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FAST WARMING IN BLASTOCYST DEVITRIFICATION: CLINICAL IMPROVEMENTS IN ASSISTED REPRODUCTION

During ESHRE 2025, several papers were presented analysing the impact of Fast Warming techniques on previously vitrified blastocysts. This protocol consists of a shorter and more intense thawing process compared to the standard one, resulting in significantly reduced exposure times to rehydration solutions and cryoprotectants.

COMPARATIVE STUDIES HAVE SHOWN THE FOLLOWING:
Separator barData showed that Fast Warming improves post-devitrification embryo viability, while maintaining high survival and development rates. In particular, some centres reported a reduction in miscarriage rates after transfer of devitrified blastocysts with this protocol compared to traditional techniques. Trends towards higher implantation and live birth rates were also observed.

CURRENT USEFULNESS:

While not yet widespread in all laboratories, Fast Warming is already being successfully implemented in European clinics as part of conventional IVF or oocyte donation programmes, especially when embryo quality and clinical safety are prioritised.

IMPROVEMENT IN OUTCOMES:
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Blastocysts that undergo Fast Warming show:

  • Increased post-devitrification survival rate
  • Reduced cellular stress and fragmentation
  • Potential decrease in miscarriage rates
  • Improved rates with regard to implantation and evolutionary gestation

ARTIFICIAL INTELLIGENCE IN OOCYTE AND EMBRYO IMAGE ANALYSIS

Multiple developments based on artificial intelligence (AI) for non-invasive assessment of embryo developmental potential were also presented this year. Some studies focused on static images of denuded oocytes prior to ICSI, while others used post-microinjection (post-ICSI) images or videos to predict development to blastocyst, embryo quality and euploidy.

COMPARATIVE STUDIES HAVE SHOWN THE FOLLOWING:
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  • Pre-ICSI:Algorithms were able to correlate certain morphological characteristics (zona pellucida, cytoplasm, first polar corpuscle) with blastulation rates and risk of aneuploidy. However, the clinical impact has not yet been validated.
  • Post-ICSI:More advanced models were presented which, based on images from day 1 or timelapse, predict blastocyst quality and probability of euploidy more accurately, surpassing conventional morphological assessment.
CURRENT USEFULNESS:
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  • Pre-ICSI AI is in the exploratory phase, useful for research or oocyte banking.
  • post-ICSI models are more suitable for clinical practice, especially in laboratories with time-lapse incubators or well-structured databases.
  • In both cases, objective and standardised evaluation is encouraged.
IMPROVEMENT IN OUTCOMES:
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  • Although algorithms show potential in predicting blastulation or embryo quality, currently available studies do not yet demonstrate a direct clinical impact on pregnancy rates or live births.
  • Furthermore, there is no evidence that this additional information translates into a clear benefit for the patient, especially considering that it does not modify ongoing treatment.
Portrait Ester ArissaBarra Marco TopBarra Marco RightBarra Marco BottomBarra Marco Left

Ester Arissa

Embrióloga

ADVANCED PATERNAL AGE AND IVF OUTCOMES WITH OOCYTE DONATION

In the session on male factors in the success and failure of assisted reproduction (Session 04), a study analysing the impact of paternal age in IVF cycles with donor eggs was presented. It consisted of a review of data on the first embryo transfer in this type of treatment.

COMPARATIVE STUDIES HAVE SHOWN THE FOLLOWING:
Separator barOlder paternal age was significantly associated with a higher risk of miscarriage and lower live birth rates, even in cases where donor oocytes are used, which eliminates the influence of maternal age on embryo quality.
CURRENT USEFULNESS:
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These findings are highly relevant for counselling couples resorting to ovodonation, as they demonstrate that the age of the male should also be considered as a prognostic factor. This may influence the decision-making process both at clinical and reproductive levels.

IMPROVEMENT IN OUTCOMES:
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Including paternal age as a criterion in the assessment of reproductive prognosis could allow for better personalisation of treatments and expectations, whilst also encouraging male fertility preservation strategies at younger ages.

SPERM QUALITY AS A BIOMARKER OF OVERALL HEALTH

In several sessions, it was discussed that semen quality is not only an indicator of fertility, but also a reflection of the overall health status of the male. Some studies proposed that, due to its ability to alert about metabolic, hormonal or inflammatory dysfunction, it should be routinely analysed alongside parameters such as blood or urine.

COMPARATIVE STUDIES HAVE SHOWN THE FOLLOWING:
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Men with seminal alterations had a higher prevalence of chronic diseases (obesity, dyslipidaemia, hypertension, etc.), even when they had no clinical symptoms. Its inclusion as an early marker could allow earlier preventive interventions.

CURRENT USEFULNESS:
Separator barIt brings added value in terms of andrological assessment, and could be incorporated in male fertility medical check-ups or preventive check-ups for young patients.
IMPROVEMENT IN OUTCOMES:
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It facilitates early detection of systemic pathologies, improves the holistic approach to the patient and allows better prediction of reproductive outcomes.

APPLICATION OF THESE ADVANCES AT HC FERTILITY:

At HC Fertility we stay attentive to technological advances, but we also prioritise real clinical applicability and direct impact on our treatments.

The new Fast Warming protocol, presented at the ESHRE 2025 congress, will be implemented soon, once the protocols are validated, since it does not require additional equipment, only an update in the times and steps of the current procedure.

For now, artificial intelligence in oocyte analysis represents a promising concept, but it still requires further study and caution before it can be integrated into our daily practice.

With regard to men consulting for infertility, especially at older ages, we consider it important to assess semen quality not only as an indicator of fertility, but also as a reflection of overall health status. We had already taken this data into account, but now several studies have confirmed it.

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