Implantation and live births following transfer of 0pn embryos in natural cycle IVF

Abstract

Subsequent retrievals prior to live birth were needed in 30% and 24% cycles, respectively. The groups were similar for BMI, smoking, FSH dose and number of oocytes retrieved in all retrieval cycles. ICSI cycles had lower risk of TFF (AOR 0.47, 95% CI 0.39-0.58) despite lower fertilization rates (66% vs. 68%, p<0.001), and were more likely to have blastocyst transfers (AOR 1.60, 95% CI 1.47-1.74) compared to conventional insemination. In subsequent cycles, 24% of patients had new diagnoses, most commonly DOR (8.1%) and male factor (6.1%). ICSI utilization remained consistent over all cycles with minimal cross-over. There was no difference in the number of retrievals to achieve live birth (median 2 retrievals, AHR 0.97, 95% CI 0.97-1.00), and no difference in live birth rate over multiple fresh cycles by insemination method (AOR 0.95, 95% CI 0.90-1.00).CONCLUSIONS: For patients with unexplained infertility, ICSI results in a lower chance of TFF and a higher likelihood of embryo transfer over time. Insemination method is not associated with number of retrievals to, or incidence of, live birth. Further studies are needed to account for the impact of pre-implantation genetic testing and other indications for frozen embryo transfers in both cumulative live birth rates and time to pregnancy in couples with unexplained infertility.

Time-lapse monitoring of fertilized human oocytes focused on the incidence of 0PN embryos in conventional in vitro fertilization cycles

“…The primary reason for 0PN-derived embryos is thought to be due to PN being overlooked in the microscopic assessment at a fixed time point 1 . Some 0PN-derived embryos develop into morphologically normal blastocysts, and there are reports of healthy babies being born from their transfer [1][2][3][4][5][6][7][8][9][10] . However, transfer of the 0PN-derived embryo is not recommended as per the European Society of Human Reproduction and Embryology (ESHRE) guidelines; thus, most of them are discarded without being transferred 11 .…”