Predictors of embryo fragmentation and outcome after fragment removal in in vitro fertilization.
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.
Keltz
Martin D
MD
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.
Skorupski
Josh C
JC
Bradley
Katrina
K
Stein
Daniel
D
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