Is there an association between oocyte number and embryo quality? A systematic review and meta-analysis

Belinda G Vermey; Su Jen Chua; Mohammad Hadi Zafarmand; Rui Wang; Salvatore Longobardi; Evelyn Cottell; Francois Beckers; Ben W Mol; Christos A Venetis; Thomas D'Hooghe

doi:10.1016/j.rbmo.2019.06.013

Is there an association between oocyte number and embryo quality? A systematic review and meta-analysis

Reprod Biomed Online. 2019 Nov;39(5):751-763. doi: 10.1016/j.rbmo.2019.06.013. Epub 2019 Jul 3.

Authors

Affiliations

¹ School of Women's and Children's Health, University of New South Wales NSW, Australia. Electronic address: belinda.vermey@outlook.com.
² Robinson Research Institute and Adelaide Medical School, University of Adelaide SA, Australia.
³ Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, The Netherlands.
⁴ Merck Serono S.p.A, Rome, Italy.
⁵ Merck KGaA, Darmstadt, Germany.
⁶ Department of Obstetrics and Gynecology, Monash University, Clayton Victoria, Australia.
⁷ School of Women's and Children's Health, University of New South Wales NSW, Australia; Centre for Big Data Research in Health, University of New South Wales NSW, Australia.

PMID: 31540848
DOI: 10.1016/j.rbmo.2019.06.013

Abstract

This systematic review and meta-analysis determined the association between aspirated after ovarian stimulation and top/good quality embryos obtained in women undergoing ovarian stimulation for IVF/intracytoplasmic sperm injection (ICSI). MEDLINE, EMBASE, Scopus, CINAHL and Web of Science were searched for English-language publications on top/good-quality embryos at cleavage (day 2/3) and/or blastocyst (day 5/6) developmental stages, up to 18 November 2017. Twenty-eight studies (three prospective and 25 retrospective) reporting data on 291,752 assisted reproductive technology (ART) cycles were considered eligible. We confirmed a strong positive association between oocytes retrieved and top/good-quality day 2/3 embryos (weighted correlation coefficient [r_w] = 0.791), day 5/6 embryos (r_w = 0.901), metaphase II oocytes (r_w = 0.988), oocytes exhibiting two pronuclei (r_w = 0.987) and euploid embryos (r_w = 0.851); P < 0.001 for all correlations (evaluated in subsets of the 17 studies). Data from 5657 cycles showed that the group with the most oocytes aspirated had the most top/good-quality day 2/3 embryos (pooled standardized mean differences (high [>15] versus low [<4] 1.91, 95% confidence interval [CI] 1.05-2.77, P < 0.0001; high versus medium [4-15] 1.15, 95% CI 0.74-1.55, P < 0.0001; medium versus low 1.41, 95% CI 0.79-2.03, P < 0.0001). Individual participant meta-analysis would enable accurate determination of these associations and other outcomes.

Keywords: Embryo quality; Euploid; Oocyte number; Oocyte yield.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Blastocyst / cytology
Embryo Transfer / methods*
Female
Fertilization
Humans
Male
Oocytes / cytology*
Ovulation Induction / adverse effects
Ovulation Induction / methods*
Prospective Studies
Regression Analysis
Reproductive Techniques, Assisted
Retrospective Studies
Risk
Sperm Injections, Intracytoplasmic / methods
Spermatozoa / pathology
Treatment Outcome