Purpose

To compare morphokinetic parameters and quality of embryos derived from GnRH antagonist ICSI cycles triggered either with GnRH agonist or standard hCG between matched groups of patients.

Methods

Morphokinetic parameters of embryos derived from matched first GnRH antagonist ICSI cycles triggered by GnRH agonist or standard hCG between 2013 and 2016 were compared. Matching was performed for maternal age, peak estradiol levels, and number of oocytes retrieved. Outcome measures were: time to pronucleus fading (tPNf), cleavage timings (t2-t8), synchrony of the second and third cycles (S2 and S3), duration of the second and third cycle (CC2 and CC3), optimal cell cycle division parameters, and known implantation data (KID) scoring for embryo quality. Multivariate linear and logistic regression analyses were performed for confounding factors.

Results

We analyzed 824 embryos from 84 GnRH agonist trigger cycles and 746 embryos from 84 matched hCG trigger cycles. Embryos derived from the cycles triggered with hCG triggering cleaved faster than those deriving from GnRH agonist trigger. The differences were significant throughout most stages of embryo development (t3-t6), and a shorter second cell cycle duration of the hCG trigger embryos was observed. There was no difference in synchrony of the second and third cell cycles and the optimal cell cycle division parameters between the two groups, but there was a higher percentage of embryos without multinucleation in the hCG trigger group (27.8% vs. 21.6%, p < 0.001).

Conclusion

The type of trigger in matched antagonist ICSI cycles was found to affect early embryo cleavage times but not embryo quality.

中文翻译：

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促性腺激素释放激素激动剂与人绒毛膜促性腺激素触发器后胚胎形态动力学的匹配倾向评分研究

目的

比较匹配组患者之间用 GnRH 激动剂或标准 hCG 触发的 GnRH 拮抗剂 ICSI 周期衍生的胚胎的形态动力学参数和质量。

方法

比较了 2013 年至 2016 年间由 GnRH 激动剂或标准 hCG 触发的匹配的第一个 GnRH 拮抗剂 ICSI 周期衍生的胚胎的形态动力学参数。对产妇年龄、雌二醇峰值水平和取卵数量进行匹配。结果指标是：原核衰落时间 (tPNf)、卵裂时间 (t2-t8)、第二个和第三个周期的同步（S2 和 S3）、第二个和第三个周期的持续时间（CC2 和 CC3）、最佳细胞周期分裂参数，以及胚胎质量的已知植入数据 (KID) 评分。对混杂因素进行多变量线性和逻辑回归分析。

结果

我们分析了来自 84 个 GnRH 激动剂触发周期的 824 个胚胎和来自 84 个匹配的 hCG 触发周期的 746 个胚胎。由 hCG 触发触发的周期衍生的胚胎比由 GnRH 激动剂触发衍生的胚胎分裂得更快。在胚胎发育的大多数阶段（t3-t6），差异是显着的，并且观察到 hCG 触发胚胎的第二个细胞周期持续时间较短。两组之间的第二个和第三个细胞周期的同步性和最佳细胞周期分裂参数没有差异，但 hCG 触发组中没有多核的胚胎百分比更高（27.8% vs. 21.6%，p < 0.001）。

结论

发现匹配拮抗剂 ICSI 周期中的触发类型影响早期胚胎分裂时间但不影响胚胎质量。