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Human Reproduction, Vol. 14, No. 12, 3002-3008, December 1999
© 1999 European Society of Human Reproduction and Embryology

Selection of good embryos for transfer depends on embryo cohort size: implications for the `mild ovarian stimulation' debate

Fabienne Devreker1,2,4, Elena Pogonici2, Viviane De Maertelaer3, Philippe Revelard2, Marc Van den Bergh2 and Yvon Englert1,2

1 Laboratory for Biology and Psychology of Human Fertility, the Faculty of Medicine, Free University of Brussels, 2 Clinic of Fertility, Department of Obstetrics and Gynaecology, Hospital Erasme, and 3 IRIBHN Statistical Unit, Free University of Brussels, Route de Lennik 808, 1070 Brussels, Belgium

Embryo quality evaluated by the embryo morphology is a critical parameter in human in-vitro fertilization (IVF) and embryo transfer. It determines which and how many embryos will be replaced, as pregnancy rates are directly related to number and quality of transferred embryos. This retrospective analysis included 1301 IVF and embryo transfer cycles to identify which factors influenced embryo quality. Embryo quality did not correlate with maternal age, causes of infertility, ovarian stimulation parameters or embryo cohort size. However, the mean score of transferred embryos was significantly higher for patients with more than five embryos compared to fewer than five embryos (P < 0.001), irrespective of maternal age. Patients tended to produce a similar embryo quality from cycle to cycle, r = 0.33 (P < 0.001) for the embryo cohort and r= 0.47 (P < 0.001) for the transferred embryos. Poor embryo morphology probably reflects oocytes with compromised development competence and could be an independent factor of infertility. Furthermore, a large embryo cohort was the main factor increasing the chances of at least one good embryo in the cohort.

Key words: embryo cohort size/embryo quality/maternal age/oocyte maturity

4 To whom correspondence should be addressed at: Clinic of Fertility, Department of Obstetrics and Gynaecology, Hospital Erasme, Route de Lennik 808, 1070 Brussels, Belgium


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