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REI Written Boards 2024 - AK > Lab Stuff > Flashcards

Lab Stuff Flashcards

1
Q

What is the effect of FSH on corona radiata?

What is the effect of LH on corona radiata?

A

FSH&raquo_space; granulosa cell proliferation&raquo_space; MORE granulosa cell layers in corona radiata

LH/HCG&raquo_space; expansion of cumulus cells&raquo_space; less dense/tightly packed

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2
Q

What do oocytes undergoing premature luteinization look like?

A

Premature luteinization due to early elevated progesterone

Granulosa cells become dark/less refractile

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3
Q

What do follicles responding poorly to FSH indicate?

A

Scanty corona radiata

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4
Q

What is the percentage of IVF cases involving contamination?

A

0.7%

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5
Q

Which type of contamination may still allow for ET?

A

Fungal

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6
Q

Even if contamination cannot overtly be observed on IVF dishes, what percentage contain bacteria when tested?

A

1/2 !

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7
Q

Why is inside air dirtier than outside air?

A

Human skin debris!

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8
Q

Which bacteria can pass through filters?

A

Mycoplasma (small, lack cell wall)

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9
Q

What is likely the largest source of IVF culture contamination?

A

Follicular aspirates, Sperm

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10
Q

What is gentamicin active against?

A

Gram negative bacteria

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11
Q

First source to evaluate for contaminants?

A

Media

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12
Q

Pre-compaction (D1-3) v Post-compaction (D4-6)

A

Embryo genome activates between day 2-3 (8-cell stage)

Day 1-3:
Pyruvate
Lactate
Non-essential AAs
Low O2 consumption

Day 4-6:
Glucose
Essential AAs
High O2 consumption

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13
Q

Blastocyst stage transfer has a higher ___ rate than day 3 transfer

A

implantation/pregnancy

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14
Q

Pros/Cons of blastocyst transfer

A

Pros:
- Higher implantation/pregnancy rate than with Day 3 transfers
- More viable option for eSET (opportunity for more embryo development allowing for better embryo selection)
- Decrease potential for embryo trauma with trophectoderm biopsy (compared to cleavage stage biopsy)

Cons:
- Longer culture time, longer exposure to in vitro environment
- More labor intensive for lab
- Higher chance of lacking embryo development –> no embryos for transfer
- High rates of multiple gestation
- Increased chance of monozygotic pregnancy
- Possible inadequate endometrial receptivity with early stage blastocyst

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15
Q

Describe the Gardner grading scale
- Progression score
- ICM grade
- TE grade

A

Gardner scale allows for counseling of likelihood of success based on individual available embryos.

It also provides quality control metric for the lab.

Progression score: degree of expansion and hatching status

  1. Early blastocyst - blastocoel <50% of embryo volume, ZP thick
  2. Expanding blastocyst - blastocoel >50% of embryo volume, ZP starting to thin
  3. Full blastocyst - blastocoel fills entire embryo, ZP not completely thin
  4. Expanded blastocyst - blastocoel volume now greater than the early embryo (fully expanded embryo), ZP very thin
  5. Hatching blastocyst - trophectoderm starting to herniate through ZP
  6. Hatching blastocyst - blastocyst completely escaped from ZP

ICM grade:
A- tightly packed, many cells
B- loosely packed, several cells
C- very few cells

TE grade:
A- cohesive epithelium, many cells
B- loose epithelium, few cells
C- very few, large cells

*3AB or better considered good quality

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16
Q

Gardner scale correlates with increased ___

A

Pregnancy/delivery rates

17
Q

Blastocyst quality score (BQS) calculation

A

Expansion score x ICM score (3-A, 2-B, 1-C) x TE score

Score of at least 36 or above (correlating to 4AA) associated with highest clinical pregnancy rates compared to <9 (correlating to <1AA)

18
Q

Blastocyst ___ score equally important to blastocyst quality score for implantation and pregnancy in fresh transfers

A

Blastocyst PROGRESSION score equally important

19
Q

Blastocysts transferred on D5 vs D6 have ___ implantation, pregnancy, and multiple gestation rates

A

Higher (by about 2x)

In both fresh/frozen transfers

(Though D6 embryos still have good outcome)

20
Q

Trophectoderm score is/is not a good indicator of outcome

A

IS

21
Q

Increased pregnancy rates with increased/decreased:

  • Blastocyst:ICM ratio
  • ICM area
  • ICM diameter
  • Embryo area
  • Embryo diameter
  • Zona thickness
A
  • INCREASED:
  • Blastocyst:ICM ratio
  • ICM area
  • ICM diameter
  • Embryo area
  • Embryo diameter
  • DECREASED:
    Zona thickness
22
Q

Day 3 cell progression (# of cells) can be predictive of ___

A

Blastocyst progression

23
Q

Euploid embryos develop ___ than aneuploid embryos

A

Faster

24
Q

A ___ euploid rate is seen in D5 vs D6 blastocysts

A

Greater

25
Q

What were early vitrification solutions composed of?

A

High molar
High viscosity
- Ethylene glycol
- DMSO

26
Q

Vitrification survival is dependent on the cooling/warming rate?

A

warming

27
Q

Open/closed system devices have exceptionally high cooling rates due to low/high thermal mass of large/small volumes

A

Open
Low
Small

28
Q

What is considered an ultra-rapid cooling rate?

Ultra-rapid warming rate?

How is this ultra-rapid warming rate achieved?

A
  • 50,000 degrees Celsius/minute

+100,000 degrees Celsius/minute

Direct placement of device into sucrose solution

29
Q

What is a universal warming solution for vitrified and slow-freeze embryos/oocytes?

A

1.0 M sucrose > transfer in multi-step decreasing dilutions at 3 min intervals

30
Q

What is the survival rate of vitrified blastocysts?

A

95%

31
Q

Number of eggs needed to approach fresh oocyte transfer pregnancy rates among vitrified oocytes is:

A

12 oocytes if <36 yo
33 if >36

32
Q

What is meant by an orthotopic site for ovarian auto-transplantation?

A

Pelvic auto-transplantation (as opposed to heterotopic)

33
Q

Which is currently the standard method of freezing of ovarian tissue?

A

Slow-freezing, though vitrification studies are promising

34
Q

What is important to leave attached when removing a whole ovary for cryopreservation?

A

Large vascular pedicle - to introduce cryoprotectant to all cells and to subsequently remove it upon re-warming

REI Written Boards 2024 - AK (25 decks)

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