title: Predictors of embryo fragmentation and outcome after fragment removal in in vitro fertilization.
abstract: OBJECTIVE
  To assess predictors of embryo fragmentation in IVF as well as to compare cycle outcomes between low-grade embryos subjected to defragmentation and high-grade embryos not undergoing defragmentation.
  
  
  METHODS
  A retrospective, case-control trial.
  
  
  METHODS
  A university hospital IVF program.
  
  
  METHODS
  Three hundred twenty-seven nondonor, fresh IVF cycles.
  
  
  METHODS
  Predictors of fragmentation. We evaluated age, basal FSH and E(2) levels, the number of retrieved oocytes, and fertilization rates. Outcome assessments following defragmentation included rates of implantation, clinical pregnancy, spontaneous abortion, and live birth.
  
  
  RESULTS
  Increased age and lower number of oocytes and embryos were associated with embryo fragmentation. Lower-grade embryos after defragmentation yielded rates of implantation, clinical pregnancy, live birth, spontaneous abortion, and fetal defects equivalent to high-grade embryos.
  
  
  CONCLUSIONS
  Fragmented embryos correlate with poorer prognosis cycles; however, fragmented embryos that undergo defragmentation result in equivalent clinical outcomes to high-grade, nondefragmented embryos.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10019, USA.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Keltz
authors.forename: Josh C
authors.initials: JC
authors.lastname: Skorupski
authors.forename: Katrina
authors.initials: K
authors.lastname: Bradley
authors.forename: Daniel
authors.initials: D
authors.lastname: Stein
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D000375:Aging; D001723:Birth Rate; D016022:Case-Control Studies; D002970:Cleavage Stage, Ovum / Q000502:physiology*; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005315:Fetal Diseases / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D050498:Live Birth; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies