Check JH, Summers-Chase D, Yuan W, Horwath D, Wilson C. Effect of embryo quality on pregnancy outcome following single embryo transfer in women with a diminished egg reserve.
Fertil Steril 2007;
87:749-56. [PMID:
17207795 DOI:
10.1016/j.fertnstert.2006.11.001]
[Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Revised: 06/14/2006] [Accepted: 11/03/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVE
To evaluate independently the effect of blastomere number and degree of fragmentation on pregnancy outcome following single ETs in women with a decreased egg reserve.
DESIGN
Retrospective cohort analysis.
SETTING
In vitro fertilization center of a university-based practice.
PATIENT(S)
Women having a single ET related to a decreased egg reserve. A requirement for inclusion was a day 3 serum FSH >12 mIU/mL and < or =3 antral follicles on ultrasound.
INTERVENTION(S)
Patients received no or minimal stimulation with gonadotropins.
MAIN OUTCOME MEASURE(S)
Pregnancy rates (PRs) following single ETs were evaluated according to blastomere number (group 1, < or =4 cells; group 2, 5 cells; group 3, 6 cells; group 4, 7 cells; and group 5, > or =8 cells) and fragmentation index (A, no fragmentation; B, 1-25% fragmentation; and C, >25% fragmentation). Embryo transfers and morphologic evaluation were performed on day 3.
RESULT(S)
The clinical and delivered PRs according to blastomere number showed that 6-8-cell embryos were six times more likely to implant than 4-5-cell embryos (6.6% versus 40.4% clinical). Degree of fragmentation did not predict outcome nearly as well as blastomere number. The overall clinical and delivered PRs per transfer were 27.8% and 24.1%, respectively, and were 14.8% and 12.8% per retrieval, respectively, and were 9.0% and 7.3% per initiated cycle, respectively.
CONCLUSION(S)
Six, seven, or eight-cell embryos have equal chances of implanting in women with day 3 elevated serum FSH. The key finding is that these embryos do better than those with <6 blastomeres. These data may be helpful in women with a diminished ovarian reserve in attempting IVF with their own eggs or when choosing donor oocytes.
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