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Expanding the time interval between ovulation triggering and oocyte injection: does it affect the embryological and
L T M Vandenberghe1, S Santos-Ribeiro2, N De Munck3
1Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Centre for Reproductive Medicine, Brussels, Belgium.
Human Reproduction (Oxford, England)
|December 28, 2020
Summary
The time interval between triggering ovulation and oocyte injection does not significantly impact embryological or clinical outcomes in intracytoplasmic sperm injection (ICSI) cycles. This finding offers flexibility for busy fertility clinics regarding precise timing.
Area of Science:
- Reproductive Endocrinology and Infertility
- Assisted Reproductive Technologies (ART)
- Embryology and Clinical Outcomes
Background:
- The precise timing between ovulation triggering and oocyte insemination is considered crucial for successful outcomes in intracytoplasmic sperm injection (ICSI).
- Established optimal intervals (38-39 hours) and concerns regarding longer intervals (>41 hours) exist, but adherence can be challenging in high-volume fertility centers.
Purpose of the Study:
- To investigate the association between the time interval from ovulation triggering to oocyte denudation/injection and embryological and clinical outcomes in ICSI cycles.
- To determine if extending this time interval impacts key performance indicators in assisted reproduction.
Main Methods:
- A retrospective cohort analysis of 8811 ICSI cycles conducted between 2010 and 2015.
- Cycles were categorized into seven groups based on the time interval (<36h, 36h, 37h, 38h, 39h, 40h, ≥41h) between ovulation triggering and oocyte injection.
- Primary outcomes included oocyte maturation, fertilization, and embryo utilization rates; secondary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR).
Main Results:
- While significant differences in adjusted mean maturation (76.4%-83.2%) and fertilization rates (69.2%-79.3%) were observed across interval groups, no significant effect on CPR or LBR was found after adjusting for confounders.
- Oocyte denudation/injection at <36 hours or ≥41 hours did not significantly impact maturation, fertilization, or embryo utilization rates compared to the 38-hour reference group.
- A trend towards lower live birth rates was observed for injections <36 hours, but this was not statistically significant (OR 0.533, P=0.099).
Conclusions:
- The time interval between ovulation triggering and oocyte injection in ICSI cycles may be less stringent than previously believed.
- Embryological and clinical outcomes were not significantly affected by variations in this time interval in the studied population.
- These findings are reassuring for busy ART centers, suggesting greater flexibility in scheduling procedures without compromising success rates.
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