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Blastocyst
Vitrification
S.SASIKUMAR ,M.SS.,(PhD)
Senior Embryologist
NOVA IVI
FERTILITY,Chennai
Vitrification
• Process that produces a glasslike
solidification of living cells that
completely avoids ice crystal formation
during cooling. It completely avoids
ice crystal formation in cryopreserved
cells during warming to recover the
cells for biological applications
Vitrification TechniquesVitrification Techniques
• Traditional Vitrification
(1998- early 2000s)
• Ultrarapid
vitrification
(2000-...today)
Problems Associated with
Traditional Vitrification Procedures
• High levels of cryoprotectants are toxic to
embryos
• (4-10 M compared to 0.5-1.0M)
• Procedure must be performed at 4o
C
• Technically demanding
Advantages of Ultra-Rapid Vitrification
• Increases in cooling rates alleviates toxicity of
high levels of cryoprotectants
• Can be performed at room temperature or 37o
C
Vitrification
solutions
DMSO+Acetami
de+ propylene
glycol
Ethylene
glycol+
Ficoll+Sucrose
Ethylene
glycol+ DMSO
Ethylene
glycol+ glycerol
Slow
Freezing
solutions
DMSO /1-2
PROH +
Sucrose
Glycerol+
Sucrose
From Kasai et al. RBM Online 2004
Base medium
+
Cryoprotectant
Differences of slow freezing and
vitrification
Slow-freezing
• low levels of
cryoprotectants
• slow controlled rates
of cooling (0.3o
C/min)
• slow dehydration to
minimize ice-crystal
formation
• takes hours
Vitrification
• high levels of
cryoprotectants
• very fast cooling rates
• (~20,000o
C/min)
• fast cooling rates result
in solidification of
solution into glass-like
structure (no
crystallization)
• takes seconds
Vitrification Slow cooling
Control of solute penetration Yes No
Control of dehydration rate Yes No
Duration out of the incubator 10min. 3 hrs.
Prolonged temperature shock No Yes
Fracture of ZP No Possible
Capture by growing ice
crystals
No Possible
Equipment and running costs Inexpensive Expensive
Vitrification & Slow-cooling
Kuleshova et al. F&S 2002
Variables in Vitrification
• Cooling &warming rates:Ideal
vitrification protocol must pass rapidly
through the critical temperature zone of
15 to – 5ºC to decrease chilling injuries.
High warming rates by directly
plunging cells into the warming
solution is suggested (-196 to 37ºC)
Variables in Vitrification
• Concentration of the cryoprotectant:
To achieve high cooling rates requires the
use of high concentrations of the
cryoprotectant solution which depresses ice
crystal formation, so a critical concentration
is required but in some cryoprotectants, this
minimal concentration (Cv) can lead to either
osmotic or chemical toxicity
Variables in Vitrification
• Sample size and carrier systems
• Sample size should be minimized to reduce the duration of
vapour coat and to increase the cooling rate, minimizing the
volume of the vitrification solution as much as possible is
necessary to facilitate vitrification by higher cooling rates
• To minimize the volume of the vitrification solution special
carriers are used for vitrification process
** Open pulled straws
** Flexipet- denuding pipette
** Microdrops
** Electron-microscopic copper grids
** Hemistraw system
** small nylon coils or nylon mash
** Cryotop,cryotip
** Cryoloop
Carriers for vitrification
Cryotop
Cryotip
Cryotip
Kuwayama et al.,RBM Online 2005
Cryoloop
Hampton Research, Laguna Niguel, CA, USA
Nylon loop
(20µm wide; 0.5-0.7 mm in diameter)
Thin film of cryoprotectant
solution by surface tension
Embryos are placed by pipette
Advantages of Cryoloop
Vitrification
• Lack of thermoinsulating layer maximizes
heat transfer (>20,000o
C/min)
• Easy manipulations
• Constant visualization of embryo
• Cryoloop stored within cryovial
• Procedure is performed at 37o
C
Necessity of blastocyst
vitrification ?
• Increasing application of BT especially for some
selected cases results with supernumerary
blastocysts for freezing to increase cumulative
pregnancy rates per oocyte retrieval
• A reliable procedure for the cryopreservation of
blastocysts is needed, because after fresh ET, only
small number of supernumerary blastocysts are
likely to be available for cryopreservation
• Based on the published cochrane data (2008),
vitrification appears to result in significantly higher
survival and pregnancy rates
Blastocyst vitrification
• First pregnancy after human blastocyst vitrification
was achieved by Yokota et al., HR 2000
• EG- based vitrification solutions are widely used as
it has a low toxicity with rapid diffusion into the cell
through ZP and cellular membrane
• 1st. Vit.sol. EG+DMSO
• 2nd. EG+DMSO+Ficoll+ Sucrose,
• Warming: Decreasing concentrations of Sucrose sol.
are preferred
• Concentration of cryoprotectants are decreased to
7.5% from 25% over the years of experience
Blastocyst
vitrification
• Is it the most effective and
successful method to
cryopreserve embryos at
blastocyst stage???
Faster re-expansion after thawing with vitrification method
Slow Freezing Vitrification
No of.
blastocysts
72 81
Survival Rate(%) 56.9 (41/72) 84 (68/81)*
Higher survival rates with blastocyst vitrification
Artifical shrinkage
by microneedle
Artifical shrinkage
by laser
Large blatocoele of more developed blastocysts may disturb
the efficacy of vitrification due to
inappropriate Dehydration and permeation of cryoprotectant,
which may cause ice crystal formation in the rapid cooling and
warming steps of vitrification. Ice crystal formation can be a
voided by reducing fluid content of the blastocoele of more
developed blastocysts
RESULTS
• Vitrification as a cryopreservation method
has many primary advantages and benefits
based on the published data
• Vitrification protocols are now starting to
enter the mainstream of human ART
• The reports of successfully completed
pregnancies following vitrification are
encouraging for further research
• More studies on vitrification and thawing
procedures are needed to develop more
efficient and optimal vitrification methods
Concerns regarding Vitrification
• LN2 still remains to be a potential source of contamination since the
technique is based on direct contact between the vitrification solution
containing cryoprotectant agents and LN2. So from a clinical point of
view:
• Is there a need to sterilize LN2? How is it possible to maintain its
sterility
• Cross contamination with viruses?? ( No publication since 1985, about
450 publications)
• Closed systems should be used in clinical human IVF in the future to
avoid this concern.(Like CBS HS vitrification straws, Cryotip……) New
clinical trials with safer closed systems should be applied
• Low toxicity vitrification solutions must be designed in the future
• Genetical structure of the vitrified cell?? Chromosal abnormalities,
gene expressions ...... More studies are needed to prove the safety of
the technique
Successful Vitrification

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Vitrification of blastocyst stage embryos

  • 2. Vitrification • Process that produces a glasslike solidification of living cells that completely avoids ice crystal formation during cooling. It completely avoids ice crystal formation in cryopreserved cells during warming to recover the cells for biological applications
  • 3. Vitrification TechniquesVitrification Techniques • Traditional Vitrification (1998- early 2000s) • Ultrarapid vitrification (2000-...today)
  • 4. Problems Associated with Traditional Vitrification Procedures • High levels of cryoprotectants are toxic to embryos • (4-10 M compared to 0.5-1.0M) • Procedure must be performed at 4o C • Technically demanding Advantages of Ultra-Rapid Vitrification • Increases in cooling rates alleviates toxicity of high levels of cryoprotectants • Can be performed at room temperature or 37o C
  • 5. Vitrification solutions DMSO+Acetami de+ propylene glycol Ethylene glycol+ Ficoll+Sucrose Ethylene glycol+ DMSO Ethylene glycol+ glycerol Slow Freezing solutions DMSO /1-2 PROH + Sucrose Glycerol+ Sucrose From Kasai et al. RBM Online 2004 Base medium + Cryoprotectant
  • 6. Differences of slow freezing and vitrification Slow-freezing • low levels of cryoprotectants • slow controlled rates of cooling (0.3o C/min) • slow dehydration to minimize ice-crystal formation • takes hours Vitrification • high levels of cryoprotectants • very fast cooling rates • (~20,000o C/min) • fast cooling rates result in solidification of solution into glass-like structure (no crystallization) • takes seconds
  • 7. Vitrification Slow cooling Control of solute penetration Yes No Control of dehydration rate Yes No Duration out of the incubator 10min. 3 hrs. Prolonged temperature shock No Yes Fracture of ZP No Possible Capture by growing ice crystals No Possible Equipment and running costs Inexpensive Expensive Vitrification & Slow-cooling Kuleshova et al. F&S 2002
  • 8. Variables in Vitrification • Cooling &warming rates:Ideal vitrification protocol must pass rapidly through the critical temperature zone of 15 to – 5ºC to decrease chilling injuries. High warming rates by directly plunging cells into the warming solution is suggested (-196 to 37ºC)
  • 9. Variables in Vitrification • Concentration of the cryoprotectant: To achieve high cooling rates requires the use of high concentrations of the cryoprotectant solution which depresses ice crystal formation, so a critical concentration is required but in some cryoprotectants, this minimal concentration (Cv) can lead to either osmotic or chemical toxicity
  • 10. Variables in Vitrification • Sample size and carrier systems • Sample size should be minimized to reduce the duration of vapour coat and to increase the cooling rate, minimizing the volume of the vitrification solution as much as possible is necessary to facilitate vitrification by higher cooling rates • To minimize the volume of the vitrification solution special carriers are used for vitrification process ** Open pulled straws ** Flexipet- denuding pipette ** Microdrops ** Electron-microscopic copper grids ** Hemistraw system ** small nylon coils or nylon mash ** Cryotop,cryotip ** Cryoloop
  • 12. Cryoloop Hampton Research, Laguna Niguel, CA, USA Nylon loop (20µm wide; 0.5-0.7 mm in diameter) Thin film of cryoprotectant solution by surface tension Embryos are placed by pipette
  • 13. Advantages of Cryoloop Vitrification • Lack of thermoinsulating layer maximizes heat transfer (>20,000o C/min) • Easy manipulations • Constant visualization of embryo • Cryoloop stored within cryovial • Procedure is performed at 37o C
  • 14. Necessity of blastocyst vitrification ? • Increasing application of BT especially for some selected cases results with supernumerary blastocysts for freezing to increase cumulative pregnancy rates per oocyte retrieval • A reliable procedure for the cryopreservation of blastocysts is needed, because after fresh ET, only small number of supernumerary blastocysts are likely to be available for cryopreservation • Based on the published cochrane data (2008), vitrification appears to result in significantly higher survival and pregnancy rates
  • 15. Blastocyst vitrification • First pregnancy after human blastocyst vitrification was achieved by Yokota et al., HR 2000 • EG- based vitrification solutions are widely used as it has a low toxicity with rapid diffusion into the cell through ZP and cellular membrane • 1st. Vit.sol. EG+DMSO • 2nd. EG+DMSO+Ficoll+ Sucrose, • Warming: Decreasing concentrations of Sucrose sol. are preferred • Concentration of cryoprotectants are decreased to 7.5% from 25% over the years of experience
  • 16. Blastocyst vitrification • Is it the most effective and successful method to cryopreserve embryos at blastocyst stage???
  • 17. Faster re-expansion after thawing with vitrification method
  • 18. Slow Freezing Vitrification No of. blastocysts 72 81 Survival Rate(%) 56.9 (41/72) 84 (68/81)* Higher survival rates with blastocyst vitrification
  • 19. Artifical shrinkage by microneedle Artifical shrinkage by laser Large blatocoele of more developed blastocysts may disturb the efficacy of vitrification due to inappropriate Dehydration and permeation of cryoprotectant, which may cause ice crystal formation in the rapid cooling and warming steps of vitrification. Ice crystal formation can be a voided by reducing fluid content of the blastocoele of more developed blastocysts
  • 20. RESULTS • Vitrification as a cryopreservation method has many primary advantages and benefits based on the published data • Vitrification protocols are now starting to enter the mainstream of human ART • The reports of successfully completed pregnancies following vitrification are encouraging for further research • More studies on vitrification and thawing procedures are needed to develop more efficient and optimal vitrification methods
  • 21. Concerns regarding Vitrification • LN2 still remains to be a potential source of contamination since the technique is based on direct contact between the vitrification solution containing cryoprotectant agents and LN2. So from a clinical point of view: • Is there a need to sterilize LN2? How is it possible to maintain its sterility • Cross contamination with viruses?? ( No publication since 1985, about 450 publications) • Closed systems should be used in clinical human IVF in the future to avoid this concern.(Like CBS HS vitrification straws, Cryotip……) New clinical trials with safer closed systems should be applied • Low toxicity vitrification solutions must be designed in the future • Genetical structure of the vitrified cell?? Chromosal abnormalities, gene expressions ...... More studies are needed to prove the safety of the technique