Degenerated oocyte in the cohort adversely affects IVF outcome

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.

Empty Zona Pellucida Only Case: A Critical Review of the Literature

“…The study conducted by Oride and colleagues reported poor fertilization and embryo development following the comparison of cycles involving no EZP oocytes in all cycles, at least one EZP in all cycles, and those with and without EZP, revealing the pregnancy rates of 30.4%, 20%, and 28.6%, respectively [2]. Finally, IVF cycles presenting with EZP were associated with significantly lower embryo quality following the observation of morphokinetics, further highlighting the adverse effect of the occurrence of EZP on IVF outcomes [11,12,39].…”

“…The occurrence of a fractured ZP in the retrieved oocytes cohort may reflect poor oocyte quality, especially if it is observed during repetitive IVF attempts. Thus, the finding of EZP or damaged oocytes has a detrimental effect on the oocyte cohort dynamic and the subsequent fertilization potential [2,[11][12][13][14], resulting in lower chances of successful fertilization, decreased numbers of embryos available for transfer, and occasional embryo transfer cancellation [11].…”

“…Regarding the scenario of oocyte maturation arrest, several studies demonstrated the association of oocyte degeneration with the EZP [9,33,34]. The degenerated oocytes may be associated with either an EZP or with oocyte fragments within the ZP [9,11]. Thus, an EZP finding can be indicative of oocyte apoptosis during the process of oocyte maturation.…”

“…Available data, which is limited, documents poor IVF outcomes in cycles where abnormal oocytes were detected, namely either EZP oocytes or degenerative ones [2,11]. The study conducted by Oride and colleagues reported poor fertilization and embryo development following the comparison of cycles involving no EZP oocytes in all cycles, at least one EZP in all cycles, and those with and without EZP, revealing the pregnancy rates of 30.4%, 20%, and 28.6%, respectively [2].…”