Clinical outcomes of in vitro fertilization programs and the birth of babies after transfer of poor-quality blastocysts subjected to the defragmentation procedure


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Abstract

Objective. To evaluate the clinical outcomes of in vitro fertilization (IVF) programs after transfer of poor-quality blastocysts subjected to microsurgical defragmentation. Materials and methods. The investigation included 20 five-to-six-old day embryos that reached the stage of blastocysts, the trophectoderm of which was classified as grade C due to the presence of 15 to 35% of cytoplasmic fragments. The blastocysts underwent assisted hatching, after which defragmentation was carried out using the micromanipulation technique. After defragmentation, the quality of the embryos was re-assessed and used for transfer or cryopreservation, followed by embryo transfer in a cryocycle. The authors analyzed the results of 20 clinical cases with a known clinical outcome after transfer of a single defragmented blastocyst. Results. Two hours after defragmentation, the trophectoderm of all the 20 blastocysts was rated as no lower than grade B. After embryo transfer, the authors diagnosed the following conditions: no pregnancy (n=12); missed miscarriage (n=2), or a clinical pregnancy resulting in live birth (n=6). Conclusion. Defragmentation of poor-quality blastocysts allows their morphological assessment to be improved. The clinical outcomes of IVF programs using defragmented blastocysts are comparable to those when transferring good-quality blastocysts, including those in term of live birth rates.

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About the authors

Konstantin V. Kirienko

AltraVita Clinic of Human Reproduction, "ECO CENTER" LLC

Email: kkiriyenko@rambler.ru
PhD, leading embryologist

Valentina P. Apryshko

AltraVita Clinic of Human Reproduction, "ECO CENTER" LLC

Email: supermycolog@mail.ru
PhD, Head of Embryology department

Vladimir V. Voloshanenko

AltraVita Clinic of Human Reproduction, "ECO CENTER" LLC

Email: veston.campbell@yandex.ru
embryologist

Sergey A. Yakovenko

AltraVita Clinic of Human Reproduction, "ECO CENTER" LLC; Faculty of Physics, M.V. Lomonosov Moscow State University

Email: altravita@mail.ru

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