RISK FACTORS FOR OOCYTE DYSMORPHISMS IN ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS

The quality of oocytes plays a fundamental role in having good-quality embryos and hence in the efficiency of infertility treatment with assisted reproductive technologies (ART). In clinical practice, the quality of oocytes is assessed from their morphological characteristics, at the same time, a major portion of oocytes have different structural abnormalities. The possible risk factors for oocyte dysmorphisms may be the clinical characteristics of patients and various iatrogenic factors, primarily the specific features of a stimulation protocol. Objective: to assess the clinicoanamnestic and iatrogenic risk factors for different oocyte dysmorphisms in patients participating in the ART programs. Subjects and methods. A prospective case-control study enrolled 343 patients treated with ART programs. According to the presence or absence of oocyte dysmorphisms, the patients were divided into 3 groups: 1) women with cytoplasmic oocyte dysmorphisms; 2) those with extracytoplasmic oocyte dysmorphisms; 3) those with morphologically normal oocytes. The clinicoanamnestic and laboratory characteristics, as well as the specific features of a chosen stimulation protocol were estimated using logistic regression and plotting ROC curves. Results. The significant impact of patient age, body mass index, and the levels of anti-Müllerian hormone (AMH) and free thyroxine (T4) on the development of cytoplasmic oocyte dysmorphisms was seen in the univariate analysis and that of women’s age and T4 level was observed in the multivariate analysis. The development of extracytoplamic oocyte dysmorphisms was significantly influenced by patient age, AMH levels, and the use of gonadotropin-releasing hormone agonists (GnRH-α) as ovulation triggers or in GnRH-α protocols, as shown by the univariate analysis, and by AMH level and GnRH-α, as indicated by the multivariate analysis. Conclusion. The quality of oocytes is determined by different factors; most of them, such as patient age, ovarian reserve, and genetic abnormalities, are unmodified. The patients at risk for morphologically abnormal oocytes require a comprehensive approach to correcting metabolic disturbances and somatic diseases and a differentiated approach to selecting a suitable ovulation induction protocol.

in vitro fertilization, assisted reproductive technologies, quality of oocytes, morphology of oocytes, oocyte dysmorphisms, anti-Müllerian hormone, gonadotropin-releasing hormone agonists