary pattern for the purpose of improving pregnancy or live birth rates in women undergoing IVF treatment.

Project description:ObjectivesCholecystectomy is one of the most common surgical procedures performed worldwide to treat gallstone-related disease. Postcholecystectomy diarrhoea (PCD) is a well-reported phenomenon, however, the actual rate, predictive factors and mechanism of action have not been well determined. A systematic review was undertaken to determine the rate and predictive factors associated with diarrhoea in the postcholecystectomy setting.MethodsThe review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Databases searched included Medline, Embase, Pubmed, Cochrane and Google Scholar up to 29 September 2020. The inclusion criteria consisted of cohort studies or randomised trials which investigated the rate of PCD and predictive factors. Case reports, case series, conference abstracts and expert opinion pieces were excluded as were other systematic reviews as all the original articles from those reviews were included in this review. Papers that did not include PCD as a separate entity were excluded. Bias assessment was performed using the Newcastle-Ottawa Scale for cohort studies and the Cochrane risk of bias tool for randomised controlled trials as appropriate. Data were extracted by two authors (AF and JAA) and an overall rate of PCD was calculated. Predictive factors were also extracted and compared between studies.Results1204 papers were obtained and 21 were found to contain relevant information about PCD, including the number of patients developing diarrhoea, method of symptom assessment and time of onset postcholecystectomy. A pooled total of 3476 patients were included across the identified studies with 462 (13.3%) patients developing PCD. Possible predictive factors varied across all studies, with characteristics such as gender, age and weight of patients postulated as being predictive of PCD, with no agreement across studies.DiscussionPCD is therefore relatively common (13.3%). This has important implications for patient consent. Patients ought to be investigated early for bile acid diarrhoea in suspected PCD. More studies are required to determine the possible predictive factors for PCD. Limitations of the study included that most studies were not powered for calculation of PCD, and assessment methods between studies varied.Prospero registration numberCRD42019140444.

Project description:The number of mature oocytes is a key factor in the success of Assisted Reproductive Techniques (ART). Exogenous gonadotropins are administered during ovarian stimulation in order to maximize the number of oocytes available for fertilization. During stimulation, monitoring is mandatory to evaluate individual response, to avoid treatment complications and assist in the determination of the optimal day for final oocyte maturation and oocyte retrieval. Routine monitoring during stimulation includes transvaginal ultrasound examinations and measurement of serum estradiol (E2). Due to multifollicular growth of follicles of varying size, serum E2 levels are commonly supraphysiological and often variable, rendering E2-measurement during ovarian stimulation unreliable as a determinant of oocyte maturity. In contrast to serum E2, serum Inhibin A levels increase once a minimum follicle size of 12-15 mm is achieved. Due to this fact, serum Inhibin A levels could present in combination with ultrasound monitoring a more reliable parameter to determine the optimal follicle size for final oocyte maturation, as only follicles with a size of 12 mm and beyond will contribute to the serum Inhibin A level. This prospective observational, cross-sectional study demonstrates, that on the day of final oocyte maturation serum Inhibin A is strongly correlated to the number of follicles ?15 mm (0.72) and to the number of retrieved and mature oocytes (? 0.82/0.77, respectively), whereas serum E2 is moderately correlated to the parameters mentioned above (? 0.64/0.69/0.69, respectively). With an area under the curve (AUC) of 0.91 for Inhibin A, compared to an AUC of 0.84 for E2, Inhibin A can be regarded as a better predictor for the optimal timing of trigger medication with a threshold number of ?10 mature oocytes. It can be concluded from this data that serum Inhibin A in combination with transvaginal ultrasound monitoring may be a more powerful tool in the decision making process on trigger timing as compared to E2.

Project description:BackgroundRadiomics has been widely used in the study of tumours, which has predictive and prognostic value in nasopharyngeal carcinoma (NPC). Therefore, we collected relevant literature to explore the role of current radiomics in predicting the prognosis of NPC.MethodsWe performed a systematic literature review and meta-analysis in accordance with the preferred reporting items in the systematic evaluation and meta-analysis guidelines. We included papers on radiomics published before May 5, 2024, to evaluate the predictive ability of radiomics for the prognosis of NPC. The methodological quality of the included articles was evaluated using the radiomics quality score. The area under the curve (AUC), combined sensitivity and combined specificity were used to evaluate the ability of radiomics models to predict the prognosis of NPC.ResultsA total of 20 studies met the inclusion criteria for the current systematic review, and 13 papers were included in the meta-analysis. The radiomics quality score ranged from 7 to 20 (maximum score: 36). The diagnostic test forest plots showed that the diagnostic OR of radiology was 11.04 (95% CI: 5.11-23.87), while the ORs for sensitivity and 1-specificity were 0.75 (95% CI: 0.73-0.78) and 0.74 (95% CI: 0.72-0.76), respectively. It cannot be determined whether the combined model was superior to the radiomics model for predicting the prognosis of NPC. It is unclear whether the fact that the radiomics model was composed of features extracted from MRI is due to CT. The AUC of PFS was larger than that of disease-free survival (P < .05). The overall AUC value is 0.8265.ConclusionThis study summarized all the studies that examined the predictive value of radiomics for NPC prognosis. Based on the summarized AUC values, as well as sensitivity and 1-specificity, it can be concluded that radiomics has good performance in predicting the prognosis of NPC. Radiomics models have certain advantages in predicting the effectiveness of PFS compared to predicting disease-free survival. It cannot be determined whether the combination model is superior to the radiomics model in predicting NPC prognosis, nor can it be determined whether imaging methods have differences in predictive ability. The findings confirmed and provided further evidence supporting the effectiveness of radiomics for the prediction of cancer prognosis.

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Predictive value of oocyte morphology in human IVF: a systematic review of the literature.

Publications

Predictive value of oocyte morphology in human IVF: a systematic review of the literature.

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