Complete embryo developmental arrest and its prognostic significance in in vitro fertilization

Area of Science:

• Reproductive Medicine
• Embryology
• In Vitro Fertilization (IVF)

Background:

• Complete embryo developmental arrest (EDA) in an in vitro fertilization (IVF) cycle presents a significant challenge.
• Understanding the recurrence risk and impact of prior EDA on subsequent IVF cycles is crucial for patient counseling and treatment planning.

Purpose of the Study:

• To determine the rate of recurrent embryo developmental arrest (EDA) in a subsequent IVF cycle.
• To assess the impact of a prior complete EDA on IVF cycle outcomes, including blastulation and euploidy rates.

Main Methods:

• A retrospective cohort study design was employed, matching patients with complete EDA in their index cycle to controls.
• Propensity score matching (1:2 ratio) was used to balance baseline characteristics between groups.
• Multivariable log-binomial regression models were utilized to analyze the association between prior complete EDA and subsequent IVF cycle outcomes.

Main Results:

• Patients with a history of complete EDA showed significantly lower fertilization rates (aRR: 0.94) and blastulation rates (aRR: 0.75) in the subsequent cycle.
• A history of complete EDA was independently associated with a higher risk of no blastulation (aRR: 1.82).
• Euploidy rates per cryopreserved blastocyst were not significantly affected by prior EDA history.

Conclusions:

• Complete EDA in an IVF cycle is a significant predictor of diminished success in subsequent cycles.
• Modifications to stimulation protocols or trigger types did not demonstrate improved blastulation rates for patients with a history of complete EDA.