Abstract
This multicenter cohort study on embryo assessment and outcome data from 11,744 IVF/ICSI cycles with 104,830 oocytes and 42,074 embryos, presents the effect of women’s age on oocyte, zygote, embryo morphology and cleavage parameters, as well as cycle outcome measures corrected for confounding factors as center, partner’s age and referral diagnosis. Cycle outcome data confirmed the well-known effect of women’s age. Oocyte nuclear maturation and proportion of 2 pro-nuclear (2PN) zygotes were not affected by age, while a significant increase in 3PN zygotes was observed in both IVF and ICSI (p<0.0001) with increasing age. Maternal age had no effect on cleavage parameters or on the morphology of the embryo day 2 post insemination. Interestingly, initial hCG value after single embryo transfer followed by ongoing pregnancy was increased with age in both IVF (p = 0.007) and ICSI (p = 0.001) cycles. For the first time, we show that a woman’s age does impose a significant footprint on early embryo morphological development (3PN). In addition, the developmentally competent embryos were associated with increased initial hCG values as the age of the women increased. Further studies are needed to elucidate, if this increase in initial hCG value with advancing maternal age is connected to the embryo or the uterus.
Highlights
It is well-recognized that the fertility potential of women decreases with increasing age
We have previously shown that there is a significant effect of age on the expression of genes involved in cell cycle regulation in oocytes in metaphase II (MII) from women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment [7]
Both were significantly correlated to female age, and the subsequent analyses were adjusted for these confounding variables
Summary
It is well-recognized that the fertility potential of women decreases with increasing age. The decline in female reproductive capacity with increasing age has two main causes: Gradual depletion of oocytes from the ovary, and a decrease in oocyte quality [1]. A fully developmentally competent oocyte is an oocyte that through oogenesis achieves the ability to resume meiosis, become fertilized with a single spermatozoa, de-condense the sperm head, create two pronuclei (PN), pass cleavage stages, undergo maternal-to-embryonic. Female age and embryo cleavage preparation of the manuscript. The specific roles of these authors are articulated in the ’author contributions’ section
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