Effect of Fragment Removal on Development of Human Fragmented Embryos in IVF-ET Program

Chi, Hee Jun; Koo, Jung Jin; Lee, Ju Ok; Ryu, Hyoung Eun; Kim, Kwang Rae; Park, Chan; Roh, Sung Il

Abstract

OBJECTIVE
To investigate the beneficial effect of fragment removal on the subsequent cell division and clinical outcome of the fragmented human embryos.
METHODS
A prospective study was performed in Hanna Women's Clinic and Mizmedi Hospital. Sixty couples undergoing In vitro fertilization-embryo transfer (IVF-ET) program were participated in the present study. The microsurgical fragment removal was performed in 106 fragmented embryos of 29 patients before the transfer. As a control group, 122 fragmented embryos of 31 patients were transferred without the fragment removal. Effects of fragment removal on morphological changes and clinical outcomes of fragmented embryos were investigated.
RESULTS
Mean morphological grade (G2.79) of fragmented embryos was significantly improved after the fragment removal (G1.63, p<0.001). Most of the fragmented embryos did not show a regeneration of fragments after the fragment removal during the subsequent development, and a beneficial effect of fragment removal on the development of the fragment removed embryos was observed. Implantation and pregnancy rates of fragment removed embryos were 12.3% and 31.3%, whereas the rates of control group embryos were 6.6% and 22.5%, respectively. There was no statistical significance in the rates between the two groups because of the low number of trials.
CONCLUSION
Microsurgical fragment removal improved the subsequent development as well as the morphological grade of fragmented embryos. The fragment removal may be beneficial for neighboring blastomeres by repairing the intercellular communication and removing the secretion of the potential toxic materials by fragments.