Effects of triploidy incidence on clinical outcomes for IVF-ET cycles in different ovarian stimulation protocols

Abstract

Purpose: To discuss the relationship between triploidy incidence and clinical outcomes of embryos derived from normally fertilized oocytes from the same cohort for in vitro fertilization-embryo transfer (IVF-ET) cycles in different ovarian stimulation protocol.

Methods: This study included 2070 in vitro fertilization (IVF) cycles with long-term protocol, 802 IVF cycles with ultra short-term protocol and 508 IVF-D (in vitro fertilization by donor semen) cycles with long-term protocol from January 2013 to September 2014. According to the different 3PN rate, patients were divided into three groups as follows: Group 1 included patients with 0% 3PN zygotes, Group 2 included patients with 1–25% 3PN zygotes and Group 3 included patients with >25% 3PN zygotes. Main outcome measure: female age, no. of retrieved oocytes, normal fertilization rate, day-3 grade I + II embryos rate, day-3 grade I + II + III embryos rate, implantation rate, pregnancy rate and early abortion rate.

Results: Triploidy cycle incidence rate in IVF and IVF-D cycles with long-term protocol were significantly higher than in IVF cycles with ultra short-term protocol (p < 0.001). Triploidy fertilization rate found no significant difference between the three groups (p > 0.05). In three protocols, normal fertilization rate in 3PN = 0% and 3PN = 1–25% groups were significantly higher compared to 3PN > 25% group (p < 0.001). In IVF cycles with long-term protocol, the day-3 grade I + II embryos, implantation and pregnancy rate in 3PN > 25% group were significantly lower than other two groups (p < 0.05). The day-3 grade I + II + III embryos and early abortion rate found no significant difference between the three groups (p > 0.05). In IVF cycles with ultra short-term protocol, there were no significant differences found in day-3 grade I + II embryos, day-3 grade I + II + III embryos, implantation, pregnancy and early abortion rate (p > 0.05). In IVF-D cycles with long-term protocol, the day-3 grade I + II embryos, day-3 grade I + II + III embryos and implantation rate in 3PN > 25% group were significantly lower than other two groups (p < 0.05). The pregnancy and early abortion rates found no significant difference in the three groups (p > 0.05).

Conclusion: We observed that high proportion of triploid zygotes made a negative effect on clinical outcomes for IVF-ET cycles with long-term protocol.

Chinese abstract

目的：探讨三倍体发生率与不同卵巢刺激方案体外受精-胚胎移植(IVF-ET)周期的临床结局的关系，胚胎采自同一队列的正常受精卵。方法：这个研究包括从2013年1月到2014年9月，2070个长期方案体外受精（IVF）周期,802个超短期方案IVF周期和508个长期方案供精者体外受精（IVF-D）周期。根据不同的3PN率，患者分为如下三组：1组患者0%3PN受精卵，2组患者1–25%3PN受精卵，3组425%3PN受精卵。主要观察指标：女性年龄，获卵数，正常受精卵率、D3天I + II级胚胎率、D3天I + II + III级胚胎率、着床率、妊娠率和早期流产率。

结果：长期方案的IVF和IVF-D周期三倍体周期发生率显著比超短期方案IVF周期高(p50.001)。三组之间三倍体受精卵率无明显差异(p40.05)。三种方案中，3PN1⁄40% 组和3PN1⁄41–25%组正常受精卵率比3PN425% 组明显高 (p50.001)。在长期方案的IVF周期中3PN425%组的D3天I + II级胚胎率、着床率，妊娠率比其他两组显著低(p50.05)。D3天I + II + III级胚胎率、早期流产率三组之间无明显差异(p40.05)。在超短期方案中，D3天I + II级胚胎率，D3天I + II + III级胚胎率，着床率、妊娠率和早期流产率无明显差异(p40.05)。在长期方案IVF-D周期中，3PN425% 组的D3天I + II级胚胎率、D3天I + II + III级胚胎率、着床率较其他两组明显低(p50.05)，妊娠率和早期流产率三组间无明显差异(p40.05)。

结论：我们发现高比例的三倍体受精卵对长期方案的IVF-ET周期的临床结局产生负效应。

• Clinical outcomes
• IVF
• triploidy

Declaration of interest

The authors report no conflicts of interest.