Abstract
The aim of this study was to evaluate if cytoplasmic transfer can improve fertilization and embryo quality of women with oocytes of low quality. During ICSI, 10–15% of the cytoplasm from a fresh or frozen young donor oocyte was added to the recipient oocyte. According to the embryo quality, we defined group A as patients in which the best embryo was evident after cytoplasmic transfer and group B as patients in which the best embryo was evident after a simple ICSI. We investigated in the period of 2002–2018, 125 in vitro fertilization cycles involving 1011 fertilized oocytes. Five hundred fifty-seven sibling oocytes were fertilized using ICSI only and 454 oocytes with cytoplasmic transfer. Fertilization rates of oocytes were 67.2% in the cytoplasmic transfer and 53.5% in the ICSI groups (P < 0.001). A reduction in fertilization rate was observed with increased women age in the ICSI but not in the cytoplasmic transfer groups. The best embryo quality was found after cytoplasmic transfer in 78 cycles (62.4%) and without cytoplasmic transfer in 40 cycles (32%, P < 0.001). No significant differences were detected between the age, hormonal levels, dose of stimulation drugs, number of transferred embryos, pregnancy rate and abortion rate between A and B groups. Cytoplasmic transfer improves fertilization rates and early embryo development in humans with low oocyte quality. All 28 children resulting from cytoplasmic transfer are healthy.
Highlights
An increasing number of women over 35 are seeking infertility treatment
Patients, giving permission for cytoplasmic transfer only to a smaller part of their eggs were not excluded from the study, because we understand the scepticism about the new method
The effects of other confounding variables, such as female age, basal follicle-stimulating hormone (FSH), E2 at the day of human chorionic gonadotropin (HCG) ovulation triggering, total number of oocytes recovered and total FSH dose used for stimulation were not supported by our data
Summary
An increasing number of women over 35 are seeking infertility treatment. There is a higher likelihood of a greater frequency of Science, Palacký University Olomouc, 77900 Olomouc, Czech Republic 4 Department of Paediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic 5 Department of Medical Genetics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic point mutations in the oocytes in these patients [1]. Minor mitochondrial dysfunctions [5] can cause a reduction in ATP production or inadequate spindle microtubule production [6] with consequent aneuploidy or maternal age-related trisomy [1]
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