PREİMPLANTASYON EMBRİYO GELİŞİM DURAKLAMASININ YARDIMLA ÜREME TEDAVİSİ SONUÇLARI ÜZERİNE ETKİSİ

Year 2019, Volume: 82 Issue: 4, 206 - 211, 21.10.2019

Sibel Bulgurcuoğlu Kuran , Bilge Özsait Selçuk

Abstract

Amaç: Yardımla üreme tedavileri sırasında, insan preimplantasyon embriyoları genellikle in vitro kültür ortamı, hasta yaşı, ovarian stimülasyon protokolleri ve gametlere bağlı nedenlerle gelişimin çeşitli aşamalarında duraklayabilmektedir. Gelişimsel duraklamanın (arrest) gözlendiği çiftlerde normal gelişim gösteren diğer embriyoların transfer edilmesinden sonra implantasyon başarısızlığı ve düşük gözlenebilmektedir. Diğer yandan, embriyonik arrestin altında yatan nedenler kesin olarak açıklanabilmiş değildir. Bu çalışmada amacımız, erken dönem embriyonik arrestin yardımla üreme teknikleri başarısı üzerine etkisinin araştırılmasıdır. Gereç ve Yöntem: Bu retrospektif çalışma kapsamında, 2010 ve 2018 yılları arasında yardımla üreme tedavisi gören ve ovulatuvar faktör, tubal faktör, endometriozis, açıklanamayan infertilite, ve erkek faktörü tanısı konulmuş olan 620 infertil çiftin intrasitoplazmik sperm enjeksiyonu-embriyo transferi (ICSI-ET) siklusu değerlendirilmiştir. Çalışma grupları, embriyonik arrest gözlenen hastalar ve tüm embriyoları duraklamadan normal hızda gelişim gösteren (kontrol) hastalardan oluşmaktadır. Çalışma datası, tek-yönlü değişken analizi (ANOVA) ve Ki-kare testi kullanılarak analiz edilmiştir. Bulgular: Çalışma toplumunda, kullanılan ilaç dozu, oosit sayısı, fertilizasyon oranı, iyi kaliteli (GI) ve düşük kaliteli (GIII) embriyo oranları anlamlı olarak arrest yönünde artmışken, gebelik oranlarının azaldığı (p<0,0001) ve canlı doğum oranlarında iki grup arasında bir farklılığın olmadığı (p=0,449) tespit edilmiştir. Sonuç: Embriyo kohortunda arrest embriyoların bulunmasının yardımla üreme teknikleri başarısı üzerine olumsuz etkilerinin olduğu çeşitli çalışmalarda belirtilmiştir. Çalışmamızda elde edilen bulgular bu doğrultudadır. 

Keywords

Preimplantasyon dönem embriyo, yardımla üreme teknikleri, gelişimsel duraklama

THE EFFECT OF PREIMPLANTATION EMBRYO DEVELOPMENT ARREST ON ASSISTED REPRODUCTIVE TREATMENT RESULTS

Abstract

Objective: During assisted reproductive treatments, human preimplantation embryo’s development can sometimes may stop cleavage at various stages due to in vitro culture media, patient age, ovarian stimulation protocols, and gametes. Implantation failure and abortion can be observed after the transfer of other embryos, which have normal development, in couples with developmental arrest. On the other hand, the underlying causes of embryonic arrest cannot be explained clearly. The aim of this study was to investigate the effect of early embryonic arrest on the success of assisted reproductive techniques. Materials and Methods: In this retrospective study of intracytoplasmic sperm injection-embryo transfer (ICSI-ET), the cycle of 620 infertile couples diagnosed with ovulatory factor, tubal factor, endometriosis, unexplained infertility, and male factor between 2010 and 2018 were evaluated. The study groups consisted of patients with embryonic arrest and control patients whose embryos developed at normal speed without interruption. The study data was analyzed using the uni-directional variable analysis (ANOVA) and the Chi-square test. Results: In the study population, the drug dose, oocyte count, fertilization rate, and high and low grade embryo ratios were increased in the direction of arrest. On the one hand, pregnancy rates decreased (p<0.0001). On the other hand, there was no difference between the two groups in live birth rates (p=0.449). Conclusion: In several studies, it was stated that the presence of arrested embryos in the embryo cohort had negative effects on the success of assisted reproductive techniques. The findings of this study support that claim. 

Keywords

Preimplantation stage embryo, assisted reproductive techniques, arrest

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