Comparison of embryonic competence and clinical outcomes between early and late cumulus cell removal for in vitro fertilization

Abstract

Objective: The impact of early mechanical removal of cumulus cells on fertilization and embryonic development is not yet precisely known. This study aimed to investigate the effects of early and late cumulus cell removal on fertilization, polyspermy, embryonic development potential, blastocyst development, and clinical outcomes.Methods: A prospective study was conducted of patients who underwent in vitro fertilization between September 2019 and October 2020. Sibling oocytes were randomly allocated after insemination to early cumulus cell removal at 6 hours (group I) and late cumulus cell removal at 16–18 hours (group II). If total fertilization failure (TFF) was determined to have occurred at early cumulus cell removal, rescue intracytoplasmic sperm injection (ICSI) was performed. Fertilization, embryonic development, and pregnancy outcomes were compared.Results: A total of 912 oocytes were assigned to group I (458 oocytes) and group II (454 oocytes). Fertilization, polyspermy, embryo quality, and pregnancy outcomes were not significantly different between both groups. Rescue ICSI enabled fertilization of 79.2% of the TFF oocytes.Conclusion: Early cumulus cell removal at 6 hours had no significant difference in fertilization, polyspermy, embryo development, or obstetric and perinatal outcomes compared to late removal. Early cumulus cell removal combined with early rescue ICSI may have the potential to help couples with TFF.

Early cumulus cell removal increases cumulative live birth rate while having no negative effect on the malformation rate in in vitro fertilization: a propensity score-matched cohort study

“…Despite the con icting results regarding the polyspermy rate, all these studies demonstrated that ECCR did not affect normal fertilization [5,17,18] . Recent one prospective study [19] found that ECCR at 6h had no signi cant difference in fertilization ,polyspermy, embryo development compared to late removal. Our study showed that ECCR was associated with a lower fertilization rate, but had no effect on polyspermy rate.…”

“…We adopted PSM to adjust basal characteristics of patients, our present results demonstrated that early removal of COC increases the cumulative clinical pregnancy rate and CLBR compared to traditional IVF. Recent studies demonstrated that ECCR was not associated with adverse pregnancy and neonatal outcomes [13,19] . This study also showed that ECCR had no negative effect on the miscarriage rate, and that early removal of COC did not increase the rate of malformations, which was similar to the results of recent studies [13] .…”

Early Cumulus Cell Removal Increases Cumulative Live Birth Rate while Having No Negative Effect on the Malformation Rate in In vitro Fertilization: A Propensity Score-Matched Cohort Study

“…Despite the conflicting results regarding the polyspermy rate, all these studies demonstrated that ECCR did not affect normal fertilization [5,17,18]. Recent one prospective study [19] found that ECCR at 6 h had no significant difference in fertilization, polyspermy, embryo development compared to late removal. Our study showed that ECCR was associated with a lower fertilization rate, but had no effect on polyspermy rate.…”

Early cumulus cell removal increases cumulative live birth rate while having no negative effect on the malformation rate in in vitro fertilization: a propensity score-matched cohort study

“…Despite the con icting results regarding the polyspermy rate, all these studies demonstrated that ECCR did not affect normal fertilization [5,17,18] . Recent one prospective study [19] found that ECCR at 6h had signi cant difference in fertilization ,polyspermy, embryo development compared to late removal. Our study showed that ECCR was associated with a lower fertilization rate, but had no effect on polyspermy rate.…”