Abstract
<p><strong>Objective</strong></p><p>Endometriosis patients who underwent IVF program has poorer embryo quality, leads to low successive rate. In order to determine embryo quality, time lapse embryo monitoring and pronuclear (PN) morphology assessment were used to predict and select the most promising embryo. This research is expected to exhibit comparison the use of both methods in endometriosis patients in order to implement the most effective evaluation in future embryo implantation prognosis.</p><p><strong>Methods</strong></p><p>This cohort research was conducted to 72 embryos from 19 endometriosis patients who underwent IVF program in Yasmin Reproductive Clinic, Cipto Mangunkusumo Hospital. After ICSI was performed two-nucleated embryo later be monitored by its cleavage time and would be classified into categories for good quality embryo and other classes were considered poor quality embryo for time lapse monitoring. Then from time lapse monitoring, PN morphology were assessed regarding pronuclear scoring.</p><p><strong>Results</strong></p><p>Based on 72 embryos observation, we found that there was no significant difference between good and poor quality embryo based on PN scoring with p=0.185, and also between time-lapse morphokinetic monitoring and embryo quality with p=0.526. However, we found that there was a weak correlation between PN scoring and embryo quality with p=0.049 and r=0.233.</p><p><strong>Conclusion</strong></p><p>There was no significant difference found between time lapse monitoring and PN scoring in endometriosis patients in order to determine embryo quality. However, there was a weak correlation between PN scoring and embryo quality. This might be due to small number of samples taken and visual bias during observation.</p>
Highlights
About 50% of endometriosis patients have subfertility problem
From the analysis above we found that neither pronuclear scoring nor morphokinetics assessment using time-lapse monitoring showed a good predictor for embryo quality of endometriosis patients
There was a weak correlation between pronuclear scoring and embryo quality of endometriosis patients
Summary
About 50% of endometriosis patients have subfertility problem. The exact mechanism between endometriosis and infertility are still not clear. The mechanisms of infertility in endometriosis patients may vary between folicullogenesis, ovulatory, and fertility disturbance, embryo development, and even with the implantation of embryos [4]. To monitor embryos quality and development, which contributing to success of IVF program, several methods could be used Those methods are static morphological assessment, preimplantation genetic diagnostic, transcryptomic, metabolomic and proteinomic, and simultaneous assessment with microscope (time-lapse monitoring) [7]. Time-lapse monitoring assessment may identify early morphological marker predicting of good quality embryos which affecting to success of embryos implantation [9]. We compared conventional pronuclear morphology assessment and morphokinetic assessment using time-lapse monitoring to predict embryos quality in endometriosis patients. This study evaluated whether conventional static morphological assessment still could be used to predict embryos quality, considering that time-lapse monitoring tools are still limited in Indonesia
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