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

• Mariam T. Pogosyan
• Nazarenko T.A.
• Albina I. Kadaeva

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 2-3^rd 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

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