TABLE 13.
The relationship between the GnRH antagonist protocol, position (θ) of the meiotic spindle relative to the polar body, and outcomes.
| Outcome | θ = 0° | 0° < θ ≤ 30° | 30° < θ ≤ 60° | 60° < θ ≤ 90° | 90° < θ ≤ 180° |
|---|---|---|---|---|---|
| Female age, mean years ± SD a | 36.7 ± 5.1 | 37.0 ± 5.1 | 37.3 ± 5.4 | 37.7 ± 5.0 | 37.6 ± 5.5 |
| n (%) | n (%) | n (%) | n (%) | n (%) | |
| ICSI b | |||||
| MII oocytes c | 679 | 389 | 224 | 104 | 36 |
| 2PN2PB oocytes | 521 (76.7) | 313 (80.5) | 171 (76.3) | 80 (76.9) | 26 (72.2) |
| 1PN oocytes | 15 (2.2) | 6 (1.5) | 6 (2.7) | 5 (4.8) | 0 (0.0) |
| Multi‐PN oocytes | 19 (2.8) | 15 (3.9) | 10 (4.5) | 5 (4.8) | 2 (5.6) |
| No‐PN oocytes | 25 (3.7) | 15 (3.9) | 11 (4.9) | 4 (3.8) | 0 (0.0) |
| Unfertilized oocytes | 64 (9.4) | 19 (4.9) | 12 (5.4) | 5 (4.8) | 0 (0.0) |
| Broken oocytes | 35 (5.2) | 21 (5.4) | 14 (6.3) | 5 (4.8) | 8 (22.2)**,§,†,# |
| Embryo development | |||||
| Cultured 2PN2PB d | 403 | 237 | 139 | 55 | 19 |
| Blastocysts | 267 (66.3) | 156 (65.8) | 88 (63.3) | 39 (70.9) | 12 (63.2) |
| Pregnancy, live birth, and miscarriage | |||||
| Blastocyst transfer cycles | 121 | 47 | 42 | 17 | 3 |
| hCG‐positive | 39 (32.2) | 14 (29.8) | 14 (33.3) | 5 (29.4) | 0 (0.0) |
| GS‐positive | 28 (23.1) | 13 (27.7) | 10 (23.8) | 2 (11.8) | – |
| FHM‐positive | 25 (20.7) | 10 (21.3) | 10 (23.8) | 2 (11.8) | – |
| LB/OP | 23 (19.0) | 9 (19.1) | 10 (23.8) | 1 (5.9) | – |
| Miscarriage e | 5 (17.9) | 4 (30.8) | 0 (0.0) | 1 (50.0) | – |
Note: Holm test used to determine significance.
Abbreviations: FHM, fetal heart movement; GnRH, gonadotropin‐releasing hormone; GS, gestational sac; hCG, human chorionic gonadotropin; ICSI, intracytoplasmic sperm injection; LB/OP, live birth, or ongoing pregnancy; MII, metaphase II; PB, polar body; PN, pronuclei.
**p < 0.01, each group vs. θ = 0°. § p < 0.05, each group vs. 0° < θ ≤ 30°. † p < 0.05, each group vs. 30° < θ ≤ 60°. # p < 0.05, each group vs. 60° < θ ≤ 90°.
Steel–Dwass test.
ICSI cycles using frozen‐thawed spermatozoa, spermatozoa retrieved by testicular sperm extraction, or oocytes that were artificially activated were excluded from the analysis.
Oocyte with spindle within ooplasm.
2PN2PB oocytes cultured until confirmation of blastocyst formation.
Rate of miscarriage = Patients with miscarriage (n)/GS‐positive patients (n) × 100.