Total fertilization success and embryo formation in ART treatments: does it have any predictive value?

Document Type : Research Paper

Authors

1 Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Fertility and Infertility Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

This retrospective study was aimed to investigate the characteristics of cycles with 100% achievement in laboratory procedures to determine the predictors of cycles with total fertilization success (TFS) and following total embryo formation (TEF). 273 ART cycles were categorized into two groups of the case (n= 121) and control (n=152). Inclusion criteria for case group were; cycles that a total number of MII oocytes were fertilized, and a total of fertilized oocytes developed into the embryos. Demographic variables, ART cycle characteristics and clinical outcomes were assessed and compared between groups. In subcategorizing, the case group was divided into two groups; A) patients with five or fewer (≤5) MII oocytes (n=94); B) patients with more than five (>5) MII oocytes (n=27). Clinical outcomes were assessed between subgroups of A, B and control. Man-Whitney U test, independent sample test and chi-square test were applied wherever appropriate to compare between two groups. P-value less than 0.5 were considered significant. Serum levels of E2, number of COCs, MII oocytes and transferred embryos differed between the groups (P< 0.0001 and P= 0.001). There was a trend manner in increasing the rate of ICSI in case group rather than controls (76.9% vs. 67.1%, respectively; P= 0.081). Furthermore, data sub-analysis showed that the rates of good quality embryos, chemical and clinical pregnancies were higher in subgroup B rather than the other subgroup; however, the differences were not significant (P= 0.07, 0.71 and 0.07, respectively). To increase the likelihood of a successful pregnancy in ART cycles, higher good quality embryos and appropriate number of available embryos for transfer could play an important role.

Graphical Abstract

Total fertilization success and embryo formation in ART treatments: does it have any predictive value?

Highlights

  • There was no difference among the female age, duration and cause of infertility, number of ART cycles and AMH levels in patients with TFS and TEF and other patients.
  • Serum levels of E2, number of COCs, MII oocytes and transferred embryos were higher in patients with TFS and TEF.
  • High-quality embryo chemical and clinical pregnancy rates were similar in patients with TFS and TEF and other patients.
  • The rates of good quality embryos, chemical and clinical pregnancy were higher in patients with TFS and TEF and>5 MII oocyte.

Keywords

Main Subjects


3. Calhaz-Jorge C, De Geyter C, Kupka MS, de Mouzon J, Erb K, Mocanu E, Motrenko T, Scaravelli G, Wyns C, Goossens V. Assisted reproductive technology in Europe, 2012: results generated from European registers by ESHRE. Hum Reprod 2016; 31(8): 1638-1652.
4. Van Loendersloot L, Van Wely M, Limpens J, Bossuyt P, Repping S, Van Der Veen F. Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis. Hum Reprod Update 2010; 16(6): 577-589.
5. Cetin MT, Kumtepe Y, Kiran H, Seydaoglu Ga. Factors affecting pregnancy in IVF: age and duration of embryo transfer. Reprod Biomed Online 2010; 20(3): 380-386.
6. van der Westerlaken L, Helmerhorst F, Dieben S, Naaktgeboren N. Intracytoplasmic sperm injection as a treatment for unexplained total fertilization failure or low fertilization after conventional in vitro fertilization. Fertil Steril 2005; 83(3): 612-617.
8. Krog M, Prior M, Carlsen E, Loft A, Forman J, Pinborg A, Andersen AN. Fertilization failure after IVF in 304 couples—a case-control study on predictors and long-term prognosis. Eur J Obstet Gynecol Reprod Biol 2015; 184: 32-37.
9. Ferraretti AP, Goossens V, De Mouzon J, Bhattacharya S, Castilla JA, Korsak V, Kupka M, Nygren KG, Nyboe Andersen A. Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE. Hum Reprod 2012; 27(9): 2571-2584.
10. Nyboe Andersen A, Carlsen E, Loft A. Trends in the use of intracytoplasmatic sperm injection marked variability between countries. Hum Reprod Update 2008; 14: 593-604.
11. Bungum L, Bungum M, Humaidan P, Andersen CY. A strategy for treatment of couples with unexplained infertility who failed to conceive after intrauterine insemination. Reprod Biomed online 2004; 8(5): 584-589.
12. Hershlag A, Paine T, Kvapil G, Feng H, Napolitano B. In vitro fertilization-intracytoplasmic sperm injection split: an insemination method to prevent fertilization failure. Fertil Steril 2002; 77(2): 229-232.
13. Kim JY, Kim JH, Jee BC, Lee JR, Suh CS, Kim SH. Can intracytoplasmic sperm injection prevent total fertilization failure and enhance embryo quality in patients with non-male factor infertility? Eur J Obstet Gynecol Reprod Biol 2014; 178: 188-191.
14. Foong SC, Fleetham JA, O’Keane JA, Scott SG, Tough SC, Greene CA. A prospective randomized trial of conventional in vitro fertilization versus intracytoplasmic sperm injection in unexplained infertility. J Assist Reprod Genet 2006; 23(3): 137-140.
15. Kim HH, Bundorf MK, Behr B, McCallum SW. Use and outcomes of intracytoplasmic sperm injection for non–male factor infertility. Fertil Steril 2007; 88(3): 622-628.
16. Ashourzadeh S, Khalili MA, Omidi M, Mahani SN, Kalantar SM, Aflatoonian A, Habibzadeh V. Noninvasive assays of in vitro matured human oocytes showed insignificant correlation with fertilization and embryo development. Arch Gynecol Obstet 2015; 292(2): 459-463.
17. Hill GA, Freeman M, Bastias MC, Rogers BJ, Herbert III CM, Osteen KG, Wentz AC. The influence of oocyte maturity and embryo quality on pregnancy rate in a program for in vitro fertilization-embryo transfer. Fertil Steril 1989; 52(5): 801-806.
18. Sabatini L, Zosmer A, Hennessy E, Tozer A, Al-Shawaf T. Relevance of basal serum FSH to IVF outcome varies with patient age. Reprod Biomed online 2008; 17(1): 10-19.
19. Omidi M, Khalili MA, Nahangi H, Ashourzadeh S, Rahimipour M. Does women’s age influence zona pellucida birefringence of metaphase ΙΙ oocytes in in-vitro maturation program? Iran J Reprod Med 2013; 11(10): 823.
20. Terriou P, Sapin C, Giorgetti C, Hans E, Spach JL, Roulier R. Embryo score is a better predictor of pregnancy than the number of transferred embryos or female age. Fertil Steril 2001; 75(3): 525-531.
21. Ottosen LD, Kesmodel U, Hindkjær J, Ingerslev HJ. Pregnancy prediction models and eSET criteria for IVF patients–do we need more information? J Assist Reprod Genet 2007; 24(1): 29-36.
22. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G, Volpe A. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update 2009; 16(2): 113-130.
23. Gleicher N, Kushnir VA, Sen A, Darmon SK, Weghofer A, Wu YG, Wang Q, Zhang L, Albertini DF, Barad DH. Definition by FSH, AMH and embryo numbers of good-, intermediate-and poor-prognosis patients suggests previously unknown IVF outcome-determining factor associated with AMH. J Transl Med 2016; 14(1): 172-182.
24. Tal R, Seifer DB, Khanimov M, Schwartz E, Grazi RV, Malter HE. Anti-Müllerian hormone as an independent predictor of twin versus singleton pregnancy in fresh cycles. Reprod Biomed Online 2013; 26(4): 360-367.
25. Nelson SM, Fleming R, Gaudoin M, Choi B, Santo-Domingo K, Yao M. Antimüllerian hormone levels and antral follicle count as prognostic indicators in a personalized prediction model of live birth. Fertil Steril 2015; 104(2): 325-332.
27. Smeenk JM, Sweep FC, Zielhuis GA, Kremer JA, Thomas CM, Braat DD. Antimüllerian hormone predicts ovarian responsiveness, but not embryo quality or pregnancy, after in vitro fertilization or intracyoplasmic sperm injection. Fertil Steril 2007; 87(1): 223-226.
29. Anifandis G, Koutselini E, Louridas K, Liakopoulos V, Leivaditis K, Mantzavinos T, Sioutopoulou D, Vamvakopoulos N. Estradiol and leptin as conditional prognostic IVF markers. Reproduction 2005; 129(4): 531-534.
31. Peña JE, Chang PL, Chan L-K, Zeitoun K, Thornton MH, Sauer MV. Supraphysiological estradiol levels do not affect oocyte and embryo quality in oocyte donation cycles. Hum Reprod 2002; 17(1): 83-87.
32. Kosmas IP, Kolibianakis EM, Devroey P. Association of estradiol levels on the day of hCG administration and pregnancy achievement in IVF: a systematic review. Hum Reprod 2004; 19(11): 2446-2453.
33. Ji J, Liu Y, Tong XH, Luo L, Ma J, Chen Z. The optimum number of oocytes in IVF treatment: an analysis of 2455 cycles in China. Hum Reprod 2013; 28(10): 2728-2734.
34. Macklon NS, Stouffer RL, Giudice LC, Fauser BC. The science behind 25 years of ovarian stimulation for in vitro fertilization. Endocr Rev 2006; 27(2): 170-207.