Effect of Early Cumulus Cell Removal on the Fertilization and Clinical Outcome in Human <i>in Vitro</i> Fertilization

Abstract

The short-term insemination technique has been widely applied, although it is not clear whether the mechanical desorption of cumulus cells can affect normal fertilization and birth outcomes. Therefore, the present study aimed to evaluate whether early cumulus cell removal could affect in vitro fertilization outcomes. Based on a history of infertility and semen analysis, 61 patients were identified, and the cumulus cells were mechanically removed at either6 h post-insemination (Group A, 387 mature oocytes) or 18-20 h post-insemination as traditional in vitro fertilization (Group B, 424 mature oocytes). There were no significant differences in the rates of fertilization, available embryos, high quality embryos, birth, premature birth, pregnancy, or implantation when we compared the two groups. However, Group A exhibited a significantly higher polyspermy rate, and significantly lower rates of blastocyst formation and high-quality blastocyst formation, compared with Group B. Therefore, the results of present study indicate that early cumulus cell removal (at 6 h post-insemination) may negatively affect the rates of polyspermy, blastocyst formation, and high-quality blastocyst formation.

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

“…Our results showed that early cumulus cell removal had comparable obstetric and prenatal outcomes with late cumulus cell removal, in agreement with Liu et al [ 14 ]. However, recent studies [ 11 , 13 ] reported higher rates of premature delivery, twins, and low-birth-weight newborns in patients who underwent early cumulus cell removal.…”

“…The ability to draw a clear conclusion may be hindered by differences in study designs and populations. In the present study, sibling oocytes were randomly allocated into two groups to minimize the confounding between patients, and the findings indicated that early cumulus cell removal had no significant difference in fertilization, polyspermy, cleavage of embryos, clinical pregnancy, and ongoing pregnancy, comparable with the findings of previous studies [4,5,[12][13][14][15][16].…”

Comparison of short and long co-incubation time of gametes for in vitro fertilization

“…15 This study found no significant difference in polyspermy, implantation, and clinical pregnancy rate in short and long co-incubation as previous studies. [9][10][11][12][13] In the short co-incubation and early cumulus cell removal, the patient had a higher premature delivery, twins and low birth weight newborn than long coincubation. 5,[11][12][13] Li et al, pointed out that cumulus cell removal at a different time can alter spindle integrity and impair cell division which results in twins or poor fetal growth.…”

“…Zhou and Liu (co-incubation 6 hours) found that implantation rate and clinical pregnancy rate were similar to long co-incubation. [4][5][6][9][10][11][12][13] In contradiction, Barraud-Lange et al, demonstrated that short co-incubation had low numbers of available embryos for transfer. 14 Nevertheless, a meta-analysis indicates that short coincubation has a significant increase in implantation rate and clinical pregnancy rate.…”

“…In current study, sibling oocytes were randomly allocated into 2 groups to minimize the confounding factors between patients and the results showed that short co-incubation had no significant difference in fertilization, polyspermy, cleavage of embryos, blastocyst formation, implantation, clinical pregnancy, and live birth rate when compared to long coincubation which go in line with previous studies. 4,[9][10][11][12][13] Therefore, in this context, short co-incubation give no any superior benefit over long co-incubation.…”