THE AIM OF THE STUDY
To clarify the dependence of reproductive outcomes in cohorts of women with a favorable and unfavorable prognosis for the success of in vitro fertilization (IVF) after the transfer of freshly obtained embryos cultured using two technologies - traditional technology (TT) and chronomonitoring technology (time-lapse, TLT).
MATERIAL AND METHODS
The outcomes of IVF were assessed by the clinical pregnancy rate per embryo transfer (CPR) and the incidence of early reproductive losses using: a) TT in 1961 cycles; b) an incubator with time-lapse technology (TLT) in 607 cycles. The results were compared in selectively identified groups of patients: Group 1 (control) — women with a favorable prognosis for the outcome of IVF; Groups 2—4 — women with specific reproductive status: Group 2 — women over 36 years old; Group 3 — with a poor response to gonadotropins; Group 4 — with repeated implantation failures.
RESULTS
In patients over 36 years old, with a poor response to gonadotropins and repeated implantation failures, compared with patients without these characteristics (control group), there was a decrease in the NNPe indicator and an increase in the frequency of early reproductive losses when using both types of cell incubators. The method of paired comparison of the values of the NNPe indicators and the frequency of early reproductive losses during embryo cultivation using TT and TLT did not reveal a statistically confirmed difference between them (p> 0.05) in any of the four groups with different prognoses for IVF success. At the same time, in all groups, a tendency towards improved treatment results was found (an increase in the NNPe indicator by 2—5% and a decrease in the frequency of early reproductive losses by 2%) when using TLT instead of TT.
CONCLUSION
In women with a favorable and unfavorable prognosis for the outcome of in vitro fertilization, time-lapse embryo culture technology does not provide statistically significant improvement in the rate of clinical pregnancy per embryo transfer and the rate of early reproductive losses during their transfer. However, due to the possibility of obtaining a larger number of high-quality blastocysts in TLT incubators, it becomes possible to increase the number of embryo transfers per stimulated cycle and thereby increase the rate of clinical pregnancy.