Author/Editor     Čižek-Sajko, Mojca; Vlaisavljević, Veljko
Title     Determination of criteria for the assessment of embryo quality with good implantation predictability on a model of unstimulated in vitro fertilization cycles - Prediction of implantation in unstimulated cycles
Translated title     Določitev meril za ocenjevanje kakovosti zarodka z možnostjo napovedovanja ugnezditve na modelu nespodbujenih ciklih zunajtelesne oploditve - napovedovanje ugnezditve pri nespodbujenih ciklih
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 80, št. Suppl 1
Publication year     2011
Volume     str. I-39-45
Language     eng
Abstract     Background: In unstimulated in vitro fertilization cycles we analysed which criteria for the assessment of day-3-embryo quality were the most important predictive factors of successful implantation. Methods: A retrospective analysis of 115 unstimulated in vitro fertilization (IVF) cycles, terminated by embryo transfer (ET) on day 3 post follicular aspiration, was done. The embryos were evaluated according to three criteria: (i) blastomere fragmentation, (ii) blastomere number on the day of ET and (iii) blastomere cleavage dynamics. The impact of individual criteria, and of combinations of several criteria for embryo quality assessment, on implantation was established. Results: The impact of embryo quality on implantation could only be confirmed in the case when the embryo was evaluated on the basis of blastomere fragmentation and blastomere cleavage dynamics simultaneously (X2 =5.23; P< 0.05). In such cases the implantation rate amounted to 27.0 % (20/74) in good quality embryos and 9.8 % (4/41) in poor quality embryos. The predictive value of implantation for the so defined embryo quality was 3.43 (95 % CI = 1.08-10.84). Conclusion: Embryo quality, defined by blastomere fragmentation and blastomere cleavage dynamics simultaneously, proved to be a good predictive factor of implantation. In good quality embryos, the odds for implantation were 3.43 times higher than in embryos of poor quality.
Summary     Izhodišča: Ugotavljali smo, katera merila za določanje kakovosti zarodka tretjega dne so bili pri nespodbujenih ciklih zunajtelesne oploditve najboljši napovedni dejavniki za uspešno ugnezditev. Metode: Retrospektivno smo analizirali 115 nespodbujenih ciklov zunajtelesne oploditve, ki so se zaključili s prenosom zarodka tretji dan po aspiraciji folikla. Zarodke smo ocenjevali na osnovi treh meril: (i) fragmentacija blastomer; (ii) število blastomer na dan prenosa zarodka in (iii) dinamika delitve blastomer. Ovrednotili smo vpliv posameznih meril in kombinacije več meril za določanje kakovosti zarodkov na ugnezditev. Rezultati: Vpliv kakovosti zarodka na ugnezditev smo lahko potrdili le v primeru, ko smo jo opredelili na podlagi fragmentacije blastomer in dinamike delitve blastomer hkrati (X2 = 5,23; P < 0,05). Pri tako opredeljeni kakovosti zarodka je bila stopnja ugnezditve pri zarodkih dobre kakovosti 27,0 % (20/74), pri zarodkih slabe kakovosti pa 9,8 % (4/41). Napovedna vrednost za ugnezditev je bila 3,43 (95-odstotni IZ = 1,08- 10,84). Zaključki: Kakovost zarodka, ki smo jo ovrednotili na osnovi fragmentacije blastomer in dinamike delitve blastomer hkrati, se je pokazala kot dober napovedni dejavnik za ugnezditev. Zarodki dobre kakovosti so imeli 3,43-krat večje obete za ugnezditev kot zarodki slabe kakovosti.
Descriptors     FERTILIZATION IN VITRO