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VITRIFICATION Dr G A RAMA RAJU

Vitrification in IVF

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Clinical overview of freezing of embryo using vitrification

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Page 1: Vitrification in IVF

VITRIFICATION

Dr G A RAMA RAJU

Page 2: Vitrification in IVF

Over viewComponents of

cryobiology

Slow freezing /vitrification

Key issues in

vitrification

sperm

EmbryoOocyt

e

Ovary /testis

Safety

New born

.

Page 3: Vitrification in IVF

Prof Hans Tinneberg

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Pioneers.

Nature

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?

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? A vitrified frog felt as a rock

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A wood frog in winter - Alaska. Nature’s expt with VITRIFICATION

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Cell injury.

1 Cell size shape ,permeability ,individual quality and sensitivity.2 cryoprotectant toxicity3 cooling and warming.

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The land mark publication “Slow cooling” Trounson and Mohr 1983

A long gap…………………………………….

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PLANER COMPUTERISED FREEZER

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Vitrification a tipping point in ART

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Gopubmed:

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Father Basile.j.luyet

work between 1937-1958

1952 Time magazine

Innovator :

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Spermatozoa : Early adopter

15

Early adopter: PARKES

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Majority

Publication from different countries

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CRYOPRESRVATIOON PROCESSES

•Add cryoprotectant

First Concept

•Cool cells to -196 & store

Second Concept

•Warm/Thaw

Third Concept

•Remove cryoprotectant

Fourth concept.

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Disadvantage and benefits of vitrification

ResultsTimeCost

vitrification

Slow freezing

*

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Variables Variable that effect vitrificationof vitrification that can profoundly influence its effectiveness

19

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Summary of the primary benefits of vitrification

20Biology of Reproduction December 1, 2002 vol. 67 no. 6 1671-1680

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Over view of current work.

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DMSOPROPYLENE GLYCOLGLYCEROL

OTHER SACCHARIDESOSMOTIC ALTERATION

CPA

HEPES BUFFERED MEDIA

VITRIFICATION SOLUTIONS

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Are all vitrification and warming solution same ?

Yes and No

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MOPS

Sol-A: 7.5% of EG +

7.5% of DMSO

Sol-B: 15% of EG + 15% of

DMSO + 1M of SUCROSE + FICOLL (10 mg/ml)

ES: 7.5%

of EG

+ 7.5% of

DMSO

VS: 15% of EG + 15% of DMSO +

0.6M of SUCROSE

Sage Bio Pharma

V1:

BUFFER

V2: EG + Propanediol

V3: EG + Propanediol + FICOLL

Vitrolife

ES: 7.5%

of EG

+ 7.5% of 1,2

Propanediol

VS: 15% of EG + 15% of 1,2

Propanediol + 0.5M of SUCROSE

Medi Cult

Rama Raju et al

Composition of Vitrification Solutions

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1M Sucrose

0.5M Sucrose

0.25M Sucrose

1M Sucrose

0.5M Sucrose

Sage Bio Pharma

W1:

Sucrose

W2: Sucrose

W3: Sucrose

Vitrolife

Medi Cult

0.125M Sucrose

1M Sucrose

0.5M Sucrose

0.25M Sucrose

Rama Raju et al

Composition of Warming Solutions

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Carrier

Cryoloop,cryotip,pulled straw, electronic grid

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Vitrification and slow freezing similar results

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Japanese group

vajata

We are working on removal of water from

oocyte and working on that

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Vitrification of 2 pronuclei

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DAY 2 OR DAY 3 EMBRYO

33

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Copyright restrictions may apply.

Devroey, P. et al. Hum Reprod Update 2009 15:391-408; doi:10.1093/humupd/dmp012

The odds of post-thawing survival rate of cleavage-stage embryos after vitrification or slow freezing

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Our first vitrification twins

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Blastocyst

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38

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Blastocyst expanded or hatched

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Safety issues

Ultraviolet light to sterilize the liquid nitrogen

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IVF children

Use of hospital services

Long hospitalizatio

n

Increase risk of infection epilepsy

Cerebral palsy

Sleep disturbances Convulsions Behavior

problems

Congenital malformation

Need for long tern follow up to look deeply

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Safe?

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cryopreservation children

Need for long tern follow up to look deeply

?

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Perinatal outcomes in vitrified oocytes

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Neonatal outcome of day 3 embryos

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Perinatal outcome of vitrificaion blastocyst

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acknowledgement Hans Tinneberg my mentor

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summaryVisakhapatnam Beach .