- Email: [email protected]
Blastocyst formation: 16 year review of IVF and ICSI cycles
the categories (P¼0.363). Out of the total number of blastocysts reached, 40.5% of them were good quality blastocysts which was comparable between groups (P¼0.825). CONCLUSION: Meiotic spindle position is not associated with blastocyst developmental competence of in vitro matured metaphase I oocytes from controlled ovarian hyperstimulation cycles.
Year
Cycles
Day 5 Blast
Day 6 Blast
Total Blast
1998-2000
392
50.8%
7.8%
58.6%
2001-2003 2004-2006 2007-2009 2010-2013
448 408 322 286
50.0% 56.8% 55.1% 64.7%
14.6% 9.9% 12.8% 8.5%
64.6% 66.7% 67.9% 73.1%
Total ICSI
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
677 638 744 685 892
42.9% 40.4% 54.3% 49.4% 52.4%
7.1% 13.4% 9.4% 12.5% 6.9%
50.1% 53.8% 63.8% 61.9% 62.0%
IVF <35
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
217 249 222 188 132
52.5% 54.0% 60.3% 60.8% 66.9%
8.5% 14.8% 10.1% 13.0% 8.2%
61.0% 68.7% 70.5% 73.8% 75.1%
ICSI <35
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
400 347 385 357 402
44.8% 43.6% 59.3% 52.9% 55.0%
8.1% 15.0% 9.4% 13.2% 10.3%
52.9% 58.6% 68.8% 66.1% 65.3%
IVF 35-37
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
95 98 99 71 69
51.0% 46.9% 58.8% 47.0% 72.4%
6.3% 15.8% 10.8% 12.8% 8.6%
57.3% 62.7% 69.5% 59.8% 81.0%
IVF 35-37
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
149 111 178 146 182
41.1% 39.8% 49.4% 48.7% 51.5%
5.9% 15.3% 11.5% 12.3% 9.2%
47.0% 55.1% 60.9% 60.9% 60.7%
IVF 38-40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
64 74 52 39 53
47.3% 41.0% 48.5% 48.2% 51.5%
8.5% 12.3% 10.6% 12.3% 9.0%
55.8% 53.3% 59.0% 60.6% 60.5%
ICSI 38-40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
92 118 111 105 167
38.7% 33.1% 50.0% 41.6% 47.7%
5.3% 8.9% 6.2% 11.9% 7.9%
44.0% 42.0% 56.2% 53.5% 55.6%
IVF >40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
15 27 35 24 27
33.3% 39.6% 27.9% 34.9% 56.4%
4.3% 12.2% 4.6% 11.9% 9.2%
37.7% 51.8% 72.1% 46.8% 65.6%
ICSI >40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
36 62 70 77 142
34.8% 30.0% 28.1% 32.4% 44.2%
3.5% 5.2% 6.8% 7.4% 8.2%
38.4% 35.3% 34.8% 39.8% 52.3%
IVF Donor
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
97 79 54 37 22
60.1% 59.0% 55.6% 66.7% 79.4%
7.3% 12.9% 13.1% 14.1% 6.9%
67.4% 71.9% 68.7% 80.7% 86.3%
ICSI Donor
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
80 70 63 54 67
56.3% 56.2% 51.1% 59.1% 71.8%
8.7% 12.1% 13.0% 14.3% 7.8%
64.9% 68.3% 64.1% 73.5% 79.6%
Total IVF
P-624 Wednesday, October 22, 2014 EMBRYO DEVELOPMENTAL POTENTIAL OF IN VITRO MATURED MI FROM STIMULATION CYCLES DEPENDS ON THE TIMING OF NUCLEAR MATURATION RATHER THAN THE LENGTH OF MII ARREST. J. H. Moon, E. Garcia-Cerrudo, S. Henderson, A. Mahfoudh, H. Holzer, W.-Y. Son. Obstetrics and Gynecology Mcgill Universtiy, MUHC Reproductive Centre, Montreal, QC, Canada. OBJECTIVE: The reduced potential of IVM oocytes has been attributed to a lack of synchrony between nuclear maturation and a loss or excess of cytoplasmic maturation. However, there is no direct evidence to describe the duration of MII arrest in order for the meiotic spindle to function normally without negatively effecting of the oocyte’s potential. The objective is to know what is more important between the timing of the first polar body (1PB) extrusion (nuclear maturation; NM) and duration of MII arrest to rescue the developmental potential of in vitro matured (IVM) human oocytes of stimulated cycles? DESIGN: This is a retrospective study of patients who had metaphase I (MI) oocytes at retrieval at the MUHC Reproductive Center between January and December 2013 (n ¼ 30 cycles). MATERIALS AND METHODS: MI oocytes were divided into two IVM MI groups according to the different timing of NM (1PB extrusion) and ICSI was performed after different durations of MII arrest. The embryo developments were compared between the two groups. The spindle of the oocytes was examined using the Polscope TM. RESULTS: Group I in which 45 out of 109 MI oocytes became MII after 1 4 h of in vitro culture. Culture was extended for ICSI until next morning because spindle in early telophase I was observed by the Polscope. Group II where 53 IVM MI oocytes became MII during overnight culture and were inseminated by ICS next morning. The rates of fertilization and blastocyst formation in Group I were 84.4 and 36.8% which are not significantly different with those in Group II which were 75.5 and 22.5% respectively. However, the freezable good quality blastocyst rate in Group I was significantly higher than that in Group II (18.4 vs. 2.5 %). CONCLUSION: Freezable good quality blastocyst is significantly higher in early NM groups with longer MII arrest than that of late NM with shorter MII arrest. This suggests that the success of IVM depends on the NM timing rather than the duration MII. Therefore if it is necessary to increase the number of available embryos for transfer using IVM MI, the optimal timing of ICSI for them may be the next morning.
P-625 Wednesday, October 22, 2014 BLASTOCYST FORMATION: 16 YEAR REVIEW OF IVF AND ICSI CYCLES. M. Langley, K. Doody, K. Doody. Center for Assisted Reproduction, Bedford, TX. OBJECTIVE: To evaluate day 5, day 6 and total blastocyst formation rates in IVF and ICSI cycles occurring over a 16 year period. DESIGN: A retrospective analysis of blastocyst formation from 6115 cycles beginning January 1, 1998 through December 31, 2013. MATERIALS AND METHODS: Embryos were cultured in Vitrolife (1998 to 2008), Sage (2008 to 2011) sequential media and Irvine continuous culture media (2012 to 2013). Extended culture was implemented in all patients undergoing IVF. RESULTS: Rates of Blastocyst Formation.
FERTILITY & STERILITYÒ
e343
CONCLUSION: This data suggest, although rates of blastocyst formation are reduced with advanced reproductive age, acceptable rates of blastocyst formation can be observed for all patients. A decrease in blastulation can be observed for all ICSI cycles versus traditional insemination. Rates of blastocyst formation were observed to increase over time. P-626 Wednesday, October 22, 2014
Supported by: Red Rock Fertility Center.
THE MOST FREQUENT ANEUPLOIDIES IN HUMAN EMBRYO ARE SIMILAR TO THOSE OBSERVED IN THE EARLY PREGNANCY LOSS. E. Littman, V. Phan, D. Harris, M. Severino, A. La. Red Rock Fertility Center, Las Vegas, NV. OBJECTIVE: To investigate whether the meiotic errors that are seen in cleavage stage embryo are the ones observed in the first trimester of pregnancy. DESIGN: Retrospective Study in an In Vitro Fertilization Laboratory. MATERIALS AND METHODS: Embryos from 156 patients (average age 34.7 years 5.5) were investigated. A-CGH was used to investigate 23 pairs of chromosomes of a single blastomere biopsied on day 3 of embryo development. RESULTS: A total of 877 day 3 embryos were analyzed, of which 474 were euploid and 403 were aneuploid. Aneuploidy can happen in any chromosomes. In the following order, the most frequently involed in aneuploidy were chromosomes 22, 19, 16, 15, 21, XY, 9, 13, 18, 1, 20, 14, 11, 4, 12, 2, 6, 3, 7, 17, 8, 5, 10. CONCLUSION: Aneuploidy is strongly affected by maternal age. Most embryos cannot survive with a missing or extra chromosome and are spontaneously aborted. This study partially corroborated with previous publications reporting chromosomal aberrations in first trimester abortion. Our results show that the most frequent aneuploidy involves the chromosome 22, 19, 16, 15, 21, XY, 9, 13,18. As observed in abortus’ karyotypes; trisomy 22, 16 and 15 are common found in the first trimester miscarriages and account for 3.8%; 4.5%; 5.2% of SABs respectively. Viable trisomies have been observed for chromosomes 13,18 and 21. Monosomy X (Turner syndrome) is
Frequency of Chromosome Aneuploidy
Chromosome #
Aneuploid
Euploid
RR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 XY
25(2.9%) 17(1.9%) 13(1.5%) 18(2.1%) 10(1.1%) 15(1.7%) 12(1.4%) 11(1.3%) 30(3.4%) 10(1.1%) 18(2.1%) 17(1.9%) 29(3.3%) 19(2.2%) 49(5.6%) 54(6.2%) 12(1.4%) 28(3.2%) 56(6.4%) 24(2.7%) 44(5.0%) 74(8.4%) 35(4%)
852(97.1%) 860(98.1%) 864(98.5%) 859(97.9%) 867(98.9%) 862(98.3%) 865(98.6%) 866(98.7%) 847(96.6%) 867(98.9%) 859(97.9%) 860(98.1%) 848(96.7%) 858(97.8%) 828(94.4%) 823(93.8%) 865(98.6%) 849(96.8%) 821(93.6%) 853(97.3%) 833(95%) 803(91.6%) 842(96%)
2.64 1.73 1.36 1.91 1.0 1.55 1.27 1.18 3.09 1.0 1.91 1.73 3.0 2.0 5.09 5.64 1.27 2.91 5.82 2.45 4.55 7.64 3.64
e344
ASRM Abstracts
frequently observed and accounts for 4.3% of SABs. Our results demonstrate that a-CGH-for detection of aneuploidies in IVF embryos is an accurate diagnosis strategy. In addition, the transfer of normal embryos prevent miscarrage and the occurrence of pregnancies resluting in the birth of children with multiple healthy problems due to aneuploidy.
P-627 Wednesday, October 22, 2014 MEIOTIC SPINDLE LOCATION OF MATURE OOCYTES ORIGINATED FROM STIMULATED CYCLES IS A PREDICTOR FOR BLASTOCYST FORMATION. A. Mahfoudh, E. Garcia-Cerrudo, J. H. Moon, S. Henderson, H. Holzer, W.-Y. Son. Obstetrics and Gynecology, MUHC Reproductive Center. McGill University, Montreal, QC, Canada. OBJECTIVE: The purposes of this study are: 1) to evaluate the relationship between the presence of spindle in metaphase II (MII) oocytes and their potential to develop blastocyst, and 2) to analyze the clinical pregnancy rate depending on the origin of the embryo transferred derived from the different spindle angle. DESIGN: Retrospective study. MATERIALS AND METHODS: This study analyzed 58 patients who underwent IVF from January-December 2013. A total of 830 eggs were collected of which 648 were MII on retrieval day. Oocytes were screened using PolscopeTM to visualize the meiotic spindle to avoid damaging the spindle during ICSI and characterized in terms of visible or non-visible spindle and its position in relation to the first polar body (PB). From the 648 MII oocytes, 581 (89%) had visible spindles and were separated into 3 groups: (group 1) 0 -29 ; (group 2) 30 -89 ; (group 3) R90 and those with no visible spindle into group 4. Blastocyst developmental potential and clinical pregnancy rate were analyzed depending on the origin of the single embryo transferred (SET). Data was analyzed using SPSS. Chi-square test and logistic regression were performed. P-values <0.05 were considered statistically significant. RESULTS: There was no significant difference in fertilization and cleavage rates among the groups. Blastocyst formation rate in group 1 (0 -29 ) was significantly higher than the other groups (P<0.001). Better clinical pregnancy rate was observed in the cycles where embryos transferred had been derived from group 1 oocytes (26/58, 44.9%) than in those where embryos were derived from other groups (group 2: 5/58, 8.6%; group 3: 3/58, 5.1%; group 4: 6/58, 10.3%), however this difference did not reach statistical significance.
IVF results based on spindle angle.
Spindle Angle
Matured (%)
Fertilized (%)
Cleavage (%)
Blastocyst (%)
0-29 30-89 R90 No visible Total P-Value
292 (45.1) 219 (33.8) 64 (9.9) 73 (11.2) 648 (78.1) 0.48
202 (43.1) 167 (35.6) 51 (10.9) 49 (10.4) 469 (73.5) 0.09
204 (43.3) 167 (35.5) 51 (10.8) 49 (10.4) 471 (56.7) 0.128
111 (47.4) a 87 (37.2) b 25 (10.7) b 11 (4.7) b 234 (28.2) <0.001
a vs. b P<0.01 CONCLUSION: Meiotic spindle of oocytes located between 0 -29 is a predictor for blastocyst developmental competence.
Vol. 102, No. 3, Supplement, September 2014
Year
Cycles
Day 5 Blast
Day 6 Blast
Total Blast
1998-2000
392
50.8%
7.8%
58.6%
2001-2003 2004-2006 2007-2009 2010-2013
448 408 322 286
50.0% 56.8% 55.1% 64.7%
14.6% 9.9% 12.8% 8.5%
64.6% 66.7% 67.9% 73.1%
Total ICSI
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
677 638 744 685 892
42.9% 40.4% 54.3% 49.4% 52.4%
7.1% 13.4% 9.4% 12.5% 6.9%
50.1% 53.8% 63.8% 61.9% 62.0%
IVF <35
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
217 249 222 188 132
52.5% 54.0% 60.3% 60.8% 66.9%
8.5% 14.8% 10.1% 13.0% 8.2%
61.0% 68.7% 70.5% 73.8% 75.1%
ICSI <35
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
400 347 385 357 402
44.8% 43.6% 59.3% 52.9% 55.0%
8.1% 15.0% 9.4% 13.2% 10.3%
52.9% 58.6% 68.8% 66.1% 65.3%
IVF 35-37
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
95 98 99 71 69
51.0% 46.9% 58.8% 47.0% 72.4%
6.3% 15.8% 10.8% 12.8% 8.6%
57.3% 62.7% 69.5% 59.8% 81.0%
IVF 35-37
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
149 111 178 146 182
41.1% 39.8% 49.4% 48.7% 51.5%
5.9% 15.3% 11.5% 12.3% 9.2%
47.0% 55.1% 60.9% 60.9% 60.7%
IVF 38-40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
64 74 52 39 53
47.3% 41.0% 48.5% 48.2% 51.5%
8.5% 12.3% 10.6% 12.3% 9.0%
55.8% 53.3% 59.0% 60.6% 60.5%
ICSI 38-40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
92 118 111 105 167
38.7% 33.1% 50.0% 41.6% 47.7%
5.3% 8.9% 6.2% 11.9% 7.9%
44.0% 42.0% 56.2% 53.5% 55.6%
IVF >40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
15 27 35 24 27
33.3% 39.6% 27.9% 34.9% 56.4%
4.3% 12.2% 4.6% 11.9% 9.2%
37.7% 51.8% 72.1% 46.8% 65.6%
ICSI >40
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
36 62 70 77 142
34.8% 30.0% 28.1% 32.4% 44.2%
3.5% 5.2% 6.8% 7.4% 8.2%
38.4% 35.3% 34.8% 39.8% 52.3%
IVF Donor
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
97 79 54 37 22
60.1% 59.0% 55.6% 66.7% 79.4%
7.3% 12.9% 13.1% 14.1% 6.9%
67.4% 71.9% 68.7% 80.7% 86.3%
ICSI Donor
1998-2000 2001-2003 2004-2006 2007-2009 2010-2013
80 70 63 54 67
56.3% 56.2% 51.1% 59.1% 71.8%
8.7% 12.1% 13.0% 14.3% 7.8%
64.9% 68.3% 64.1% 73.5% 79.6%
Total IVF
P-624 Wednesday, October 22, 2014 EMBRYO DEVELOPMENTAL POTENTIAL OF IN VITRO MATURED MI FROM STIMULATION CYCLES DEPENDS ON THE TIMING OF NUCLEAR MATURATION RATHER THAN THE LENGTH OF MII ARREST. J. H. Moon, E. Garcia-Cerrudo, S. Henderson, A. Mahfoudh, H. Holzer, W.-Y. Son. Obstetrics and Gynecology Mcgill Universtiy, MUHC Reproductive Centre, Montreal, QC, Canada. OBJECTIVE: The reduced potential of IVM oocytes has been attributed to a lack of synchrony between nuclear maturation and a loss or excess of cytoplasmic maturation. However, there is no direct evidence to describe the duration of MII arrest in order for the meiotic spindle to function normally without negatively effecting of the oocyte’s potential. The objective is to know what is more important between the timing of the first polar body (1PB) extrusion (nuclear maturation; NM) and duration of MII arrest to rescue the developmental potential of in vitro matured (IVM) human oocytes of stimulated cycles? DESIGN: This is a retrospective study of patients who had metaphase I (MI) oocytes at retrieval at the MUHC Reproductive Center between January and December 2013 (n ¼ 30 cycles). MATERIALS AND METHODS: MI oocytes were divided into two IVM MI groups according to the different timing of NM (1PB extrusion) and ICSI was performed after different durations of MII arrest. The embryo developments were compared between the two groups. The spindle of the oocytes was examined using the Polscope TM. RESULTS: Group I in which 45 out of 109 MI oocytes became MII after 1 4 h of in vitro culture. Culture was extended for ICSI until next morning because spindle in early telophase I was observed by the Polscope. Group II where 53 IVM MI oocytes became MII during overnight culture and were inseminated by ICS next morning. The rates of fertilization and blastocyst formation in Group I were 84.4 and 36.8% which are not significantly different with those in Group II which were 75.5 and 22.5% respectively. However, the freezable good quality blastocyst rate in Group I was significantly higher than that in Group II (18.4 vs. 2.5 %). CONCLUSION: Freezable good quality blastocyst is significantly higher in early NM groups with longer MII arrest than that of late NM with shorter MII arrest. This suggests that the success of IVM depends on the NM timing rather than the duration MII. Therefore if it is necessary to increase the number of available embryos for transfer using IVM MI, the optimal timing of ICSI for them may be the next morning.
P-625 Wednesday, October 22, 2014 BLASTOCYST FORMATION: 16 YEAR REVIEW OF IVF AND ICSI CYCLES. M. Langley, K. Doody, K. Doody. Center for Assisted Reproduction, Bedford, TX. OBJECTIVE: To evaluate day 5, day 6 and total blastocyst formation rates in IVF and ICSI cycles occurring over a 16 year period. DESIGN: A retrospective analysis of blastocyst formation from 6115 cycles beginning January 1, 1998 through December 31, 2013. MATERIALS AND METHODS: Embryos were cultured in Vitrolife (1998 to 2008), Sage (2008 to 2011) sequential media and Irvine continuous culture media (2012 to 2013). Extended culture was implemented in all patients undergoing IVF. RESULTS: Rates of Blastocyst Formation.
FERTILITY & STERILITYÒ
e343
CONCLUSION: This data suggest, although rates of blastocyst formation are reduced with advanced reproductive age, acceptable rates of blastocyst formation can be observed for all patients. A decrease in blastulation can be observed for all ICSI cycles versus traditional insemination. Rates of blastocyst formation were observed to increase over time. P-626 Wednesday, October 22, 2014
Supported by: Red Rock Fertility Center.
THE MOST FREQUENT ANEUPLOIDIES IN HUMAN EMBRYO ARE SIMILAR TO THOSE OBSERVED IN THE EARLY PREGNANCY LOSS. E. Littman, V. Phan, D. Harris, M. Severino, A. La. Red Rock Fertility Center, Las Vegas, NV. OBJECTIVE: To investigate whether the meiotic errors that are seen in cleavage stage embryo are the ones observed in the first trimester of pregnancy. DESIGN: Retrospective Study in an In Vitro Fertilization Laboratory. MATERIALS AND METHODS: Embryos from 156 patients (average age 34.7 years 5.5) were investigated. A-CGH was used to investigate 23 pairs of chromosomes of a single blastomere biopsied on day 3 of embryo development. RESULTS: A total of 877 day 3 embryos were analyzed, of which 474 were euploid and 403 were aneuploid. Aneuploidy can happen in any chromosomes. In the following order, the most frequently involed in aneuploidy were chromosomes 22, 19, 16, 15, 21, XY, 9, 13, 18, 1, 20, 14, 11, 4, 12, 2, 6, 3, 7, 17, 8, 5, 10. CONCLUSION: Aneuploidy is strongly affected by maternal age. Most embryos cannot survive with a missing or extra chromosome and are spontaneously aborted. This study partially corroborated with previous publications reporting chromosomal aberrations in first trimester abortion. Our results show that the most frequent aneuploidy involves the chromosome 22, 19, 16, 15, 21, XY, 9, 13,18. As observed in abortus’ karyotypes; trisomy 22, 16 and 15 are common found in the first trimester miscarriages and account for 3.8%; 4.5%; 5.2% of SABs respectively. Viable trisomies have been observed for chromosomes 13,18 and 21. Monosomy X (Turner syndrome) is
Frequency of Chromosome Aneuploidy
Chromosome #
Aneuploid
Euploid
RR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 XY
25(2.9%) 17(1.9%) 13(1.5%) 18(2.1%) 10(1.1%) 15(1.7%) 12(1.4%) 11(1.3%) 30(3.4%) 10(1.1%) 18(2.1%) 17(1.9%) 29(3.3%) 19(2.2%) 49(5.6%) 54(6.2%) 12(1.4%) 28(3.2%) 56(6.4%) 24(2.7%) 44(5.0%) 74(8.4%) 35(4%)
852(97.1%) 860(98.1%) 864(98.5%) 859(97.9%) 867(98.9%) 862(98.3%) 865(98.6%) 866(98.7%) 847(96.6%) 867(98.9%) 859(97.9%) 860(98.1%) 848(96.7%) 858(97.8%) 828(94.4%) 823(93.8%) 865(98.6%) 849(96.8%) 821(93.6%) 853(97.3%) 833(95%) 803(91.6%) 842(96%)
2.64 1.73 1.36 1.91 1.0 1.55 1.27 1.18 3.09 1.0 1.91 1.73 3.0 2.0 5.09 5.64 1.27 2.91 5.82 2.45 4.55 7.64 3.64
e344
ASRM Abstracts
frequently observed and accounts for 4.3% of SABs. Our results demonstrate that a-CGH-for detection of aneuploidies in IVF embryos is an accurate diagnosis strategy. In addition, the transfer of normal embryos prevent miscarrage and the occurrence of pregnancies resluting in the birth of children with multiple healthy problems due to aneuploidy.
P-627 Wednesday, October 22, 2014 MEIOTIC SPINDLE LOCATION OF MATURE OOCYTES ORIGINATED FROM STIMULATED CYCLES IS A PREDICTOR FOR BLASTOCYST FORMATION. A. Mahfoudh, E. Garcia-Cerrudo, J. H. Moon, S. Henderson, H. Holzer, W.-Y. Son. Obstetrics and Gynecology, MUHC Reproductive Center. McGill University, Montreal, QC, Canada. OBJECTIVE: The purposes of this study are: 1) to evaluate the relationship between the presence of spindle in metaphase II (MII) oocytes and their potential to develop blastocyst, and 2) to analyze the clinical pregnancy rate depending on the origin of the embryo transferred derived from the different spindle angle. DESIGN: Retrospective study. MATERIALS AND METHODS: This study analyzed 58 patients who underwent IVF from January-December 2013. A total of 830 eggs were collected of which 648 were MII on retrieval day. Oocytes were screened using PolscopeTM to visualize the meiotic spindle to avoid damaging the spindle during ICSI and characterized in terms of visible or non-visible spindle and its position in relation to the first polar body (PB). From the 648 MII oocytes, 581 (89%) had visible spindles and were separated into 3 groups: (group 1) 0 -29 ; (group 2) 30 -89 ; (group 3) R90 and those with no visible spindle into group 4. Blastocyst developmental potential and clinical pregnancy rate were analyzed depending on the origin of the single embryo transferred (SET). Data was analyzed using SPSS. Chi-square test and logistic regression were performed. P-values <0.05 were considered statistically significant. RESULTS: There was no significant difference in fertilization and cleavage rates among the groups. Blastocyst formation rate in group 1 (0 -29 ) was significantly higher than the other groups (P<0.001). Better clinical pregnancy rate was observed in the cycles where embryos transferred had been derived from group 1 oocytes (26/58, 44.9%) than in those where embryos were derived from other groups (group 2: 5/58, 8.6%; group 3: 3/58, 5.1%; group 4: 6/58, 10.3%), however this difference did not reach statistical significance.
IVF results based on spindle angle.
Spindle Angle
Matured (%)
Fertilized (%)
Cleavage (%)
Blastocyst (%)
0-29 30-89 R90 No visible Total P-Value
292 (45.1) 219 (33.8) 64 (9.9) 73 (11.2) 648 (78.1) 0.48
202 (43.1) 167 (35.6) 51 (10.9) 49 (10.4) 469 (73.5) 0.09
204 (43.3) 167 (35.5) 51 (10.8) 49 (10.4) 471 (56.7) 0.128
111 (47.4) a 87 (37.2) b 25 (10.7) b 11 (4.7) b 234 (28.2) <0.001
a vs. b P<0.01 CONCLUSION: Meiotic spindle of oocytes located between 0 -29 is a predictor for blastocyst developmental competence.
Vol. 102, No. 3, Supplement, September 2014