TABLE 3.
The relationship between the visibility of meiotic spindle in the oocyte and controlled ovarian stimulation protocol.
| Outcome/COS protocol | Total | Visible spindle | Nonvisible spindle | p value |
|---|---|---|---|---|
| Female age at OPU, mean years ± SD | 35.8 ± 4.8 | 36.8 ± 5.1 | <0.001 a | |
| n (%) | n (%) | n (%) | ||
| MII oocytes b , c | ||||
| Total | 5737 | 4829 (84.2) | 908 (15.8) | – |
| PPOS | 1884 | 1610 (85.5) | 274 (14.5) | – |
| Long | 396 | 335 (84.6) | 61 (15.4) | – |
| Short | 1371 | 1190 (86.8) | 181 (13.2) | – |
| GnRH antagonist | 2086 | 1694 (81.2)**,† | 392 (18.8)**,† | – |
| 2PN2PB oocytes/MII oocytes with ICSI d , e | ||||
| Total | 3753/5086 (73.8) | 3331/4324 (77.0) | 422/762 (55.4) | <0.001 f |
| PPOS | 1306/1720 (75.9) | 1157/1479 (78.2) | 149/241 (61.8) | <0.001 f |
| Long | 229/336 (68.2) | 209/290 (72.1) | 20/46 (43.5) | <0.001 f |
| Short | 923/1252 (73.7) | 840/1096 (76.6) | 83/156 (53.2) | <0.001 f |
| GnRH antagonist | 1295/1778 (72.8) | 1125/1459 (77.1) | 170/319 (53.3) | <0.001 f |
| Embryo development | ||||
| Blastocysts/2PN2PB oocytes cultured until confirmation of blastocyst formation e | ||||
| Total | 2020/3079 (65.6) | 1835/2751 (66.7) | 185/328 (56.4) | <0.001 f |
| PPOS | 764/1130 (67.6) | 680/1003 (67.8) | 84/127 (66.1) | 0.763 f |
| Long | 133/197 (67.5) | 125/180 (69.4) | 8/17 (47.1) | 0.101 f |
| Short | 508/775 (65.5) | 462/703 (65.7) | 46/72 (63.9) | 0.795 f |
| GnRH antagonist | 615/977 (62.9) | 568/865 (65.7) | 47/112 (42.0)**,† | <0.001 f |
| Pregnancy, live birth, and miscarriage | ||||
| Clinical Pregnancy (gestational sac‐positive)/Blastocyst transfer cycles e | ||||
| Total | 181/672 (26.9) | 163/612 (26.6) | 18/60 (30.0) | 0.546 f |
| PPOS | 60/173 (34.7) | 55/155 (35.5) | 5/18 (27.8) | 0.608 f |
| Long | 15/55 (27.3) | 14/51 (27.5) | 1/4 (25.0) | 1.000 f |
| Short | 47/195 (24.1) | 41/176 (23.3) | 6/19 (31.6) | 0.408 f |
| GnRH antagonist | 59/249 (23.7) | 53/230 (23.0) | 6/19 (31.6) | 0.405 f |
| Live birth or ongoing pregnancy/Blastocyst transfer cycles e | ||||
| Total | 151/672 (22.5) | 136/612 (22.2) | 15/60 (25.0) | 0.628 f |
| PPOS | 53/173 (30.6) | 48/155 (31.0) | 5/18 (27.8) | 1.000 f |
| Long | 9/55 (16.4) | 8/51 (15.7) | 1/4 (25.0) | 0.522 f |
| Short | 42/195 (21.5) | 37/176 (21.0) | 5/19 (26.3) | 0.565 f |
| GnRH antagonist | 47/249 (18.9) | 43/230 (18.7)* | 4/19 (21.1) | 0.764 f |
| Miscarriage g | ||||
| Total | 30/181 (16.6) | 27/163 (16.6) | 3/18 (16.7) | 1.000 f |
| PPOS | 7/60 (11.7) | 7/55 (12.7) | 0/5 (0.0) | 1.000 f |
| Long | 6/15 (40.0) | 6/14 (42.9) | 0/1 (0.0) | 1.000 f |
| Short | 5/47 (10.6) | 4/41 (9.8) | 1/6 (16.7) | 0.511 f |
| GnRH antagonist | 12/59 (20.3) | 10/53 (18.9) | 2/6 (33.3) | 0.591 f |
Abbreviations: COS, controlled ovarian stimulation; GnRH, gonadotropin‐releasing hormone; ICSI, intracytoplasmic sperm injection; MII, metaphase II; PB, polar body; PN, pronuclei; PPOS, progestin‐primed ovarian stimulation.
**p < 0.01, *p < 0.05 each protocol vs. PPOS protocol. † p < 0.05 each protocol vs. short protocol.
Mann–Whitney U test.
Holm test.
Oocyte with first polar body regardless of visibility or any position of spindle.
ICSI cycles using frozen‐thawed spermatozoa, spermatozoa retrieved by testicular sperm extraction, or oocytes that were artificially activated were excluded from the analysis.
Comparison between each COS protocol in visible or nonvisible of spindle groups by Holm test.
Fisher's exact test.
Rate of miscarriage = Patients with miscarriage (n)/GS‐positive patients (n) × 100.