Morphokinetic analysis of early human embryonic development and its relationship to endometriosis resection: a retrospective time-lapse study using the KIDScore™ D3 and D5 implantation data algorithm

Saskia-Laureen Herbert, Claudia Staib, Theresa Wallner, Sanja Löb, Carolin Curtaz, Michael Schwab, Achim Wöckel, Sebastian Häusler
Archives of gynecology and obstetrics · 2023 · vol. 308(2) , pp. 587–597 · doi:10.1007/s00404-023-07008-6 · PMID:37179499 · PMC10293388 · W4376598384
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Abstract

RESEARCH QUESTION: Does complete resection of endometriosis improve embryo quality as assessed by morphokinetic parameters using time-lapse microscopy? DESIGN: For this retrospective study we analysed 237 fertilised, cultured and transferred embryos from 128 fresh IVF and/ or ICSI transfer cycles. Endometriosis was confirmed or excluded by laparoscopy. Patients were stimulated with recombinant FSH using GnRH agonist and antagonist protocols. After fertilisation, a time-lapse incubation system was used for observation. Embryo quality was assessed using the KIDScore™ D3 and D5 implantation data algorithm. RESULTS: The analysis showed a median KIDScore™ D5 of 2.6 (on a scale of 1 to 9.9) for embryos from patients with endometriosis without complete resection. The control group without endometriosis achieved a score of 6.8 (p = 0.003). The median score for embryos from endometriosis patients with complete resection was 7.2, which was a significant increase compared to embryos from patients without complete resection (p = 0.002). We observed an effect size of r = 0.4 for complete resection versus no resection of endometriosis using the KIDScore™ D5. There were no differences in KIDScore™ D3 between the three patient groups. Pregnancy and miscarriage rates showed the same clinical trends. In three of our four case series of patients who underwent IVF/ ICSI cycles before and after complete resection, we found a marked improvement in embryo quality after complete resection. CONCLUSIONS: Complete resection of endometriosis could significantly improve the otherwise poor embryo quality of patients undergoing IVF-procedures. The data, therefore, strongly support recommending surgery to patients with endometriosis prior to assisted reproduction.

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endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Algorithms Algorithms Algorithms Algorithms Algorithms Algorithms Algorithms Embryonic Development Embryonic Development Embryonic Development Embryonic Development Embryonic Development

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