Table 7 Effect of cytoplasmic fragmentation on embryo implantation and pregnancy
Author | Year | Title of Paper | Type of study | No. of study participants | Embryo stage | Age | Intervention (stim protocol) | Outcome measure |
|---|---|---|---|---|---|---|---|---|
Giorgetti et al. | 1995 | Embryo score to predict implantation after in-vitro fertilization: based on 957 single embryo transfers | Retrospective | 957 single embryo transfers. | Cleavage stage embryos. | Used 38 years as a cutoff age for comparison. | Ovarian stimulation using HMG treatment (150-300 IU/day) or 150-300 IU/day Humegon and/or FSH treatment. Oocytes retrieved after 5000 IU HCG. | Implantation, pregnancy rate, delivery rate. |
Racowsky et al. | 2009 | Is there an advantage in scoring early embryos on more than one day? | Retrospective | 1595 embryos, 564 resulted from ICSI and 1031 underwent assisted hatching with or without ICSI. 269 transferred alone, 1326 transferred in double embryo transfers. | Day-3 embryo selection. | Total age range 21.6 - 44.8 years. Mean ICSI: 34.18 +/- 4.37 years. Mean IVF: 35.22 +/- 4.36 years. | Controlled ovarian stimulation using protocols previously described in Skiadas et al., 2006.1 | Embryonic features: No. cells, pronuclei, fragmentation, symmetry, distribution of nuclei. |
Ebner et al. | 2001 | Embryo fragmentation in vitro and its impact on treatment and pregnancy outcome | Retrospective | 460 fresh embryo transfers. | Day-2 embryo transfers. | Mean patient age 32.5 +/- 4.9 years. | Long protocol combining GnRH with HMG. 5,000 - 10,000 IU of hCG was administered to induce ovulation. | Implantation and clinical pregnancy rate, obstetric and perinatal outcome. |
Alikani et al. | 1999 | Human embryo fragmentation in vitro and its implications for pregnancy and implantation | Retrospective | 2,410 patients. | Day-3 embryos. | Mean maternal age 35.7 +/- 4.25 years. | Stimulation with standard down-regulation protocol or a modification of the microflare protocol (Scott and Navot, 19942) for pts ≥40 and those with previous response to down-regulation was unsatisfactory. | Degree and pattern of fragmentation on pregnancy and implantation. |
Paternot et al. | 2013 | Semi-automated morphometric analysis of human embryos can reveal correlations between total embryo volume and clinical pregnancy | Prospective | 458 patients; 2796 embryos. | Day-3 after IVF/ICSI. | All patients younger than 36 years. | Stimulation protocol as previously described by Debrock et al., 2010.3 | Ongoing pregnancy (one intrauterine gestational sac at 20 weeks). |