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2 . 2024

The essential parallels between clinical practice and embryological features of early embryo developmental arrest

Abstract

Aim of the study - to determine the relationship between the anamnestic and clinical and laboratory characteristics of patients with embryo developmental arrest at different stages of cultivation.

Material and methods. A retrospective clinical study was conducted with the participation of 95 patients aged 32 to 41 years, who had from 3 to 11 mature oocytes and from 1 to 10 zygotes and no embryos appropriate for transfer in at least 2 IVF attempts. The first group consisted of 30 patients whose embryo developmental block occurred on the 2-3rd day of cultivation. The second group included 65 women whose embryos stopped to develop after 4 days of cultivation, or blastocysts were not appropriate for transfer.

Results. The analysis has demonstrated that early embryo development disorder is typical for women with gonadotoxic effects, such as polychemotherapy (PCT) (13.3% vs 0), HIV infection, hepatitis C and treatment of these infections (16.7 vs 1.5%), whereas violation of embryo fragmentation at later stages and formation of blastocysts of poor quality are more common in patients with a history of factors related to the category of epigenetic effects - obesity (20.0 vs 43.1%), autoimmune and inflammatory diseases: autoimmune thyroiditis -10.0 vs 30.8%; allergic reactions - 10.0 vs 32.3%; frequent diseases of bacterial and viral etiology - 6.7 vs 24.6%, chronic inflammatory diseases of pelvic organs - 6.7 vs 27.7%. In addition, with early "arrest" of embryo development, external genital endometriosis was more often diagnosed - 16.7 vs 3.1%. Also, among the causes of infertility identified among the patients of the study groups, the only difference was unexplained infertility, the proportion of which in patients with early embryo development disorders was 7/30=23.3%, and in women with late-stage embryo development disorders - 5/65=7.7% (p=0.047). At the same time, a genetic examination of patients of both groups showed that among patients with early "arrest" of embryo development, fragility of the X chromosome was detected in 2 (6.7%) women.

Conclusion. The establishment of the day of embryo development arrest may be an important fact associated with the anamnestic, clinical and laboratory characteristics of patients, the genesis of infertility. This knowledge might help in modification of the transfer day and, ultimately, may increase the frequency of pregnancy.

Keywords: IVF; assisted reproductive technologies; embryo development arrest; infertility

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Searching and analysis of the literature data, analysis of all materials of the study, writing the text of the manuscript - Pogosyan M.T.; concept development, editing and final approval of the manuscript - Nazarenko T.A.; searching and analysis of the literature data - Kadaeva A.I.

Patients' consent. All patients signed an informed consent form for publication of their data.

Ethics approval. The study was approved by the Ethical Committee of National Medical Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation.

Sharing of research data. Data of the research is available and can be shared by the authors after confirmation.

For citation: Pogosyan M.T., Nazarenko T.A., Kadaeva A.I. The essential parallels between clinical practice and embryological features of early embryo developmental arrest. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2024; 12 (2): 14-20. DOI: https://doi.org/10.33029/2303-9698-2024-12-2-14-20 (in Russian)

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Institute in the Russian People?s Friendship University named after P. Lumumbа

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