The presence of Degenerated Oocyte (DEG) was mostly described after intracytoplasmic sperm injection (ICSI), with fewer reports on DEG at the time of ovum pick-up (OPU). This study aims to assess morphokinetics of embryos cultured in a time-lapse incubator and compare cohorts with and without DEG at OPU. In a retrospective cohort study from January 1, 2016 until September 31, 2017 a total of 399 IVF/ICSI cycles and 2980 embryos were evaluated. In 81 of 399 cycles at least one DEG oocyte was observed at the time of OPU. The remaining 318 cycles with no DEG oocyte were compared as a control group. In the DEG group, significantly more oocytes were collected per patient (12.9 ± 7.2 vs. 10.1 ± 6.1. P < 0.001). Fertilization rate, pregnancy and clinical pregnancy rates were comparable between the two groups, however, the morphokinetics and developmental scores of the embryos were significantly worse in the DEG group, (KID 3.4 ± 1.6 vs. 3.2 ± 1.6 P = 0.002 and ESHRE 1.5 ± 1.1 vs. 1.4 ± 1.0 P = 0.046). Significantly more patients achieved top-quality embryos in the NON DEG group (58.8% vs. 53.0%, P = 0.03), however, comparable delivery rate was achieved in both groups. In the DEG group, the frequency of DEG oocyte per cycle was negatively correlated with pregnancy rate. GnRH agonist protocol and the 17-20G needle used for OPU were significant predictors for the presence of DEG oocyte at OPU. In conclusions DEG oocyte may negatively affect IVF outcome, however, younger patients, and significantly more oocytes collected in the DEG group compensate for the IVF results.
This study investigates the incidence of irregular cleavage (IRC) among human embryos and their influence on IVF treatment outcomes. This study was designed as a prospective observational study in a single-centre IVF clinic including 1,001 women who underwent 1,976 assisted reproduction treatments during 2016–2021. Morphokinetics of embryos was analysed and evaluated for the association between IRC and women’s characteristics, treatment characteristics, and pregnancy outcome. We found IRC incidence to be 17.5% (1,689/9,632 embryos). Of these, 85% embryos had one IRC, and 15% had multiple IRC. 35% of IRC events occurred during the embryo's first cell cycle. IRC embryos were found to correlate with male factor (p = 0.01) and higher ICSI rate (p = 0.01). Age, BMI, parity, basal FSH level, stimulation protocol and number of retrieved oocytes did not differ between groups. Embryos with early IRC or more than one IRC event had lower blastulation rate (p = 0.01 and p = 0.01, respectively). Fresh cycles with IRC embryos had a lower clinical pregnancy rate (p = 0.01), and early IRC embryos had a lower live birth rate (p = 0.04) compared to embryos without IRC. Frozen embryo transfer (FET) cycles of blastocyst embryos, with and without IRC, had comparable results. In conclusion, number of abnormal cleavage events and their timing are of great importance for the prognosis of the developing human embryo.
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