P-094. Correspondence of day 3 selection of best quality embryos and actual development to blastocyst on day 5

K.F. Miller, K.L. Fry, R.L. Arciaga, M. Attaran, J.M. Goldberg, T. Falcone
1999 Human Reproduction  
Initiation of gonadotrophin-releasing hormone agonist (GnRHa) in the luteal phase may result in ovarian cyst formation. There have been some studies, with variable results, on the effect of these cysts on cancellation and clinical pregnancy rates. Our aim was to assess whether baseline ovarian cyst formation is a sign of poor prognosis and the effect of the aspiration of the cyst on cancellation and pregnancy rate. Materials and methods: We retrospectively evaluated the first IVF cycles of 315
more » ... atients without cyst and 95 patients in whom baseline ovarian cyst >25 mm was diagnosed after use of leuprolide acetate starting in the midluteal phase. GnRHa was continued until desensitization was achieved and ovulation induction was initiated following down-regulation confirmed by oestradiol <40 pg/ml. Results: In patients without cyst, cycle cancellation rate was 18.7% (59/315) and pregnancy rate per cycle was 27.0% (85/315). In patients with baseline ovarian cyst cycle cancellation rate was 32.6% (31/95) and pregnancy rate per cycle was 30.5% (29/95). Cycle cancellation rate in patients with cyst was significantly higher (P = 0.04) than that in patients with no cyst but pregnancy rate per cycle between two groups did not differ. Of 95 patients with baseline ovarian cyst, ovulation induction was initiated after transvaginal cyst aspiration in 27 and in the presence of ovarian cyst in 68 patients. In the cyst-aspirated group, cancellation rate was 22.2% (6/27) and pregnancy rate per cycle was 40.7% (Ill 27) and in the non-aspirated group cancellation rate was 36.7% (25/68) and pregnancy rate per cycle was 26.4% (18/68) (P > 0.05 for both parameters). Oestradiol level at the day of human chorionic gonadotrophin administration and number of oocytes aspirated were similar in the two groups (1920 ± 430 versus 2140 ± 320 pglml and 11.8 ± 3.7 versus 9.5 ± 2.7 oocytes respectively). Conclusions: Baseline cyst formation is a sign of increased cycle cancellation rate but does not imply lower pregnancy rate per cycle overall. Even though cancellation rate appeared to be higher, and pregnancy rate per cycle lower, in the nonaspirated group than in aspirated group, the differences did not reach statistical significance. Abstracts of the 15th Annual meeting of the ESHRE, Tours, France 1999 P-093. BLEFCO vigilance: French web site for in-vitro fertilization culture media quality control and assisted reproductive technology quality assurance BLEFCO (French Federation of IVF Biologists), presented Assisted reproductive technology requires culture media, materials and equipment whose qualities and conditions of use can have an influence on the result of the attempts. Quality control concerns processes, procedures and means. Quality assurance, however, concerns results and outcomes of the attempts. Various quality tests are applied to culture media by the manufacturers and today in France there are microbiological control requirements before marketing, and for media used to culture human embryos. The ultimate quality test is the assessment of each batch of media with gametes and embryos during the assisted reproduction procedures. Since 1995, biologists in French in-vitro fertilization (IVF) centres, joined together in the French Federation of IVF Biologists (BLEFCO), have developed a quality control system based on monthly parameter collection in a database for both IVF and intracytoplasmic sperm injection procedures. It concerns firstly biological attempt parameters (i.e. no. of attempts, inseminated oocytes, diploid embryos obtained, transfers, embryo transferred, freezing procedures and frozen embryos) and secondly results of these attempts (no. of implantations and ongoing pregnancies). These data concern each medium or batch of media used in participating laboratories. At the end of 1998 the database contained more than 13 000 attempts. In September 1998 a Web site (http://amp-chu-besancon. univ-fcomte.fr/blefco/) was placed at BLEFCO members' disposal to facilitate collection and data analysis. Moreover, this web site is organized in both a public and a secure zone that also supplies professional information, links for other assisted reproduction professional sites and a private membersonly forum for a vigilance discussion group. Data collection of media is regularly analysed and the general results provided in graph form. If quality control data are outside the tolerable range, an alert message is published on site and an e-mail message is sent to connected assisted reproduction centres. This original and preliminary experiment needs to be developed, and specific statistical process control tests used in industrial sectors must be transposed to improve the efficiency of this new biological tool. P-094. Correspondence of day 3 selection of best quality embryos and actual development to blastocyst on day 5
doi:10.1093/humrep/14.suppl_3.187-b fatcat:ah3pv4bs6fb5hh7zz45xvnijt4