Patient and in vitro fertilization (IVF) cycle characteristics associated with variable blastulation rates: a retrospective study from the Duke Fertility Center (2013–2017)

Abstract

Background: To evaluate the association of patient and IVF cycle characteristics with blastulation rate and formation of high-quality blastocysts Results: We analyzed autologous blastocyst cycles from 2013 to 2017. Cycles were subdivided into low (< 33%), intermediate (33-66%), and high (> 66%) blastulation rates. Embryo quality was assigned by embryologists using Gardner Criteria. R statistical package was used, and the blastulation groups were compared using analysis of variance (ANOVA) for continuous variables and chi-squared tests for categorical variables. The Bonferroni correction was used to adjust for multiple comparisons. One hundred seventeen IVF cycles met our inclusion criteria. Of these, 20 (17.1%) had low, 74 (63.2%) had intermediate, and 23 (19.7%) had high blastulation rates. Low blastulation rate was associated with a lower number of blastocysts, including fewer high-quality blastocysts. The mean number of oocytes retrieved was highest (18.1) in the group with the lowest blastulation rate, and lowest (13.4) in those with the highest blastulation rate, although this did not reach statistical significance. There were no significant differences between blastulation rates and age, gravidity, prior live birth, anti-mullerian hormone, estradiol and progesterone levels on the day of ovulation trigger, follicle-stimulating hormone dose, or fertility diagnosis. Conclusions: High blastulation rate is associated with a greater number of blastocysts, including a greater number of high-quality blastocysts. Higher oocyte yield, however, is not associated with improved blastulation rates. Blastulation rates, blastocyst number, and quality remain difficult to predict based on cycle characteristics alone, and oocyte yield may not be an accurate predictor of either outcome. Precis High oocyte yield may be associated with a lower blastulation rate and a lower number of high-quality blastocysts.

Effects of controlled ovarian stimulation regimens on top-quality blastocyst development and perinatal outcomes with the freeze-all strategy: A retrospective comparative study

“…In the present study, despite the higher number of retrieved and mature oocytes in the GnRHa group, blastocyst development rates were comparable between both COS regimens. These results again highlight the previously established notion that a higher oocyte yield is not associated with an improved blastocyst development rate [ 25 ]. Aggressive ovarian stimulation poses a serious risk of developing OHSS.…”

Impact of the number of retrieved oocytes on IVF outcomes: oocyte maturation, fertilization, embryo quality and implantation rate

“…Nevertheless, the blastulation rate of group 3 was significantly higher when compared with group 2. Cycle characteristics alone may not be an accurate predictor for the rate of blastulation, as there have been many conflicting results reported in previous literature (Jones et al, 2020). It has been shown that better quality blastocysts are mostly generated by oocytes originating from a follicular volume of between 13 and 23 mm (Agrawal et al, 2020).…”

Clinical and laboratory key performance indicators in IVF: A consensus between the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR) and the Italian Society of Embryology, Reproduction and Research (SIERR)

“…Moreover, confounders exist such as timing of observation, culture medium, and culture conditions. This parameter was chosen because several studies emphasized the importance of these laboratory data in influencing clinical results [34,39,40]. We also established an assessment of the data by stratifying for maternal age as some studies reported that quantity and quality of blastocysts formed are independent from the number of collected oocytes, but negatively associated with female age [39].…”

“…This parameter was chosen because several studies emphasized the importance of these laboratory data in influencing clinical results [34,39,40]. We also established an assessment of the data by stratifying for maternal age as some studies reported that quantity and quality of blastocysts formed are independent from the number of collected oocytes, but negatively associated with female age [39]. In addition, several authors showed a maternal age-dependent effect on embryo development emerging only at the blastocyst stage [34,41,42].…”