RESUMEN
OBJECTIVE: To compare two different blastocyst biopsy protocols. DESIGN: Retrospective single-center cohort study. SETTINGS: Private in vitro fertilization center. PATIENT(S): The study included 1,670 frozen-thawed embryo transfers (FETs) with preimplantation genetic testing for aneuploidy (PGT-A). INTERVENTION: None. MAIN OUTCOME MEASURE(S): Survival rate (SR) after thawing, clinical pregnancy rate (CPR), ongoing implantation rate (IR), and live birth rate (LBR). RESULT(S): Eight hundred thirty-five FETs with PGT-A cycles including only embryos biopsied in the sequential blastocyst hatching and biopsy protocol paired with the ablation of one-fourth of the zona pellucida (ZP) were matched with 835 FETs with PGT-A cycles including only embryos biopsied in the day 3 prehatching protocol by female age (±1 year), number of embryos transferred, use of gestational carrier or egg donor, and day of blastocyst transfer. Only FETs with euploid blastocysts graded no lower than 4BB were included, and cycles with fewer than five oocytes were excluded. SR after thawing, CPR, ongoing IR, and LBR were significantly higher in the FET cycles with the embryos biopsied in the sequential hatching and biopsy protocol. Four cases of monozygotic twin pregnancies were reported with the day 3 prehatching protocol and none with the sequential hatching and biopsy protocol. CONCLUSION(S): Our results show, for the first time, that using different blastocyst biopsy protocols can affect clinical outcomes. Because the study was retrospective, our findings should be validated in a prospective trial.
Asunto(s)
Biopsia , Blastocisto/patología , Transferencia de Embrión , Fertilización In Vitro , Pruebas Genéticas , Diagnóstico Preimplantación , Aneuploidia , Biopsia/efectos adversos , Transferencia de Embrión/efectos adversos , Femenino , Fertilización In Vitro/efectos adversos , Humanos , Nacimiento Vivo , Valor Predictivo de las Pruebas , Embarazo , Índice de Embarazo , Diagnóstico Preimplantación/efectos adversos , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Resultado del TratamientoRESUMEN
Potato production and processing are very important activities in the agricultural economy of the Pacific Northwest. Part of the reason for the development of this industry has been the availability of water for both growing and processing. A great amount of water is used in processing potato products, such as frozen French fries, and the waste water is a pollutant because it contains high levels of nitrate and other nutrients. Using this waste water to irrigate the fields can be a suitable disposal method. Field application will reduce potato fertilizer costs, but it can also cause underground water contamination if over-applied to the field. In this econometric study, we used field data associated with current waste water applications in central Washington to examine the yield response as well as the soil nitrogen content response to waste water applications. Our results from the production model show that both water and nitrogen positively affect crop yields at the current levels of application, but potassium has been over applied. This implies that replacing some waste water with fresh water and nitrogen fertilizer will increase production. The environmental model results show that applying more nitrogen to the soil leads to more movement below the root zone. The results also suggest that higher crop yields lead to less nitrogen in the soil, and applying more water increases crop yields, which can reduce the nitrogen left in the soil. Therefore, relative to the current practice, waste water application rates should be reduced and supplemented with fresh water to enhance nitrogen use by plants and reduce residual nitrogen in the soil.