title: Association between Number of Formed Embryos, Embryo Morphology and Clinical Pregnancy Rate after Intracytoplasmic Sperm Injection.
abstract: IntroductionInfertility has a high prevalence in the general population, affecting ∼ 5 to 15% of couples in reproductive age. The assisted reproduction techniques (ART) include in vitro manipulation of gametes and embryos and are an important treatment indicated to these couples. It is well accepted that the implantation rate is positively influenced by the morphology of transferred embryos. However, we question if, apart from the assessment of embryo morphology, the number of produced embryos per cycle is also related to pregnancy rates in the first fresh transfer cycle.PurposeTo evaluate the clinical pregnancy rate according to the number of formed embryos and the transfer of top quality embryos (TQEs).MethodsIn a retrospective cohort study, between January 2011 and December 2012, we evaluated women who underwent intracytoplasmic sperm injection (ICSI), aged < 40 years, and with at least 1 formed embryo fresh transferred in cleavage stage. These women were stratified into 3 groups according to the number of formed embryos (1 embryo, 2-3 and ≥ 4 embryos). Each group was divided into 2 subgroups according to the presence or not of at least 1 transferred TQE (1 with TQE; 1 without TQE; 2-3 with TQE, 2-3 without TQE; ≥ 4 with TQE; ≥ 4 without TQE). The clinical pregnancy rates were compared in each subgroup based on the presence or absence of at least one transferred TQE.ResultsDuring the study period, 636 women had at least one embryo to be transferred in the first fresh cycle (17.8% had 1 formed embryo [32.7% with TQE versus 67.3% without TQE], 42.1% of women had 2-3 formed embryos [55.6% with TQE versus 44.4% without TQE], and 40.1% of patients had ≥ 4 formed embryos [73.7% with TQE versus 26.3% without TQE]). The clinical pregnancy rate was significantly higher in the subgroup with ≥ 4 formed embryos with at least 1 transfered TQE (45.2%) compared with the subgroup without TQE (28.4%).ConclusionsHaving at least two available embryos and at least one TQE for embryo transfer are predictors of the pregnancy rates.
authors.affiliation: Obstetrics and Gynecology Department, Ribeirão Preto Medicine School, Universidade de São Paulo (DGO-FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: Caroline Mantovani da
authors.initials: CM
authors.lastname: Luz
authors.affiliation: Obstetrics and Gynecology Department, Ribeirão Preto Medicine School, Universidade de São Paulo (DGO-FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: Vanessa Silvestre Innocenti
authors.initials: VS
authors.lastname: Giorgi
authors.affiliation: Obstetrics and Gynecology Department, Ribeirão Preto Medicine School, Universidade de São Paulo (DGO-FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: Marcela Alencar
authors.initials: MA
authors.lastname: Coelho Neto
authors.affiliation: Obstetrics and Gynecology Department, Ribeirão Preto Medicine School, Universidade de São Paulo (DGO-FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: Wellington de Paula
authors.initials: WP
authors.lastname: Martins
authors.affiliation: Obstetrics and Gynecology Department, Ribeirão Preto Medicine School, Universidade de São Paulo (DGO-FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: Rui Alberto
authors.initials: RA
authors.lastname: Ferriani
authors.affiliation: Obstetrics and Gynecology Department, Ribeirão Preto Medicine School, Universidade de São Paulo (DGO-FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: Paula Andrea
authors.initials: PA
authors.lastname: Navarro
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D004622:Embryo, Mammalian / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic