Clinical and laboratory characteristics of patients with embryonic arrest in the early embryonic period of in vitro fertilization programs

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Abstract

Objective: To investigate the clinical and hormonal parameters and outcomes of in vitro fertilization (IVF) programs in patients with impaired embryo cleavage compared to those in patients with embryos suitable for transfer.

Materials and methods: Patients meeting the inclusion and non-inclusion criteria were divided into two groups. Group 1 (study group) included 287 patients with arrested embryogenesis, that is fertilized oocytes were present, and the embryos stopped fragmenting in the early or late stages of culture. Group 2 (control group) included 483 patients with the presence of a blastocyst on the 5th or 6th day of culture. Ovarian stimulation was conducted according to standard protocols using gonadotropin-releasing hormone agonists or antagonists. Fertilization of the aspirated oocytes was performed using IVF or ICSI.

Results: Clinical factors associated with impaired embryo development in women of reproductive age included late reproductive age of 38 (34.5; 41) and 35 (32;39) years in groups 1 and 2, respectively; reduced ovarian reserve in 71.8% and 24.4% patients in groups 1 and 2, respectively; history of missed miscarriage in 59.6% and 16% of women in groups 1 and 2 among patients with a history of pregnancy; infertility of unknown origin in 40.1% and 12%, respectively; extragenital endometriosis in 16% and 8.9% of women in groups 1 and 2, respectively.

Conclusion: The development of embryos in the early stages of culture and the frequency of blastocyst formation depend on the number of mature oocytes and zygotes obtained, which in turn are determined by the age of the patient and the state of the ovarian reserve. A history of missed miscarriage, infertility of unknown origin, extragenital endometriosis, and impaired embryo development in previous IVF attempts may be risk factors for embryonic arrest in young women, even if at least 5 mature oocytes and at least 3 zygotes are obtained.

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About the authors

Mariam T. Pogosyan

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

Author for correspondence.
Email: mariam-pogosyan@yandex.ru

PhD student

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Tatyana A. Nazarenko

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

Email: t_nazarenko@oparina4.ru

Dr.Med. Sci., Professor, Head of the Institute of Reproductive Medicine

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Emil A. Gaysin

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

Email: emil.g17@mail.ru

Embryologist, Clinical embryology laboratory employee

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

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