Early fragment removal on in vitro fertilization day 2 significantly improves the subsequent development and clinical outcomes of fragmented human embryos.
10.5653/cerm.2018.45.3.122
- Author:
Seok Gi KIM
1
;
Youn Young KIM
;
Ji Young PARK
;
Su Jin KWAK
;
Chang Seok YOO
;
Il Hae PARK
;
Hong Gil SUN
;
Jae Won KIM
;
Kyeong Ho LEE
;
Hum Dai PARK
;
Hee Jun CHI
Author Information
1. IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea. hanna129@hanmail.net
- Publication Type:Original Article
- Keywords:
Day 2 embryos;
Embryo fragmentation;
Embryo grade;
Fragment removal;
Pregnancy outcome
- MeSH:
Biopsy;
Blastomeres;
Cohort Studies;
Embryonic Structures*;
Female;
Fertilization in Vitro*;
Humans*;
In Vitro Techniques*;
Paraffin;
Pregnancy;
Pregnancy Outcome;
Retrospective Studies;
Suction
- From:Clinical and Experimental Reproductive Medicine
2018;45(3):122-128
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To determine whether fragment removal on in vitro fertilization (IVF) day 2 improved the subsequent development and pregnancy outcomes of fragmented embryos compared to similar-grade embryos without fragment removal. METHODS: This study was a retrospective analysis involving 191 IVF cycles in which all embryos had over 10% fragmentation (grade 3 or 4) on day 2 of the IVF-embryo transfer cycle from March 2015 to December 2017. IVF cycles were divided into the fragment removal group (n=87) and the no fragment removal group (n=104) as a control cohort. Before fragment removal, embryos with fragmentation on day 2 were incubated in Ca2+- and Mg2+-free biopsy medium under paraffin oil for 30 minutes. Microsurgical fragment removal was performed with later-assisted hatching and a handmade suction micropipette that had an outer diameter of 30 µm. RESULTS: There were no significant differences in the characteristics of the patients between the control and the fragment removal groups. After fragment removal and subsequent in vitro culture for 24 hours, the number of blastomeres (7.1±1.7 vs. 6.9±1.6) was comparable between the transferred embryos in the two groups, but the morphological grade of the embryos in the fragment removal group (1.9±0.7) was significantly higher than that of the control group (3.1±0.5, p < 0.01). The clinical pregnancy (43.7%) and implantation rates (25.8%) in the fragment removal group were significantly higher than those in the control group (28.8% and 14.0%, respectively; p < 0.05). CONCLUSION: Early fragment removal on day 2 significantly improved the subsequent development and pregnancy outcomes of fragmented embryos.
