Geburtshilfe Frauenheilkd 2016; 76 - P206
DOI: 10.1055/s-0036-1592755

Higher pregnancy rate of embryos with synchronous transition from the 2-cell to the 4-cell stage independently of the GnRH analogue used for controlled ovarian stimulation

L Sela 1, N Rogenhofer 1, S Mittenzwei 1, S Mahner 1, CJ Thaler 1, V von Schönfeldt 1
  • 1Department of Gynaecology and Obstetrics, Ludwig-Maximilians-University, Division of Human Gynaecologic Endocrinology and Reproductive Medicine, Munich, Deutschland

Objectives: To validate different morphokinetic parameters of early human embryonic development in vitro as predictors for the developmental potential of human embryos. To this end we compared pregnant and non-pregnant patients following controlled ovarian stimulation (COS) with two types of GnRH analogue and intracytoplasmic sperm injection (ICSI).

Study design: In a retrospective observational study we analysed different morphokinetic parameters of 432 embryos cultured in the EmbryoScopeTM time-lapse monitoring system (TMS) from 217 patients (from 25 to 45 years of age) undergoing a fresh cycle of oocyte retrieval, ICSI and day 3 or day 5 embryo transfer at our outpatient clinic.

Methods: Patients receiving GnRH agonist to prevent mid-cycle LH surge were assigned to the 'agonist' group; accordingly, patients receiving GnRH antagonist were assigned to the 'antagonist' group.

Results: Embryos with a high implantation potential display a significantly shorter duration of the 3-cell stage (s2) in both the GnRH agonist (p = 0.01) and the GnRH antagonist group (p = 0.03). In the agonist group, embryos with an implantation potential also showed a significantly earlier time of cleavage to the 3-cell stage and to the 4-cell stage compared to embryos with an implantation potential (p = 0.001, respectively).

Conclusions: The synchronicity of transition from the 2-cell stage to the 4-cell stage (s2) is positively correlated with high implantation potential independently of the GnRH analogue used for COS. The TMS together with the application of morphokinetic parameters for a non-invasive identification of embryonic implantation potential offers a clear advantage over the conventional discontinuous evaluation of embryo morphology.