Degenerated oocyte in the cohort adversely affects IVF outcome
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(2020) 13:109
RESEARCH
Open Access
Degenerated oocyte in the cohort adversely affects IVF outcome Yuval Atzmon*, Mediea Michaeli, Diana Poltov, Nechami Rotfarb, Oshrit Lebovitz, Nardin Aslih and Einat Shalom-Paz
Abstract 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. Keywords: Degenerated oocyte, Embryo morphokinetics, Ovum pick-up, Top-quality embryo, Aspiration needle
Introduction The success rate of in vitro fertilization (IVF) depends on several parameters, of which good quality oocytes is the most important [1]. A degenerated (DEG) oocyte is described as an empty zona pellucida (EZP) or damaged oocyte (fragments of oocytes) within the zona pellucida [2]. These oocytes can be seen at the time of ovum pick-up (OPU) or after intracytoplasmic sperm injection (ICSI) (Fig. 1). To the best of our knowledge the presence of DEG oocytes immediately after OPU has not been previously studied as itis usually not reported by embryology labs. Oocyte quality before ICSI is very important and affects * Correspondence: [email protected] IVF Unit, Department of Obstetrics and Gynecology, Hillel-Yaffe Medical Center, Hadera, Israel; affiliated with the Ruth and Bruce Rappaport School of Medicine, The Technion – Israel Institute of Technology, Haifa, Israel
treatment outcomes. The presence of EZP or DEG oocyte at OPU before ICSI correlates with the quality of the entire oocyte cohort [3–6]. Studies that examined the presence of EZP oocyte at OPU, found worse quality of oocytes collected in the same cycle, lower ferti
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