Recent publicized events of cryogenic storage tank failures have created nationwide concern among infertility patients and patients storing embryos and gametes for future use. To assure patient confidence, quality management (QM) plans applied by in vitro fertilization (IVF) laboratories need to include a more comprehensive focus on the cryostorage of reproductive specimens. The purpose of this review is to provide best practice guidelines for the cryogenic storage of sperm, oocytes, embryos, and other reproductive tissues (e.g., testicular and ovarian tissue, cord blood cells, and stem cells) and recommend a strategy of thorough and appropriate quality and risk management procedures aimed to alleviate or minimize the consequences from catastrophic events.

Purpose The study aims to contrast the efficacy of trophectoderm biopsy preimplantation genetic screening (PGS)/vitrification (VTF)-all cycles to past treatment protocols. Specifically, do these applied technologies increase live birth rates on a per cycle/first transfer basis? Materials and methods An observational, retrospective cohort study of first transfer outcomes was performed in two groups. Group 1 (PGS) included PGS/VTF-all cycles, and group 2 (no PGS) included the first transfer from non-PGS fresh cycles or VTF-ALL cycles. In group 1, all blastocysts were biopsied on days 5/6, vitrified and array CGH performed. Group 2 patients had embryo transfers on day 3 or day 5. All blastocysts were vitrified and warmed according to μS-VTF protocols. Clinical pregnancies and implantation were confirmed by ultrasound and live birth information attained. Results were stratified by age with donor cycles excluded, and to eliminate bias, the same groups were then validated on a per cycle basis. Chi-squared used to determine significance. Results Analyzing 287 embryo transfers and 1,000+ PGS-tested blastocysts, an overall 97 % increase in live births favored group 1 (PGS). When utilizing PGS/VTF-ALL cycles, patients under 43 years old exhibited higher implantation, clinical pregnancy, and ongoing/live birth rates. Re-analyzing the data to include all cycles initiated revealed higher live birth rates in group 1 age groups ≤34 and 38–40 years old. Conclusion Validating PGS on a per cycle basis eliminated data bias by including patients without blastocysts to biopsy or euploid embryos. Clearly, PGS uses blastocysts more efficiently to achieve success, while many women over 40 may benefit most by understanding why some failures occur. Support None

After more than 2 decades of development in mammalian models and the clinical focus of a few pioneering laboratories, vitrification of human oocytes and embryos has transformed today’s assisted reproductive technology (ART) industry. Our ability to cryopreserve gametes and embryos without fear of the damaging effects of ice formation has instilled great confidence in post-warming specimen viability. In turn, clinical treatment options are progressively eliminating fresh embryo transfer (ET; ie, freeze-all cycles), integrating preimplantation genetic screening and contemplating the use of cryopreserved oocytes as a viable resource. Vitrification’s impact on clinical treatments is akin to the advent of sperm injection technology in the 1990s on male factor infertility. An appreciable and quantifiable difference was made, with procedural efficacy and global reliability essentially being guaranteed. Yet, there are challenges in the current trends and perspectives in how this technology is and will be optimized in the future. User variation in vitrification products and procedures warrants stricter adherence to quality control measures to enhance specimen biosafety and patient satisfaction, while reducing potential liability concerns. Furthermore, future progress in our understanding of the chemical and cryophysical processes of vitrification will insure the effective cryostorage of reproductive tissues and gametes at a level attained for embryo cryopreservation today.