Analysis of the embryonic stage of in vitro fertilization programs in patients with unexplained infertility


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Abstract

Objective: The purpose of the study was analysis of the embryonic stage of in vitro fertilization programs (IVF and ICSI) in patients with unexplained infertility compared to patients with tubo-peritoneal factor of infertility. Materials and methods: We collected and analyzed information on embryonic stage of IVF programs in women with unexplained infertility (the study group consisting of 80 women), who underwent 113 IVF programs, and in women with tubo-peritoneal factor of infertility (the control group consisting of 30 patients), who underwent 41 IVF programs in the Departments of the Institute of Reproductive Medicine of the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia in the period from 2019 to 2021. The comparison groups of patients were representative of the general population in qualitative and quantitative parameters, comparable in age, duration of infertility, ovarian reserve status, stimulation protocols and the number of IVF programs per woman. Results: The blastulation rate was considered to be the endpoint in IVF programs, and it was significantly lower in the group of women with unexplained infertility. In-depth analysis of the embryonic stage of IVF programs showed, that low blastulation rate in unexplained infertility was mainly due to the fact that embryos stopped developing about three days after they were cultured. At the same time the morphological assessment showed that the quality of blastocysts was higher in the group of unexplained infertility compared to the group of tubo-peritoneal factor of infertility. Preimplantation genetic testing for aneuploidy (PGT-A) showed similar frequency of detection of euploid embryos. Conclusion: Given the identified impairments of early embryonic development in unexplained infertility, it is appropriate to recommend the patients to undergo early use of IVF with good quality embryo (>3, AA, AB, BA) transfer on day 5 of culture without long-lasting preliminary examination and empirical treatment.

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About the authors

Alexey V. Bachurin

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_bachurin@oparina4.ru
embryologist, Head of the Laboratory of Clinical Embryology, Scientific and Clinical Department of ART named after F. Paulsen

Evgeniya V. Kirakosyan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: evgeniya.kirakosyan@mail.ru
PhD. student, Department of Obstetrics, Gynecology, Perinatology and Reproductology

Tatyana A. Nazarenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: t_nazarenko@oparina4.ru
Dr. Med. Sci., Professor, Director of the Institute of Reproductive Medicine

Stanislav V. Pavlovich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: s_pavlovich@oparina4.ru
Ph.D., Academic Secretary

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