Abstract
ObjectiveThe pathology of endometriosis and its impact on embryo development is still a black box in reproductive medicine. In this time-lapse study we investigated the influence of endometriosis on morphokinetic parameters of embryo development, taking variables of dynamic monitoring into account. Furthermore we evaluated reproductive medicine treatment outcome such as fetal heartbeat and live birth rate.Methods1148 embryos (control: n = 596, endometriosis: n = 552) were retrospectively analyzed. Patients were stimulated with GnRH antagonist protocol. After fertilization, embryos were incubated in a time-lapse system (EmbryoScope).ResultsThe mixed-model analysis revealed a significant main effect of time (p<0.001), with post-hoc tests showing that any time needed to reach a specific developmental stage was significantly different from all the others (all p<0.001). Embryos of endometriosis patients showed the same absolute morphokinetic time parameters as the control group, however, synchronization of early embryo cell divisions (s2) was faster in endometriosis patients compared to the control group.ConclusionIn general, endometriosis does not induce changes in early embryo morphokinetics. However, observed acceleration in cell cycle synchronization of embryo cleavage patterns might be a missing explanation for contradicting results in literature regarding the impairments in reproductive medicine treatment outcome of endometriosis patients.
Highlights
Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is one of the leading gynecologic disorders affecting approximately 10% of women in reproductive age [1]
Embryos of endometriosis patients showed the same absolute morphokinetic time parameters as the control group, synchronization of early embryo cell divisions (s2) was faster in endometriosis patients compared to the control group
Observed acceleration in cell cycle synchronization of embryo cleavage patterns might be a missing explanation for contradicting results in literature regarding the impairments in reproductive medicine treatment outcome of endometriosis patients
Summary
Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is one of the leading gynecologic disorders affecting approximately 10% of women in reproductive age [1]. The pathology and mechanisms of how endometriosis impairs female fertility remain largely unknown. Endometriosis is frequently associated with impaired fertilization and implantation characterized by abnormal folliculogenesis, elevated oxidative stress, altered immune function and hormonal milieu in the follicular and peritoneal environments, and reduced endometrial receptivity [4]. Higher spindle abnormalities in oocytes from endometriosis patients have been reported [5]. Severe stages of endometriosis might lead to deteriorating mechanical disturbances of the female reproductive system [6]
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