Predictors of embryo fragmentation and outcome after fragment removal in in vitro fertilization

Objective: To assess predictors of embryo fragmentation in IVF as well as to compare cycle outcomes between low-grade embryos subjected to defragmentation and high-grade embryos not undergoing defragmentation. Design: A retrospective, case-control trial. Setting: A university hospital IVF program. Patient(s): Three hundred twenty-seven nondonor, fresh IVF cycles. Main Outcome Measure(s): Predictors of fragmentation. We evaluated age, basal FSH and E-2 levels, the number of retrieved oocytes, and fertilization rates. Outcome assessments following defragmentation included rates of implantation, clinical pregnancy, spontaneous abortion, and live birth. Result(s): Increased age and lower number of oocytes and embryos were associated with embryo fragmentation. Lower-grade embryos after defragmentation yielded rates of implantation, clinical pregnancy, live birth, spontaneous abortion, and fetal defects equivalent to high-grade embryos. Conclusion(s):Fragmented embryos correlate with poorer prognosis cycles. however, fragmented embryos that undergo defragmentation result in equivalent clinical outcomes to high-grade, nondefragmented embryos.