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.
Highlights
The success rate of in vitro fertilization (IVF) depends on several parameters, of which good quality oocytes is the most important [1]
In analyses of the DEG group for the prevalence of DEG oocytes in the cohort at ovum pick-up (OPU), we found that a lower proportion of DEG in the cohort resulted in a higher pregnancy rate (OR = 0.11, 95%CI 0.02–0.56, P = 0.008)
The current study evaluated the effect of degenerated oocytes (DEG) found at OPU on clinical outcomes, including cycle outcome and embryo morphokinetics comparing the presence and absence of DEG oocyte in the cohort of aspirated oocytes
Summary
The success rate of in vitro fertilization (IVF) depends on several parameters, of which good quality oocytes is the most important [1]. A degenerated (DEG) oocyte is described as an empty zona pellucida (EZP) or damaged oocyte (fragments of oocytes) within the zona pellucida [2]. These oocytes can be seen at the time of ovum pick-up (OPU) or after intracytoplasmic sperm injection (ICSI) (Fig. 1). An automated time-lapse incubator allows for continuous and objective evaluation of fertilized oocytes and early embryo developmental morphokinetics [8], using the Known Implantation Data (KID) score which assigns morphokinetic parameters from 1 to 5 to estimate embryo viability and implantation potential [9].
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