Clinical predictors of embryo quality among women of advanced age receiving intracytoplasmic sperm injection cycles in Malaysia: A cohort study.

Nisar Omar Hafizi E, Abdul Rahim R, Mohamad Zon E, Ibrahim A
International journal of reproductive biomedicine · 2022 · doi:10.18502/ijrm.v20i7.11560 · PMID:36187735 · PMC9446443
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This prospective cohort study of 124 women aged 35 to 45 undergoing intracytoplasmic sperm injection found that the total number of retrieved oocytes and available embryos strongly predicted high-quality embryo formation.

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This prospective cohort study evaluated clinical predictors of embryo quality in 124 women aged 35 to 45 years undergoing their first intracytoplasmic sperm injection cycle. The researchers analyzed various baseline characteristics and stimulation parameters to determine which factors independently correlated with the development of high-quality embryos according to standardized morphological grading criteria. Multiple linear regression analysis revealed that while several variables showed initial correlation, only the total number of retrieved oocytes and the total number of available embryos served as independent predictors for obtaining high-quality embryos. This paper is centrally about endometriosis — specifically laparoscopic excision of deep infiltrating lesions.

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Abstract

BackgroundDeclining fertility in a woman of advanced age is associated with a depletion in ovarian reserve as well as declining oocyte and embryo quality. Determining the predictors of embryo quality may assist in stimulation target and cycle prediction.ObjectiveThis study aims to identify factors affecting embryo quality among women of advanced age receiving intracytoplasmic sperm injection (ICSI) cycles.Materials and methodsThis prospective cohort study was conducted over a period of 12 months, from January until December 2018, on 734 mature oocytes retrieved from 124 women of advanced age (35-45 yr old) receiving ICSI. The Society of Assisted Reproductive Techniques system was used to determine the morphological grading of embryo quality. The fertilization rate, cleavage rate, and pregnancy rate per cycle were expressed as a percentage per cycle for a total of 76 embryo transfers. Possible predictors of high-quality embryos were evaluated using single and multiple regression tests, with p < 0.05 considered as significant.ResultsOut of the 586 available embryos, 288 (49.15%) high-quality embryos were obtained. The fertilization and cleavage rates were 86.18% and 97.83%, respectively. The total number of retrieved oocytes (R2 = 0.857) and the total available embryos (R2 = 0.857) were closely related to high-quality embryos. 76 embryo transfers were conducted, with 17 successful conceptions (implantation rate = 22.37% per transfer). There were no miscarriages among the pregnancies.ConclusionIncreasing the number of collected oocytes and the cleavage rate could increase the chance of obtaining more high-grade embryos. This could increase the success of ICSI among women of advanced age.
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There is evidence that the embryo quality declines with maternal age. This study showed that the chance of obtaining a high-quality embryo can be improved by increasing the number and quality of collected oocytes and the number of available embryos. This measure can be achieved by regulating the stimulation regimens and methods of embryo incubation.

Coi Statement

The authors declare that there is no conflict of interest.

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