Dr Edson Borges Jr. obtained his MD degree in 1984 at the University of Campinas, Brazil. He then prepared his first PhD, in Urology, in 2005, at the Federal University of São Paulo and his second PhD in Gynaecology, in 2007, at the Botucatu Medical School in São Paulo State University.
Since 1992, he is the founder, partner and managing director of Fertility – Assisted Fertilization Center in São Paulo, Brazil and Scientific Director at Sapientiae Institute in São Paulo, Brazil.
Dr Borges has published over 100 papers, review articles, books and chapters and is a member of the editorial boards of Arquivos Médicos, Fertility and Sterility, Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa and the Jornal Brasileiro de Reprodução Assistida.
Project: Non-invasive prediction of embryo implantation potential and culture media quality control by mass spectrometry fingerprinting for ART routine quality control
A number of strategies to obtain more oocytes and to transfer more embryos have been tested in order to improve pregnancy rates and overcome the low rate of successful embryo implantation in Assisted Reproductive Technologies (ART). This procedure, however, frequently leads to the inconvenient outcome of multiple pregnancies, a higher risk of adverse maternal and infant morbidity and mortality, as well as increased health costs.
Embryo selection methods based on detailed morphological parameters have long been known to be associated with successful ART. Morphological assessment is the easiest way to predict viability, but most studies suggest that morphological appearance is insufficient to predict a successful implantation, since morphologically normal embryos can be genetically abnormal.
To achieve the highest possible live birth rates after ART while minimizing the risk for multiple pregnancies, the investigation of adjunctive technologies for the non-invasive assessment of embryo viability would be beneficial.
In ART, besides embryo viability there is considerable awareness that the environment of the laboratory regarding composition of the culture medium can alter the quality of the embryos produced. Embryo culture conditions may have long-term effects on embryo, foetal and post-term development. Culture media transportation, storage or preparation can cause media components degradation. Currently methods of evaluating media quality, such as pH and osmolarity check as well spermatozoa survival evaluation are unable to detect minor changes in chemical composition that may cause sub-optimal embryo culture conditions and poor Intracytoplasmic Sperm Injection (ICSI) outcomes.
Mass spectrometry fingerprinting (MS-fingerprinting) is a global screening approach that compares and classifies samples based on their metabolite patterns, known as “fingerprintings”. This technology is able to detect and define the structure of metabolites at the micromolar concentration level. The MS data are frequently analysed using multivariate statistics for sample classification.
The aim of this project is to evaluate the performance of a multivariate statistical model to predict embryo implantation potential by processing data from the MS-fingerprinting of culture medium samples used to produce embryos from patients undergoing ICSI. We will correlate the chemical profiles with embryo implantation outcomes (0%, 50%, 66,7% and 100% of implantation outcomes) at the third and fifth day of development. Furthermore, we are going to characterize embryo culture media for routine quality control management in ART laboratory.
So far, the culture medium harvested after embryo transfer at the third day of development of 113 embryos from 55 patients was used. After embryo transfer, the remaining culture media were collected and samples were split into positive (n=29) and negative (n=84) implantation groups according to implantation outcomes (100% or 0% of implantation). The statistical model could categorize the samples in two clusters, based on their positive and negative implantation outcomes. The statistical model described more than 77% of the data variance. In the validation process, samples of positive group were correctly identified with 100% of probability and 76% of the negative samples were correctly identified. Differential chemical patterns were observed in culture media from positive and negative implantation groups. Our findings suggest a differential chemical profile between viable and non-viable embryos.