Time lapse observation of embryos through incubation allows continuous monitoring of development from fertilization. This non-invasive technique creates a developmental timeline used to assess embryo health and select the best embryo for transfer based on adherence to normal timing of cleavages and divisions. Precise timing data of early embryonic events like pronuclear fading and cell divisions correlates with implantation potential, with substantial deviations linked to lower success rates. Abnormal cell patterns or asynchronous cell cycles seen through time lapse also indicate higher risk of aneuploidy.
Invited lecture by Dr Sujoy Dasgupta in the Scientific Session on "Embryo Transfer and Beyond " in the AICOG (All India Congress of Obstetrics and Gynaecology) at Kolkata, 2023
Invited lecture by Dr Sujoy Dasgupta in the Scientific Session on "Embryo Transfer and Beyond " in the AICOG (All India Congress of Obstetrics and Gynaecology) at Kolkata, 2023
In-vitro fertilization (IVF) is a process by which oocytes are fertilized by sperm outside the women’s womb, in vitro. It still represents one of the most exciting modern scientific developments and continues to have a tremendous impact on
people's lives.
Here, we will discuss all about the embryo development inside the dish.
Also we discuss which embryo to choose for transferring into female's uterus.
Selection of an embryo from a large number of embryos and then placing it to the uterus is known as selective embryo transfer. This fertility preservation process is usually done after the process of IVF cycle and cancels the risks of spontaneous transfer of multiple embryos. Have a look at the detailed description of elective single embryo transfer in the following ppt.
the objective is to clarify the problem of recurrent implantation failure , regarding the definition, the caused, diagnosis, and management in cases of IVF
Dr Parul Katiyar discusses simple strategies to optimize clinical outcome of Intra Uterine Insemination (IUI). She talks about the importance of appropriate patient selection and choosing the correct stimulation protocol, among other factors.
Hysteroscopy is a procedure of diagnostic and treat causes of abnormal bleeding.
Hysteroscopy procedure is done by Hysteroscpe and Hysteroscopic Instruments. Hysteroscop is connected with Light Source and Camera system.
Hysteroscopy products includes Hysteroscope, Hysteroscope Sheath, Hysteroscopy Forcep, Bugbee Electrodes.
In-vitro fertilization (IVF) is a process by which oocytes are fertilized by sperm outside the women’s womb, in vitro. It still represents one of the most exciting modern scientific developments and continues to have a tremendous impact on
people's lives.
Here, we will discuss all about the embryo development inside the dish.
Also we discuss which embryo to choose for transferring into female's uterus.
Selection of an embryo from a large number of embryos and then placing it to the uterus is known as selective embryo transfer. This fertility preservation process is usually done after the process of IVF cycle and cancels the risks of spontaneous transfer of multiple embryos. Have a look at the detailed description of elective single embryo transfer in the following ppt.
the objective is to clarify the problem of recurrent implantation failure , regarding the definition, the caused, diagnosis, and management in cases of IVF
Dr Parul Katiyar discusses simple strategies to optimize clinical outcome of Intra Uterine Insemination (IUI). She talks about the importance of appropriate patient selection and choosing the correct stimulation protocol, among other factors.
Hysteroscopy is a procedure of diagnostic and treat causes of abnormal bleeding.
Hysteroscopy procedure is done by Hysteroscpe and Hysteroscopic Instruments. Hysteroscop is connected with Light Source and Camera system.
Hysteroscopy products includes Hysteroscope, Hysteroscope Sheath, Hysteroscopy Forcep, Bugbee Electrodes.
EMBRYO QUALITY ASSESSMENT, WHICH TO SELECT? Rahul Sen
Traditional embryo evaluation systems are simple, non-invasive, cost-effective & mainstay in majority of IVF laboratories. Embryo selection based on combinations of morphology scores at different stages of embryonic development with time may be more effective
Cryo-storage Chain of Custody: RFID tags in Liquid nitrogenKosmogonia IVF
Improving sample identification and reducing risks during
cryostorage of vitrified gametes and embryos using radio
frequency identification (RFID) tags that operate while samples are
immersed in liquid nitrogen.
Kustodian proves proof of concept of readable RFID working in LN2
Correctly recognises samples from within LN2
Identifies missing samples and sample location in Dewars
Simplifies and reduces time completing a Tank audit
Reduces the exposure of samples to sub-optimal condition.
Tags for Chain of Custody
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Time lapse observations
1. Time lapse observations of
pre-implantation embryos
Giles Palmer, Mitera ACU, Athens
gpalmer@mitera.gr
2. There are no commercial relationships or other
activities that might be perceived as a
potential conflict of interest
3. Time lapse in the IVF Laboratory
• Continuous viewing of embryo development
• Embryo monitored from inside incubator
• Creates archives of embryo development used to select
embryo(s) for embryo transfer
4. Embryo selection
• Embryo selection-
subjective assessment
• Call for consensus of
embryo grading
• Early cleavage, pronuclear
morphology & orientation
limited
• Trend to reduce multiple
births after ART
5. Embryo selection
• Invasive techniques
Euploid selection (PGS) not
fulfilled expectations
CGH replacing FISH
RCT underway
• Non-invasive
techniques-”omics” search for
biomarkers: metabolomics-
not implemented at present.
Promising developments but time
consuming/ technically
challenging
6. The (Short) History of Time lapse
monitoring
• Payne (1997) Preliminary observations on polar body extrusion and
pronuclear formation in human oocytes using time lapse
cinematography
• Pribenszky (2010) Pregnancy achieved by transfer of a single blastocyst
selected by time lapse monitoring
• Wong (2010) Non-invasive imaging of human embryos before
embryonic genome activation predicts development to blastocyst stage
• Meseguer (2011) The use of morphokinetics as a predictor of embryo
implantation
7. Time lapse 2013
• Primo Vision (Bright field)
• Embryoscope (Bright field-self contained incubation)
• Eeva (Dark field, automatic embryo prediction software)
Conventional incubator Time lapse microscope Microwell embryo culture dish with the developing embryos
8. Static observations are misleading!
Fragmentation:
•Pribenszky (2010)
12% embryos fragmenting
89% reabsorbed
Average time for fragments to
appear/disappear 9.1 h ( +/- 442)
Chance for NOT noticing fragments
at bi-daily monitoring: 72% !!!
Blastocyst contractions:
15. Implantation is linked to exact
timing events
Event PN appear PN fading* 1st
division* 2nd
division* 3rd
division*
Range
(h)
7.8-11.1 Out of
range
22.3-
25.8
Out of
range
24.4-
28.2
Out of
range
35.3-
40.6
Out of
range
36.0-
41.6
Out of
range
100%
Implanted
N (%)
15
(54%)
13
(46%)
23
(66%)
12
(34%)
23
(66%)
12
(34%)
13
(72%)
5
(28%)
19
(73%)
7
(27%)
0%
Implanted
N (%)
60
(49%)
62
(51%)
55
(45%)
67
(55%)
57
(46%)
67
(54%)
43
(45%)
52
(55%)
45
(45%)
56
(55%)
Herrero, 2010
20. t2 t3 t4 t5
cc2 cc3s2
t: exact time
t2: time to 2-cell
t3: time to 4-cell
t4: time to 4-cell
t5: time to 5-cell
cc: cell cycle
cc2 = t3-t2
cc3 = t5-t4
S:synchrony
s2 = t4-t3
cc2=11,8h
s2 = <0.76h
t2=25,6h (24,3-25,8h)
t3=37,4h (35,4-37,8h)
t4=38h (36,4-38,9h)
t5=52,3h (48,8-56,6,h)
Proposed a multivariable model to classify embryos into implantation potential
25. Time line profile
e
Time line profile
e
eCGH profile- molecular karyotype
3-4 Cells
Abnormal cell division & aneuploidy
26. Time line profile
e
Time line profile
e
e
3-4 Cells
Davies (ESHRE 2012) Delayed cleavage divisions and prolonged transition between 2-4-cell stages
identified as aneuploid at 8-cell by array CGH
The timing of first and second divisions were delayed in aneuploidy and more marked in those with
multiple aneuploidy
2-4 cell transition: euploidy<single aneuploidy<multiple aneuploidy
Basile (2013) Increasing the probability of selecting chromosomally normal embryos by studying their
kinetics
Classification system based on time parameters relates to selection of euploid embryos
Normal embryos A+: 36,3%, A: 33,9%;B+: 32,0%, B:19,5%;C+:14,3%, C:11,5%;D+: 10,0%, D: 9,0%
Campbell (2013) Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived
from time-lapse imaging without PGS
Aneuploidy risk model
Abnormal cell division linked to aneuploidy
28. Conclusions
• Improves knowledge of in vitro embryo
development
• Potential to standardize embryo assessment
• Easily incorporated into IVF lab
• Exclude embryos with direct/ abnormal
cleavage, sub-optimum development,
fragmentation, multinucleation
• Improved embryo selection may increase
pregnancy rates
29. Cell Cycle
Nuclear organization and Mitosis
Cellular organization
Cell division
Cell synchronicity
Zygotic Clock
Maternal to zygotic
Fertilization
Maternal control Zygotic control
Karyokinetics and cytokinetics
30. Implantation is linked to exact
timing events
Herrero, 2010
Event PN appear PN fading* 1st
division* 2nd
division* 3rd
division*
Range
(h)
7.8-11.1 Out of
range
22.3-
25.8
Out of
range
24.4-
28.2
Out of
range
35.3-
40.6
Out of
range
36.0-
41.6
Out of
range
100%
Implanted
N (%)
15
(54%)
13
(46%)
23
(66%)
12
(34%)
23
(66%)
12
(34%)
13
(72%)
5
(28%)
19
(73%)
7
(27%)
0%
Implanted
N (%)
60
(49%)
62
(51%)
55
(45%)
67
(55%)
57
(46%)
67
(54%)
43
(45%)
52
(55%)
45
(45%)
56
(55%)
Editor's Notes
22% multiple births
Success rate rel. low
Tendency in N. European countries to reduce multiple pregnancies/ SET
Public health concern
Andersen (ESHRE) 2009, Seli 2011
include culture to bc LINK TH
Global view- array CGH, SNP, Next generation sequencing
EN TO SELECTION..MAYBE DON’T WANT TO GO TH BC..THEREFORE PREDICT EARLY
Autonomous incubation unit, stand alone
Others fit inside existing cabinate incubators
The first two you can programm what parametres you want
Single time point is misleading
Positive factors
PN formation
Embryo cleavage
Symmetry of cleavage
Synchrony of cells
Compaction/cavitation
(ID, interval division)
Interphase division
Complicated no!!!!Improved culture system
Embryos are cultured in a group (“group effect”)
Embryos can develop their own microenvironment
Embryos’ cross talk Vajta et al., 2008
See new paper on improved embryos
Morphokinetics link to aneuploidy detection (Davies 2012)
Classification system based on time parameters relates to selection of euploidy embryo ( Basile 2013)
Morphokinetics link to aneuploidy detection (Davies 2012)
Classification system based on time parameters relates to selection of euploidy embryo ( Basile 2013)
Useful cost effected tool to select optimum embryo selection
The timing of first and second divisions were delayed in aneuploidy and more marked when in those with multiple aneuploidy
2-4 cell transition was prolonged in
Important to link this to aneu because represents largest cause of failed implantation and miscarraige after IVF
Yang CGH shows BC can have aneuploidy
Overall time lapse markers have exhibited remarkable correlation wth human embryo devstudies shoe remarkable reproducibility across different clinics and labs..clustering on early stages before 5 cell stage
Timing from later stages a bit more subject/diff to define but may give us addition help
Dark red =at least three publications
Objective assessment
Allows for a flexible/ dynamic scoring viewed at the embryologist leisure
Insight into developing embryo
Allowing morphological analysis and temporal analysis
Kinetic markers for embryo quality a) early cleavage b) 2,3,5 cell
Exclusion factors: 1-3 cell division, abnormal timing, fragmentation, multinucleiation