http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241845/
J Assist Reprod Genet. 2011 Dec;28(12):1205-11. doi: 10.1007/s10815-011-9630-9. Epub 2011 Sep 6.
Effects of cumulus cells removal after 6 h co-incubation of gametes on the outcomes of human IVF.
Author information
- Chong Qing Reproductive and Genetics Institute, Chongqing Obstetrics and Gynecology Hospital, 64 Jing Tang ST, Yu Zhong District, Chongqing, 400013, China.
Abstract
PURPOSE:
To investigate the effects of cumulus cells removal after 6 h co-incubation of gametes on the fertilization, polyspermy, multinucleation and clinical pregnancy rates in human IVF.
METHODS:
A total of 1,200 IVF-ET cycles undergoing 6 h co-incubation of gametes in 2009 were included in this study. Inclusion criteria were: female age <38 years, first IVF treatment, with bi-ovary and normal ovarian response, e.g., 4 ~ 20 oocytes could be obtained. A 6 h period of co-incubation was applied in all IVF cycles. According to the history of infertility, cumulus cells were mechanically removed either 6 h post-insemination or 20 h post-insemination. For couples with primary infertility, or unexplained infertility, or mild oligospermia or asthenospermia, the cumulus cells were removed at 6 h of insemination for the polar body observation (6 h group, n = 565). Of these, 80 cycles received early rescue ICSI due to fertilization failure or low fertilization rate at 6 h of insemination. For couples with secondary infertility and normal semen analysis, the cumulus cells were removed at 20 h of insemination as routine (20 h group, n = 635). Of these, three cycles received late rescue ICSI due to fertilization failure at 20 h of insemination. Normal fertilization, polyspermy (≥3PN), multinucleation and clinical pregnancy rates were compared between the two groups (rescue ICSI cycles were not included in the comparison in both groups).
RESULTS:
Significant difference (P < 0.05) was observed between the groups regarding polyspermy rates (7.48% in 6 h group and 9.22% in 20 h group). No difference was observed between the groups regarding normal fertilization rates (2PN rate) (64.89% in 6 h group and 65.74% in 20 h group). No difference was observed between the groups regarding multinucleation and clinical pregnancy rates (11.01% and 65.15% in 6 h group, 10.75% and 66.93% in 20 h group, respectively). The clinical pregnancy rate was 51.43% in cycles receiving early rescue ICSI, while no clinical pregnancy was obtained in cycles receiving late rescue ICSI.
CONCLUSION:
The present results indicate that cumulus cells removal at 6 h of insemination is a relatively safe operation, which yielded comparable normal fertilization rate, multinucleation and clinical pregnancy rates compared with 20 h group. This protocol may be beneficial for early obsevation of fertilization failure and make early rescue ICSI possible.
Table 2
Details of treatment outcome in two groups*
| 6 h group | 20 h group | P-value | Power | |
|---|---|---|---|---|
| Total No. of oocytes retrieved | 5,295 | 6,797 | ||
| Normal fertilization rate | 64.89% | 65.75% | NS | 0.16 |
| (3436/5295) | (4469/6797) | |||
| Polyspermy rate | 7.48% | 9.22% | <0.05 | 0.92 |
| (396/5295) | (627/6797) | |||
| Multinucleation rate | 11.01% | 10.75% | NS | 0.05 |
| (370/3360) | (472/4389) | |||
| Clinical pregnancy rate | 65.15% | 66.93% | NS | 0.08 |
| (316/485) | (423/632) |
*Rescue ICSI cycles were not included in both groups
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