Early cleavage of human embryos to the two cell stage a simple effective indicator of implantation and pregnancy in intracytoplasmic sperm injection

Abstract

The objective of our study is to study the effect of oocyte and embryo quality on the time of cleavage of embryosTo study the effect of stimulation protocol and dose of gonodotropins on the time of cleavage of embryosA prospective observational study of four hundred and three patients were recruited in the age group of twenty one to forty five years with all patients enrolled for Intra Cytoplasmic sperm injection during this study period as per the department protocol were included Patients underwent short and ultra short protocol for stimulation as the number of patients were less and embryos beyond grade III for transfer were excluded Sixty seven point three percent were between twenty six to thirty five years age group The total number of oocytes retrieved were five thousand eight hundred forty with mean oocytes retrieved being fifteen Of them eighty percent were M II Of these oocytes fifty eighty point one percent were good quality oocytes The mean number of oocytes injected were eleven and the oocytes fertilized were nine Fertilization was achieved in eighty percent of the oocytes injected Early cleavage embryos observed in forty one percent Late cleavage observed in thiry two percent and combined cleavage were twenty seven percent Sixty six percent were grade I embryos Clinical pregnancy rate was fifty six percent There was no significant difference in age duration of infertility type of infertility in both early and late cleavage groups There was no significant difference in the stimulation protocol in both the groups There was no significant effect of rFSH dose on cleavage between the groups There was no significant effect of both rFSH and HMG dose on cleavage between the groups The number of MII oocytes and good quality oocytes were significantly more with early cleavage group followed by late cleavage groupSeventy sixpercentof good quality embryos in early cleavage group and twenty four percent in late cleavage group which was statistically significantSo study population with early cleavage embryos had significantly better pregnancy rate implantation rate clinical pregnancy rate and live birth rateTherefore early cleavage criteria can be included for selecting embryos with a higher potential for implantation and pregnancy in Intra Cytoplasmic sperm injectioncycles newline