Extended embryo culture in natural and modified cycles in assisted reproductive technology programs
DOI:
https://doi.org/10.37800/RM.3.2022.76-86Keywords:
assisted reproductive technologies (ART), natural cycle (NC), modified natural cycle (mNC), cleavage-stage, blastocyst-stage, extended cultivation, embryo transferAbstract
Relevance: About 20% of women undergoing assisted reproductive technology art (ART) programs encounter low responses following ovarian stimulation. One of the effective medical strategies for “poor” responders is to conduct IVF / ICSI programs in a natural or modified natural cycle. The application of extended embryo culture improved embryo selection, increased ART programs’ effectiveness, and reduced the number of embryos per transfer. But in the case of “poor” responders, the additional embryo selection by applying extended embryo culture may not be effective.
The study aimed to compare the effectiveness of ART programs with embryo transfer on the third or fifth day of development in natural and modified natural cycles.
Methods: This study included natural or modified natural IVF/ICSI cycles conducted in 2013-2019 at the Institute of Reproductive Medicine (Almaty, Kazakhstan). The patients who underwent natural or modified natural IVF/ICSI cycles were divided into two groups: group A (185 cycles), with embryo transfer on Day 3 of development, and group B (171 cycles), with extended embryo culture and embryo transfer on Day 5.
Results: The clinical pregnancy rate and implantation rate were significantly increased in group B (Day 5 embryo transfer) compared to group A (Day 3 embryo transfer): 25,7 and 22,1% vs. 15,14 and 12,72%, respectively (р<0,05). The ongoing pregnancy rate was significantly higher in group B: 21,9 vs. 8,1% (р<0,001). The miscarriage rate was higher in group A: 44,8 vs.14,3% (р<0,001). The live birth rate was significantly lower in group A: 8.11 vs. 21.9% (р<0,001).
Conclusion: Our study showed that blastocyst transfers are more effective in natural and modified natural cycles than cleavage-stage embryo transfers, even in the case of “poor” responders.
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