Nisar Omar Hafizi Ezanaton, Abdul Rahim Rahimah, Mohamad Zon Erinna, Ibrahim Adibah
Department of Obstetrics and Gynecology, Hospital Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia.
Department of Obstetrics and Gynecology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Int J Reprod Biomed. 2022 Aug 8;20(7):581-590. doi: 10.18502/ijrm.v20i7.11560. eCollection 2022 Jul.
Declining fertility in a woman of advanced age is associated with a depletion in ovarian reserve as well as declining oocyte and embryo quality. Determining the predictors of embryo quality may assist in stimulation target and cycle prediction.
This study aims to identify factors affecting embryo quality among women of advanced age receiving intracytoplasmic sperm injection (ICSI) cycles.
This prospective cohort study was conducted over a period of 12 months, from January until December 2018, on 734 mature oocytes retrieved from 124 women of advanced age (35-45 yr old) receiving ICSI. The Society of Assisted Reproductive Techniques system was used to determine the morphological grading of embryo quality. The fertilization rate, cleavage rate, and pregnancy rate per cycle were expressed as a percentage per cycle for a total of 76 embryo transfers. Possible predictors of high-quality embryos were evaluated using single and multiple regression tests, with p 0.05 considered as significant.
Out of the 586 available embryos, 288 (49.15%) high-quality embryos were obtained. The fertilization and cleavage rates were 86.18% and 97.83%, respectively. The total number of retrieved oocytes (R = 0.857) and the total available embryos (R = 0.857) were closely related to high-quality embryos. 76 embryo transfers were conducted, with 17 successful conceptions (implantation rate = 22.37% per transfer). There were no miscarriages among the pregnancies.
Increasing the number of collected oocytes and the cleavage rate could increase the chance of obtaining more high-grade embryos. This could increase the success of ICSI among women of advanced age.
高龄女性生育力下降与卵巢储备减少以及卵母细胞和胚胎质量下降有关。确定胚胎质量的预测因素可能有助于辅助生殖的目标设定和周期预测。
本研究旨在确定接受卵胞浆内单精子注射（ICSI）周期的高龄女性中影响胚胎质量的因素。
本前瞻性队列研究于2018年1月至12月进行，为期12个月，对124名接受ICSI的高龄女性（35 - 45岁）获取的734个成熟卵母细胞进行研究。采用辅助生殖技术协会系统确定胚胎质量的形态学分级。每个周期的受精率、卵裂率和妊娠率以每个周期的百分比表示，共进行了76次胚胎移植。使用单因素和多因素回归检验评估优质胚胎的可能预测因素，p<0.05被认为具有统计学意义。
在586个可用胚胎中，获得了288个（49.15%）优质胚胎。受精率和卵裂率分别为86.18%和97.83%。回收的卵母细胞总数（R = 0.857）和可用胚胎总数（R = 0.857）与优质胚胎密切相关。进行了76次胚胎移植，其中17次成功受孕（每次移植的着床率 = 22.37%）。妊娠期间没有发生流产。
增加收集的卵母细胞数量和卵裂率可以增加获得更多优质胚胎的机会。这可以提高高龄女性ICSI的成功率。
