IVF hastalarında, 3. gün erken kompakt olan/olmayan embriyoların 3. veya 5. gün transferleri ile gebelik ve canlı doğum oranlarının karşılaştırılması
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi, Lisansüstü Eğitim Enstitüsü
Erişim Hakkı
Attribution-NonCommercial-NoDerivs 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Embriyoların erken kompaktlaşması ile ilgili literatür henüz sınırlıdır. Çalışmamızda 3.gün erken kompaktlaşmanın transfer günlerine (3.gün ve 5.gün) göre gebelik ve canlı doğum oranlarına etkisi incelendi. Böylelikle erken kompaktlaşmanın implantasyondan sonra gebeliğin sağlıklı bir şekilde devamlılığına katkı sağlayıp sağlamadığı sorusuna yanıt aradık bunun yanı sıra morfolojik skorlama yöntemlerine bir ek kriter olup olamayacağını araştırdık. Yöntem-Gereçler: Toplam 400 hastanın transfer edilen 776 embriyosunu değerlendirmeye aldık. Veriler, 01.03.2012-01.03.2019 tarihleri arasında Altunizade Acıbadem Hastanesi Tüp Bebek ve Üreme Sağlığı Merkezine başvurmuş çiftlerin tedavi dosyalarından retrospektif olarak derlendi. 40 yaşından küçük, en az 3 oosit toplanabilmiş, kadın faktörü (female factor) ya da açıklanamayan infertilite (unexplained infertility) tanısı almış olgular çalışmamıza dahil edildi. Bulgular: Olguların yaş, BMI ve uygulanan kontrollü ovaryen stimülasyon protokolünün (antagonist protokol) aynı olmasına karşın, 3.gün erken kompaktlaşan embriyo transfer edilen Deney grubunda; toplanan oosit sayıları, MII oosit sayıları ve fertilizasyon oranları istatistiksel olarak anlamlı oranda yüksek olduğu görüldü (p<0.05). Gebelik oranlarının karşılaştırılmasında 3.gün transfer sonuçlarında Deney grubunun anlamlı oranda yüksek olduğu saptandı (p=0.042). Doğum oranlarına bakıldığında ise genel olarak Deney grubu yüksektir ve 3.gün transferinde fark anlamlı vi düzeydedir (p= 0.026). Transfer edilen embriyoların ikisi de 3.gün erken kompaktlaşan embriyolardan oluştuğunda; istatistiksel olarak anlamlı olmamakla birlikte hem deney hem de kontrol gruplarında görece daha yüksek gebelik ve canlı doğum oranları saptandı. Sonuç: 3.gün embriyo transferinde; hasta en az bir erken kompaktlaşan embriyoya sahip ise (Deney grubu) gebelik (p=0.042) ve canlı doğum (p=0.026) için tercih edilebilir olduğu görüldü. 5.gün embriyo transferinde ise sadece 3.gün erken kompaktlaşan ve 5.gün blastosist olan embriyo hastaya transfer edilirse bulgularımıza göre, canlı doğum oranı Deney (%30.0) ve Kontrol (%23.7) gruplarından görece daha yüksektir. Ancak istatistiksel olarak anlamlı değildir (p=0.635). Dikkat çekici bir şekilde 5.gün embriyo transferinde Kontrol grubunun gebelik oranı (%79.3) Deney grubunun gebelik oranından (%77.3) yüksek olmasına rağmen canlı doğum oranlarında tam tersi olarak Deney grubunun (%30.0), Kontrol grubundan (%23.7) çok daha yüksek olduğu saptandı. Bu durum 3.gün erken kompaktlaşan embriyoya sahip olmayan transfer grubunda gebelik kayıplarının yüksek olduğunu düşündürmekte olup, bu konuda çalışmaya gereksinim olduğunu göstermektedir.
Aim: The literature on the early compacting of embryos is still very limited. In this study, the effect of early compacting on the 3rd day of pregnancy and live birth rates according to the transfer days (3rd and 5th days) is examined. Thus, an answer to the question of whether early compacting contributes to a healthy transformation of pregnancy after implantation was sought, and whether it could be an additional criterion for morphological scoring methods were investigated. Methods-Materials: 776 embryos transferred from 400 patients were evaluated. The data were retrospectively compiled from treatment files of couples who applied to Altunizade Acıbadem Hospital IVF and Reproductive Health Center between 01.03.2012-01.03.2019. At least 3 oocytes were collected, cases younger than 40 and diagnosed with a female factor or unexplained infertility were included in the study. Results: Although the age, BMI, and the controlled ovarian stimulation protocol (antagonist protocol) of the cases were the same, in the Experimental group where the embryo that had compacted early on the 3rd day was transferred; It was observed that the collected oocyte count, MII oocyte count, and fertilization were statistically significantly higher (p <0.05). In the comparison of pregnancy rates, it was found that the experimental group was significantly higher in the transfer results on the 3rd day (p = 0.042). When the birth rates are considered, the experimental group is generally high and the difference is significant on the 3rd-day transfer (p = 0.026). When both of the viii transferred embryos consist of early compacted embryos on the 3rd day; Although it was not statistically significant, relatively higher pregnancy and live birth rates were found in both experimental and control groups. Conclusion: On the 3rd-day embryo transfer; If the patient has at least one early compacted embryo (Experimental group), it was found to be preferable for pregnancy (p = 0.042) and live birth (p = 0.026). In the 5th-day embryo transfer, if only the embryo that compacts early on the 3rd day and has blastocyst on the 5th day is transferred to the patient, the live birth rate is relatively higher than the Experiment (30.0%) and Control (23.7%) groups. However, it is not statistically significant (p = 0.635). Remarkably, on the 5th-day embryo transfer, the pregnancy rate of the control group (79.3%) was higher than the pregnancy rate of the experimental group (77.3%). 23.7%) was found to be much higher. This case suggests that pregnancy losses are high in the transfer group that does not have early compacted embryos on the 3rd day and shows that there is a need for further studies on this subject.
Aim: The literature on the early compacting of embryos is still very limited. In this study, the effect of early compacting on the 3rd day of pregnancy and live birth rates according to the transfer days (3rd and 5th days) is examined. Thus, an answer to the question of whether early compacting contributes to a healthy transformation of pregnancy after implantation was sought, and whether it could be an additional criterion for morphological scoring methods were investigated. Methods-Materials: 776 embryos transferred from 400 patients were evaluated. The data were retrospectively compiled from treatment files of couples who applied to Altunizade Acıbadem Hospital IVF and Reproductive Health Center between 01.03.2012-01.03.2019. At least 3 oocytes were collected, cases younger than 40 and diagnosed with a female factor or unexplained infertility were included in the study. Results: Although the age, BMI, and the controlled ovarian stimulation protocol (antagonist protocol) of the cases were the same, in the Experimental group where the embryo that had compacted early on the 3rd day was transferred; It was observed that the collected oocyte count, MII oocyte count, and fertilization were statistically significantly higher (p <0.05). In the comparison of pregnancy rates, it was found that the experimental group was significantly higher in the transfer results on the 3rd day (p = 0.042). When the birth rates are considered, the experimental group is generally high and the difference is significant on the 3rd-day transfer (p = 0.026). When both of the viii transferred embryos consist of early compacted embryos on the 3rd day; Although it was not statistically significant, relatively higher pregnancy and live birth rates were found in both experimental and control groups. Conclusion: On the 3rd-day embryo transfer; If the patient has at least one early compacted embryo (Experimental group), it was found to be preferable for pregnancy (p = 0.042) and live birth (p = 0.026). In the 5th-day embryo transfer, if only the embryo that compacts early on the 3rd day and has blastocyst on the 5th day is transferred to the patient, the live birth rate is relatively higher than the Experiment (30.0%) and Control (23.7%) groups. However, it is not statistically significant (p = 0.635). Remarkably, on the 5th-day embryo transfer, the pregnancy rate of the control group (79.3%) was higher than the pregnancy rate of the experimental group (77.3%). 23.7%) was found to be much higher. This case suggests that pregnancy losses are high in the transfer group that does not have early compacted embryos on the 3rd day and shows that there is a need for further studies on this subject.
Açıklama
Anahtar Kelimeler
Erken kompakt, 3. gün embriyo, Kompaktlaşma, Embriyonik seçim, Gebelik, Canlı doğum, Early compaction, 3. day embryo, Compaction, Embryonic selection, Pregnancy, Live birth
Kaynak
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Scopus Q Değeri
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Sayı
Künye
Aslan Öztürk, S. (2021). IVF hastalarında, 3. gün erken kompakt olan/olmayan embriyoların 3. veya 5. gün transferleri ile gebelik ve canlı doğum oranlarının karşılaştırılması / Camparison of 3rd day early compact/con-compact embryos' 3rd of 5th day transfers with pregnancy and live birth rates IVF patients (Yayımlanmamış Yüksek Lisans Tezi). Maltepe Üniversitesi, Lisansüstü Eğitim Enstitüsü, İstanbul.
