OBJECTIVE:To evaluate a possible association between oxidative parameters in COC medium as measured by Thermochemiluminesce (TCL) assay and outcome parameters in IVF.DESIGN: A prospective cohort study. MATERIALS AND METHODS: Sixty four women undergoing a fresh IVF cycle using conventional oocyte insemination during 2017-2019 participated in the study. COCs were incubated in a well containing 680 ml of culture media for approximately 4-6 hours. Immediately prior to addition of semen, 20 ml of COC culture medium were removed from each dish, examining for each sample 4 parameters: TCL amplitudes, after 50 seconds (TCLH1), 150 seconds (TCLH2), 250 seconds (TCLH3) and TCL ratio ((TCLH3-TCLH1)/100). TCL amplitudes were measured as counts per second (CPS).RESULTS: We examined 97 COC fertilization media. Mean patients' age was 38 AE4.7 years. Mean number of aspirated oocytes, COCs per well and number of wells per patient were 6.2AE 3.7, 4.6 AE 2.06 and 1.48 AE 0.5 respectively. Of 64 IVF cycles, in one cycle (1.5%) oocytes were not fertilized, in 8 cycles (12.7%) no embryos developed and in another 8 (12.7%) cycles, all embryos were frozen. Altogether fresh embryos were transferred in 46 cycles. Twenty one pregnancies were achieved (33.3% per started cycles, or 45.9% per embryo transfer cycle). In order to find an optimal cutoff that would distinguish between TCL values that were associated with higher chances of pregnancy, Youden index was used. A discriminatory TCLH2 value of > 62.9 CPS was associated with higher chances for pregnancy (46.5% vs. 8.3%, OR¼9.6, 95% CI(1.13-80.7) (p¼0.03)). This value had a 95.2% sensitivity (95% CI¼76.2-99.9), 32.4% specificity (95% CI¼17.4-50.5), a positive predictive value of 46.5% (95% CI¼31.2-62.3) and a negative predictive value of 91.7% (95% CI¼61.5-99.8). No association was found between TCL parameters, regrading patient's age and number of aspirated oocytes. Multivariate analysis, correcting for age and number of aspirated oocytes, revealed that TCLH2 >62.9 was the only significant variable associated with the occurrence of pregnancy (p<0.03).CONCLUSIONS: Oxidative parameters of COC medium may affect the likelihood of pregnancy. Measurement of oxidative parameters may serve as a potential aid in prediction of treatment outcome.
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