The Effect of Follicle Size and Homogeneity of Follicular Development on the Morphokinetics of Human Embryos

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2017 May 5

PMID 28470453

Citations 9

Authors

Semra Kahraman

Caroline Pirkevi Cetinkaya

Murat Cetinkaya

Hakan Yelke

Yesim Kumtepe Colakoglu

Melih Aygun

Markus Montag

Affiliations

Soon will be listed here.

Abstract

Purpose: Our aim was to investigate follicular size (large, ≥17 mm and small, <17 mm) at the time of OPU and homogeneity of follicular development (homogenous development: follicles being present in a homogenous spread of all sizes; heterogeneous: a predominance of small and large follicles) by analysing the morphokinetics of embryo development.

Methods: In this prospective cohort study, 2526 COCs belonging to 187 patients were cultured to day 5. Embryos were evaluated morphokinetically. Four subgroups were defined: large follicles from heterogeneous cycles (LHet) and homogenous cycles (LHom) and small follicles from heterogeneous cycles (SHet) and homogenous cycles (SHom).

Results: Rates of fertilization, blastocyst formation and top and good quality blastocysts were found to be significantly higher in embryos from the LHom group (p < 0.001; p < 0.001; p < 0.001). Small follicles from both homogenous and heterogeneous cycles had significantly lower blastocyst formation and top and good quality blastocyst rates (p < 0.001; p < 0.001). Embryos from SHet had significantly more direct cleavages (p = 0.011). Time to reach blastocyst was shorter in SHom than LHet and LHom (p = 0.002; p = 0.027, respectively). However, once the blastocyst stage was achieved, implantation rates were not significantly different between subgroups, the highest rate being observed in the LHom group. Multivariable analysis revealed that homogeneity of follicular development and follicular size had a significant effect on blastocyst development and quality (p = 0.049; p < 0.001, respectively).

Conclusion: Follicular dynamics, illustrated by follicular size and homogeneity of follicular development, influence early human embryo development. Patterns of follicular growth have an impact on embryo quality and viability which is reflected in morphokinetic variables.

Citing Articles

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Wang Y, Pang C, Wu H, Wei C, Yu Y, Xin X BMC Pregnancy Childbirth. 2023; 23(1):64.

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References

Latham K . Endoplasmic reticulum stress signaling in mammalian oocytes and embryos: life in balance. Int Rev Cell Mol Biol. 2015; 316:227-65. PMC: 4617547. DOI: 10.1016/bs.ircmb.2015.01.005. View

Landau G, Kodali V, Malhotra J, Kaufman R . Detection of oxidative damage in response to protein misfolding in the endoplasmic reticulum. Methods Enzymol. 2013; 526:231-50. DOI: 10.1016/B978-0-12-405883-5.00014-4. View

Lemmen J, Agerholm I, Ziebe S . Kinetic markers of human embryo quality using time-lapse recordings of IVF/ICSI-fertilized oocytes. Reprod Biomed Online. 2008; 17(3):385-91. DOI: 10.1016/s1472-6483(10)60222-2. View

Depalo R, Lorusso F, Palmisano M, Bassi E, Totaro I, Vacca M . Follicular growth and oocyte maturation in GnRH agonist and antagonist protocols for in vitro fertilisation and embryo transfer. Gynecol Endocrinol. 2009; 25(5):328-34. DOI: 10.1080/09513590802617762. View

Van Blerkom J . Mitochondrial function in the human oocyte and embryo and their role in developmental competence. Mitochondrion. 2010; 11(5):797-813. DOI: 10.1016/j.mito.2010.09.012. View

Opsahl M, Blauer K, BLACK S, Lincoln S, Thorsell L, Sherins R . The number of embryos available for transfer predicts successful pregnancy outcome in women over 39 years with normal ovarian hormonal reserve testing. J Assist Reprod Genet. 2001; 18(10):551-6. PMC: 3455314. DOI: 10.1023/a:1011906024170. View

Kirkegaard K, Hindkjaer J, Ingerslev H . Effect of oxygen concentration on human embryo development evaluated by time-lapse monitoring. Fertil Steril. 2012; 99(3):738-744.e4. DOI: 10.1016/j.fertnstert.2012.11.028. View

Lee T, Lee R, Hwu Y, Chih Y, Tsai Y, Su J . Relationship of follicular size to the development of intracytoplasmic sperm injection-derived human embryos. Taiwan J Obstet Gynecol. 2010; 49(3):302-5. DOI: 10.1016/S1028-4559(10)60065-4. View

Ectors F, Vanderzwalmen P, Van Hoeck J, Nijs M, Verhaegen G, Delvigne A . Relationship of human follicular diameter with oocyte fertilization and development after in-vitro fertilization or intracytoplasmic sperm injection. Hum Reprod. 1997; 12(9):2002-5. DOI: 10.1093/humrep/12.9.2002. View

10.

Devreker F, Pogonici E, De Maertelaer V, Revelard P, Van den Bergh M, Englert Y . Selection of good embryos for transfer depends on embryo cohort size: implications for the 'mild ovarian stimulation' debate. Hum Reprod. 1999; 14(12):3002-8. DOI: 10.1093/humrep/14.12.3002. View

11.

Leese H . Quiet please, do not disturb: a hypothesis of embryo metabolism and viability. Bioessays. 2002; 24(9):845-9. DOI: 10.1002/bies.10137. View

12.

Cruz M, Garrido N, Gadea B, Munoz M, Perez-Cano I, Meseguer M . Oocyte insemination techniques are related to alterations of embryo developmental timing in an oocyte donation model. Reprod Biomed Online. 2013; 27(4):367-75. DOI: 10.1016/j.rbmo.2013.06.017. View

13.

Rosen M, Shen S, Dobson A, Rinaudo P, McCulloch C, Cedars M . A quantitative assessment of follicle size on oocyte developmental competence. Fertil Steril. 2008; 90(3):684-90. PMC: 4624406. DOI: 10.1016/j.fertnstert.2007.02.011. View

14.

Salha O, Nugent D, Dada T, Kaufmann S, Levett S, Jenner L . The relationship between follicular fluid aspirate volume and oocyte maturity in in-vitro fertilization cycles. Hum Reprod. 1998; 13(7):1901-6. DOI: 10.1093/humrep/13.7.1901. View

15.

Wissing M, Bjerge M, Olesen A, Hoest T, Mikkelsen A . Impact of PCOS on early embryo cleavage kinetics. Reprod Biomed Online. 2014; 28(4):508-14. DOI: 10.1016/j.rbmo.2013.11.017. View

16.

Sanchez F, Romero S, De Vos M, Verheyen G, Smitz J . Human cumulus-enclosed germinal vesicle oocytes from early antral follicles reveal heterogeneous cellular and molecular features associated with in vitro maturation capacity. Hum Reprod. 2015; 30(6):1396-409. DOI: 10.1093/humrep/dev083. View

17.

Mehri S, Levi Setti P, Greco K, Sakkas D, Martinez G, Patrizio P . Correlation between follicular diameters and flushing versus no flushing on oocyte maturity, fertilization rate and embryo quality. J Assist Reprod Genet. 2013; 31(1):73-7. PMC: 3909131. DOI: 10.1007/s10815-013-0124-9. View

18.

Nagai S, Mabuchi T, Hirata S, Shoda T, Kasai T, Yokota S . Correlation of abnormal mitochondrial distribution in mouse oocytes with reduced developmental competence. Tohoku J Exp Med. 2006; 210(2):137-44. DOI: 10.1620/tjem.210.137. View

19.

Bellver J, Mifsud A, Grau N, Privitera L, Meseguer M . Similar morphokinetic patterns in embryos derived from obese and normoweight infertile women: a time-lapse study. Hum Reprod. 2013; 28(3):794-800. DOI: 10.1093/humrep/des438. View

20.

Nivet A, Leveille M, Leader A, Sirard M . Transcriptional characteristics of different sized follicles in relation to embryo transferability: potential role of hepatocyte growth factor signalling. Mol Hum Reprod. 2016; 22(7):475-84. PMC: 4941807. DOI: 10.1093/molehr/gaw029. View