Akademik Veri Yönetim Sistemi
11. TSRM Üreme Sağlığı ve İnfertilite Kongresi, Antalya, Türkiye, 16 - 19 Kasım 2023, ss.1-2, (Özet Bildiri)
OBJECTIVE: Recurrent pregnancy loss (RPL) is one of the most common reproductive problems among women who applied for ART treatment. Studies investigating the embryo morphokinetics in RPL patients are limited in the literature. Thus, in this study, we aimed to compare embryo related factors such as morphokinetics, morphology and euploid embryo frequency between RPL and unexplained infertility (UEI) groups.
MATERIALS-METHODS: A hundred and ninety RPL, 90 UEI patients with normozoospermic partners and 1704 embryos (RPL:1169, UEI:535) that were incubated in Time-Lapse Monitoring System (TLM) were included into the study. Patients with >38 years of age, endometrial factor (<7mm) and severe male factor were excluded from the study. RPL patients had a history of ≥3 pregnancy losses. Gardner’s classification was used for embryo grading. Embryos were grouped as following; Top Quality (TQ): Hatched AA, 6AA, 5AA, 4AA, Good Quality (GQ): Hatched AB/BA/BB, 5AB/BA/BB, 4AB/BA/BB, 3AA, Moderate Quality (MQ): 3AB/BA, 2AA. Next Generation Sequencing (NGS) method was used for PGT-A analysis. Morphokinetic parameters were compared using Student’s t-test and Anova. Categorical parameters were compared with Chi-square.
RESULTS: Demographic and clinical characteristics of the study groups were similar in terms of age, AMH, basal FSH, duration of ovarian stimulation, total and mature oocytes, 2PN, blastulation. The frequency of euploid embryos was significantly lower in RPL patients than UEI group (43.5% vs 52.3%, respectively (p=0.018)). The statistical significance was more pronounced when BMI was <25, (RPL-euploid: 40.9%, UEI-euploid: 56.2%, p=0.001). Embryo morphology was similar between two groups (RPL-TQ: 47.6%, UEI-TQ:48.2%, p>0.05). The occurence of direct cleavage and separate blastomere in the blastocysts was found to be similar in each group. Regarding embryo morphokinetics, euploid embryos reached to morula after starting compaction (tSC-tM) faster in RPL patients than in UEI patients (9.3±4.8 vs 17.0±25.5 respectively (p<0.001)).
CONCLUSIONS: In this retrospective study, aneuploidy prevalance was higher in RPL patients than UEI patients when advanced maternal age and severe male factor were excluded. Embryo morphology, frequencies of direct cleavage and separate blastomere in the blastocysts were similar in study groups. Euploid embryos showed faster development to morula stage in RPL than UEI patients. Since the aneuploidy is found one of the main causes of RPL patients, it may be useful to offer PGD-A to RPL patients whose endometrial factors are excluded. Our results should be confirmed with further studies.