scholarly journals The ovarian sensitivity index is predictive of live birth chances after IVF in infertile patients

2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
A Weghofer ◽  
D H Barad ◽  
S K Darmon ◽  
V A Kushnir ◽  
D F Albertini ◽  
...  
Keyword(s):  
Live Birth ◽  
Odds Ratio ◽  
Embryo Quality ◽  
Oocyte Retrieval ◽  
Sensitivity Index ◽  
Validation Group ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Oocyte Yield ◽  
Ovarian Sensitivity Index

Abstract STUDY QUESTION Does the ovarian sensitivity index (OSI) predict embryo quality, pregnancy and live birth in patients undergoing FSH/hMG stimulation for IVF? SUMMARY ANSWER The OSI is predictive of pregnancy and live birth in older women with a more unfavorable prognosis undergoing FSH/hMG stimulation for IVF. WHAT IS KNOWN ALREADY The OSI was previously reported to reflect gonadotrophin requirements among high, normal and poor responders and to predict pregnancy potential in younger patients undergoing ovarian stimulation with FSH. STUDY DESIGN, SIZE, DURATION A retrospective cohort study that included 1282 women undergoing IVF with FSH/hMG stimulation was carried out between January 2010 and December 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS We evaluated 1282 women who underwent fertility treatment with FSH/hMG stimulation and oocyte retrieval at an academically affiliated private fertility center. OSI was calculated as (oocytes ×1000)/total gonadotrophin dose and grouped into two classes based on a receiver operating characteristic (ROC) curve analysis of a randomly selected development sample comprising one-third of the cycles. The remaining cycles comprised the validation group. ROC curves were also used to compare the predictive value of OSI to that of baseline FSH and anti-Müllerian hormone (AMH). Logistic regression models evaluated the effect of high (OSI >0.83) and low (OSI ≤0.83) on clinical pregnancy and live birth in the validation group. Models were adjusted for female age, baseline FSH, AMH and oocyte yield and gonadotrophin dose. MAIN RESULTS AND THE ROLE OF CHANCE Women presented with a mean ±SD age of 38.6 ± 5.4 years and showed median AMH levels of 0.65 (95% CI 0.61–0.74) ng/ml. They received 5145 ± 2477 IU of gonadotrophins and produced a median 5.2 (95% CI 5.0–5.5) oocytes. Pregnancy and live birth rates per oocyte retrieval for all women were 20.6% and 15.8%, respectively. Patients with higher OSI (less gonadotrophin required per oocyte retrieved) produced significantly more high-quality embryos than patients with low OSI (3.5 (95% CI 3.2–3.8) versus 0.6 (95% CI 0.5–0.7) (P = 0.0001)) and demonstrated higher pregnancy (23.2% versus 9.7%) and live birth rates (8.8% versus 5.3%) than their counterparts (P = 0.0001 and P = 0.0001, respectively). After adjustments for age, baseline AMH and FSH, total gonadotrophin dosage and oocyte yield, an OSI >0.83 was associated with greater odds of pregnancy (odds ratio 2.12, 95% CI 1.30–3.45, P < 0.003) and live birth (odds ratio 1.91, 95% CI 1.07–3.41, P < 0.028). LIMITATIONS, REASONS FOR CAUTION The results may not be applicable to women with excellent pregnancy potential or FSH-only stimulation. WIDER IMPLICATIONS OF THE FINDINGS The predictive capacity of OSI for embryo quality, pregnancy and live birth, which is independent of AMH or FSH, may help in counseling patients about their pregnancy potential and live birth chances. STUDY FUNDING/COMPETING INTEREST(S) Intramural funding from the Center for Human Reproduction and the Foundation for Reproductive Medicine. A.W., V.A.K., D.F.A., D.H.B. and N.G. have received research grant support, travel funds and speaker honoraria from various pharmaceutical and medical device companies: none, however, related to the topic presented here. D.H.B. and N.G. are listed as inventors on already awarded and still pending US patents, claiming beneficial effects on diminished ovarian reserve and embryo ploidy from dehydroepiandrosterone supplementation. TRIAL REGISTRATION NUMBER N/A.

scholarly journals Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Zachary Walker ◽  
Andrea Lanes ◽  
Elizabeth Ginsburg
Keyword(s):  
Fertility Preservation ◽  
Live Birth ◽  
Oocyte Retrieval ◽  
Oocyte Cryopreservation ◽  
Utilization Rate ◽  
Birth Rates ◽  
Aged Patients ◽  
Live Birth Rates ◽  
Oocyte Yield ◽  
Age Related

Abstract Background The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; however, it is now available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. The primary aim of this paper is to provide a narrative review of the most recent and robust data on the utilization and outcomes of OC in both patient populations. Summary OC results in similar oocyte yield in patients facing gonadotoxic therapies and patients undergoing planned OC. Available data are insufficient to predict the live birth rates or the number of oocytes needed to result in live birth. However, oocyte yield and live birth rates are best among patients < 37.5 years old or with anti-mullerian hormone levels > 1.995 ng/dL, at the time of oocyte retrieval. There is a high ‘no use’ rate (58.9%) in patients using planned OC with 62.5% returning to use frozen oocytes with a spouse. The utilization rate in medical OC patients is < 10%. There is currently no data on the effects of BMI, smoking, or ethnicity on planned OC outcomes. Conclusion It is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; however, preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs. Higher oocyte yield, with fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation. More studies are needed in medical OC and planned OC to help guide counseling and decision-making in patients seeking these services.

O-014 How effective is oocyte cryopreservation?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Cobo
Keyword(s):  
Cancer Patients ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Oocyte Retrieval ◽  
Success Rates ◽  
Birth Rates ◽  
Oocyte Vitrification ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
Different Populations

Abstract text The challenge of cryopreserve, store for prolonged period, and successfully implant the female gamete is nowadays feasible thanks to vitrification. The technology that was initially validated in oocyte recipients is currently applied to a vast population, including women at risk of losing their ovarian function due either to iatrogenic causes as occurs in cancer patients, or due to the natural depletion of the ovarian reserve as a result of age related fertility decline. That is the case of a growing population of women who wish to postpone childbearing and decide on oocyte vitrification as a means of fertility preservation (FP). At present, there is a growing body of evidence regarding the use of vitrified oocytes by many women under different indications, which makes it possible to evaluate the approach from different scenarios. So that vitrification can be evaluated in terms on survival rates, embryo development and the rate at which vitrified oocytes develop into live-born children in IVF cycles using vitrified oocytes which were initially stored due to different reasons. The effects of vitrification at the subcellular level and its impact on oocyte competence is of interest in the evaluation of the efficacy of the technology. Some studies have indicated that vitrification may affect ultrastructure, reactive oxygen species (ROS) generation, gene expression, and epigenetic status. However, it is still controversial whether oocyte vitrification could induce DNA damage in the oocytes and the resulting early embryos. Recent studies show that oocytes survival and clinical outcome after vitrification can be impaired by patients’ age and the clinical indication or the reason for vitrification. These studies show that age at oocyte retrieval strongly affects the survival and reproductive prognosis. In our experience, oocyte survival, pregnancy and cumulative live birth rates are significantly higher when patients are aged 35 years or younger versus patients older than 35 years at oocyte retrieval. Therefore, elective-FP patients should be encouraged to decide at young ages to significantly increase their chances of success. There is also evidence that the reason for vitrification is associated to the success rates. Poorer reproductive outcome was reported in cancer patients, low responders and endometriosis patients when compared to healthy women in age matching groups. Moreover, there are certain individualities linked to specific populations, as occurs when endometriosis patients had cystectomy earlier than the oocyte retrieval for FP. These women achieved lower success rates as compared to non-operated age matching counterparts. In this case, the lower cumulative live birth rates observed in operated women are, most probably, due to the smaller number of oocytes available, as a consequence of the detrimental effect of the surgery on the ovarian reserve. In this regard, several reports show that the number of oocytes available per patient is another variable closely related to the outcome in all populations using vitrified oocytes after FP. Thus, a significant improvement in the cumulative live birth rates can be achieved by adding a few oocytes, especially in healthy young patients. Different populations using vitrified oocytes under several indications achieve differential results in terms of pregnancy rates, when calculated in overall. Nonetheless, when the calculations for the cumulative probability of achieving a baby are made according the number of oocytes used per patient belonging to the same group of age, the results become comparable between different populations, as shown by the comparison between elective freezers versus endometriosis patients. Undoubtedly, vitrification can be recognized as one of the latest brakethrough in the ART field, but certainly the next step forward would be the successfull automatization of the vitrification and warming processes to achieve fully consistency among different laboratories.

P–237 The good, the fast and the slow: which is better? Live birth rate following single blastocyst frozen embryo transfer

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Sokol ◽  
E Clu. Obradó ◽  
M Sol Inarejos ◽  
M Parrieg. Beltrán ◽  
F Martíne. Sa. Andrés ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Embryo Transfer ◽  
Live Birth ◽  
Embryo Quality ◽  
Frozen Embryo Transfer ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Actual Effect ◽  
Blastocyst Quality ◽  
The Impact

Abstract Study question Are embryo quality and day of vitrification (Day 5, 6 or 7) associated with live birth rates (LBR) following single blastocyst transfer (SBT) in frozen embryo transfer cycle (FET)? Summary answer Both blastocyst quality and day of vitrification are significantly associated with LBRs, with very low LBR when poor quality embryos are frozen on day 6. What is known already Evidence suggests that chromosomal status (ploidy) is strongly associated with blastocyst morphology and good quality embryos are more likely to be euploid. Furthermore, previous studies have shown a relationship between the time that embryos need to reach blastocyst stage and their euploidy rate with slowly developing blastocysts showing higher rate of aneuploidy. Nonetheless, despite all this evidence little is known about the actual effect of the combination of blastocyst quality and day of its vitrification. The scope of this study was to quantify the actual effect of the embryo quality and day of vitrification on live birth rates following FET. Study design, size, duration Retrospective analysis of 1546 FET cycles with SBT conducted between 2017 and 2019 in the university-affiliated private clinic. The embryos used for FET were obtained from IVF/ICSI: with PGT (FET-PGT) or without PGT (FET0) or from donated oocytes (FET-DON). Participants/materials, setting, methods FET with natural, natural-modified and completely medicated cycles to prepare endometrial lining were included. Blastocysts were classified according to Spanish Association for the Study of Reproductive Biology (ASEBIR) classification, ranging from A (the highest) to D (the lowest). The impact on LBR of different subgroups, formed within FET-PGT, FET0, FET-DON groups due to different day of vitrification and blastocyst quality, was assessed, using logistic regression after adjusting for age, day of vitrification and embryo quality. Main results and the role of chance We included 1546 FET cycles. Of those, 543 (35%) corresponded to FET-PGT; 648 (42%) to FET0 and 355 (23%) to FET-DON cycles. Overall, 1051 (68%) embryos were frozen on day 5(D5), 472 (30.5%) on day 6(D6) and 23 (1.5%) on day 7(D7). As far as embryo quality was concerned, 215 (13.9%) grade A; 957 (61.9%) B; 371(24%) C and 3(0.2%) D blastocysts were transferred. LBRs were significantly different between different embryos frozen on D5 44.3%; on D6 28.8% and on D7 8.7%, p &lt; 0.001. When blastocyst quality was considered, LBR were 48.4% for grade A; 42.5% for B; 25.1% for C and 0% for D, p &lt; 0.001. After applying logistic regression analysis, the odds ratio (OR) for transferring D6-blastocyst was 1.08, 95% CI[0.45; 2.62] and blastocyst with grade B and C; 0.71, 95% CI[0.51; 1.00]; 0.57,95% CI[0.36; 0.88] respectively. However, after transferring D6-blastocyst graded as C, the OR was 0.33, 95% CI[0.12; 0.90]. Our predictive model showed that the impact of the embryo quality on LBR was sustained across three groups. Transfer of D5/D6 grade A blastocyst resulted in the highest, while D6-C in the lowest LBR in all the groups. In the latter case vitrification on D6 impaired additionally the outcome. Limitations, reasons for caution The study should be interpreted with caution due to its retrospective character and the assessment of blastocyst quality on the day of vitrification and not on the day its transfer. Wider implications of the findings: Our robust findings could be considered a useful tool for counselling couples who seek advice regarding their expected success rates in the setting of FET with SBT. The very low livebirth rates in low quality (C) slow developing (D6) embryos should be communicated to patients prior to planning a FET. Trial registration number Not applicable

P–225 The effect of rapid and delayed insemination on reproductive outcome in conventional insemination and intracytoplasmic sperm injection invitro-fertilization cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Esiso ◽  
F Lai ◽  
D Cunningham ◽  
D Garcia ◽  
B Barrett ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Detrimental Effect ◽  
Live Birth Rate ◽  
Oocyte Retrieval ◽  
Fertilization Rate ◽  
Time Intervals ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

Abstract Study question Does rapid or delayed insemination after egg retrieval affect fertilization, blastocyst development and live birth rates in CI and ICSI cycles? Summary answer When performing CI or ICSI &lt;1.5h and &gt;6.5h after retrieval, detrimental effects are moderate on fertilization but do not impact blastocyst usage and birth rates. What is known already Several studies have shown that CIor ICSI performed between 3 to 5 h after oocyte retrieval has improved laboratory outcomes. However, some studies indicate that insemination of oocytes, by either CI or ICSI, within 2 hours or more than 8 hours after oocyte retrieval has a detrimental effect on the reproductive outcome. With some ART centres experiencing an increase in workload, respecting these exact time intervals is frequently challenging. Study design, size, duration A single-center retrospective cohort analysis was performed on 6559 patients (9575 retrievals and insemination cycles) between January 1st2017 to July 31st2019. The main outcome measures were live-birth rates. Secondary outcomes included analysis of fertilization per all oocytes retrieved, blastocyst utilization, clinical pregnancy, and miscarriage rates. All analyses used time of insemination categorized in both CI and ICSI cycles. Fertilization rates across categories was analyzed by ANOVA and pregnancy outcomes compared using Chi-square tests. Participants/materials, setting, methods As part of laboratory protocol, oocyte retrieval was performed 36 h post-trigger. Cycles involving injection with testicular/epidydimal sperm, donor or frozen oocytes were excluded. The time interval between oocyte retrieval and insemination was analyzed in eight categories: 0 (0- &lt;0.5h), 1 (0.5-&lt;1.5h), 2 (1.5-&lt;2.5h), 3 (2.5-&lt;3.5h), 4 (3.5-&lt;4.5), 5 (4.5-&lt;5.5), 6 (5.5-&lt;6.5) and 7 (6.5-&lt;8h). The number of retrievals in each group (0–7) was 586, 1594, 1644, 1796, 1836, 1351, 641 and 127 respectively. Main results and the role of chance This study had a mean patient age of 36.0 years and mean of 12.2 oocytes per retrieval in each category. There were 4,955 CI and 4,620 ICSI retrievals. The smallest groups were time category 7 and 0 for CI and ICSI respectively. The results showed that the mean fertilization rate per egg retrieved for CI ranged from 54.1 to 64.9% with a significant difference between time category 0 and 5 (p &lt; 0.001) and category 1 and 5 (p &lt; 0.0.001). Mean fertilization rate for ICSI per egg retrieved ranged from 52.8 to 67.3% with no significant difference between time categories compared to category 5. Blastocyst utilization rate for CI and ICSI were not significantly different for all time categories. In the CI and ICSI groups there were 6,540 and 6,178 total fresh and frozen transfers. The miscarriage and clinical pregnancy rate in CI and ICSI were not significantly different across time categories. The overall mean live birth rate for CI was 32.4% (range: 23.1 to 35.5%). Live-birth rates differed significantly (p = 0.04) in CI with time categories 0 and 7 the lowest. In the ICSI group, the overall mean live birth rate was 30.8% (range: 29.1 to 35.7%),with no significant differences between time categories. Limitations, reasons for caution As this is a retrospective study, the influence of uncontrolled variables cannot be excluded. The group spread was uneven with the early and late time categories having the lowest number of representative retrievals and this could have affected the results obtained. Wider implications of the findings: Our results indicate that both CI and ICSI are optimal when performed between 1.5–6.5 hours after oocyte retrieval. Further prospective studies on reproductive outcomes related to time of insemination are warranted. This data indicates a minimal detrimental effect when it is untenable to follow strict insemination time intervals. Trial registration number 2015P000122

scholarly journals The effect of cult-active medium on pregnancy outcomes after intracytoplasmic sperm injection in azoospermic men: A case-control study

2022 ◽  
pp. 1059-1066
Author(s):  
Elham Asa ◽  
Rahil Janatifar ◽  
Seyedeh Saeideh Sahraei ◽  
Atefeh Verdi ◽  
Naser Kalhor
Keyword(s):  
Active Medium ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Embryo Quality ◽  
Obstructive Azoospermia ◽  
Oocyte Activation ◽  
Control Groups ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

Background: Failed oocyte activation following intracytoplasmic sperm injection (ICSI) as a result of calcium deficiency is a major challenge. Objective: We compared the effect of cult-active medium (CAM) on ICSI outcomes in obstructive azoospermia cases. Materials and Methods: The present study was conducted with 152 ICSI cases, classified into CAM and control groups. The injected oocytes in the control group were cultured in the cleavage medium, while in the artificial oocyte activation group, oocytes were chemically activated through exposure to 200 µL of CAM for 15 min. Fertilization and cleavage rates, quality of embryos, and biochemical pregnancy and live birth rates were assessed in both groups. Results: There were significant differences between the groups in terms of fertilization and cleavage rates after using the CAM in the percutaneous epididymal sperm aspiration (PESA) subgroup (p = 0.05, p ≤ 0.001) and in the testicular sperm extraction subgroup (p = 0.02, p = 0.04), compared to their control groups. Also, the pregnancy rate was significantly higher in the PESA-CAM subgroup (p = 0.03). The PESA-CAM subgroup demonstrated a significant difference in embryo quality after ICSI (p = 0.04). Unsuccessful embryo transfer and abortion were lower in both subgroups compared to the control groups, but this difference was not significant. Surprisingly, live birth rate was higher in the PESA-CAM subgroup (p = 0.03). Conclusion: CAM treatment could improve fertilization and cleavage rates in obstructive azoospermia participants. It had a significant effect on embryo quality, and pregnancy and live birth rates in PESA cases. Key words: Calcium ionophore, Obstructive azoospermia, Fertilization, ICSI.

Elevated progesterone in GnRH agonist down regulated in vitro fertilisation (IVFICSI) cycles reduces live birth rates but not embryo quality

2011 ◽  
Vol 285 (2) ◽  
pp. 535-540 ◽  
Author(s):  
Robert Lahoud ◽  
Michele Kwik ◽  
John Ryan ◽  
Moamar Al-Jefout ◽  
Jane Foley ◽  
...  
Keyword(s):  
Live Birth ◽  
Gnrh Agonist ◽  
Embryo Quality ◽  
In Vitro Fertilisation ◽  
Birth Rates ◽  
Live Birth Rates

scholarly journals Endocrine, sexual and reproductive functions in patients with Klinefelter Syndrome compared to non-obstructive azoospermic patients.

2021 ◽  
Author(s):  
Fatih Kocamanoğlu ◽  
Bulent Ayas ◽  
Mustafa Bolat ◽  
Ummet Abur ◽  
Recep Bolat ◽  
...  
Keyword(s):  
Live Birth ◽  
General Health ◽  
Embryo Quality ◽  
Psychological Status ◽  
Sperm Retrieval ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Group 2 ◽  
Group 1

Aims: We aimed to investigate fertilization rates, quality of embryo, pregnancy and live birth rates, endocrine, sexual function, psychological status and quality of life of cases diagnosed with Klinefelter syndrome (KS). Methods: Clinical findings, hormone values and semen analyses in patients with nonmosaic KS (Group 1, n=121) and those with non-genetic nonobstructive azoospermia (NOA) (Group 2, n=178) were retrospectively analyzed. Sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE), fertilization rates and embryo quality, pregnancy, abortion, and live birth rates were compared. Sexual functions were assessed using IIEF-15, quality of life was evaluated, and psychological status was assessed. Results: There was no difference in terms of age between groups. Sperm retrieval rates was 38% and 55.6% in Group 1 and 2, respectively (p=0.012). Sperm retrieval rates were higher in Group 1 before 31.5 years than in Group 2 (AUC=0.620, 0.578). Compared to Group 2, the fertilization rate was low in Group 1, whereas embryo quality was similar. Live birth rates were 12.5% and 23% in Group 1 and 2, respectively (p=0.392). The education level, libido, erectile functions, and general health satisfaction were lower in Group 1 than in Group 2 (buraya p değeri yaz). Depression and anxiety levels were higher in Group 2 than Group 1 (p değeri yaz). Conclusion: Higher sperm retrieval rate has been achieved in group 1 younger than 31.5 years. Similar embryo quality is provided between groups. Sexual dysfunction and psychiatric problems were higher in Group 1, with lower satisfaction and general health than Group 2. Patients with KS should be monitored not only with their reproductive functions but also with their general health status.

P–066 Does microfluidic sperm sorting (MSS) affect embryo euploidy rates in couples with high sperm DNA fragmentation (SDF)?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Keskin ◽  
E G Pabuçcu ◽  
A Tufan ◽  
D.Ö Demirkıran ◽  
R Pabuçcu
Keyword(s):  
Dna Fragmentation ◽  
Live Birth ◽  
Embryo Quality ◽  
Gradient Centrifugation ◽  
Small Sample ◽  
Sperm Dna Fragmentation ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Sperm Dna ◽  
Euploidy Rates

Abstract Study question Does MSS (microfluid chip-sorted spermatozoa selection) provide improvement on embryo quality and euploidy rates in couples with high SDF (sperm DNA fragmentation) and previous failed in vitro fertilization/ intracystoplasmic sperm injection (IVF/ICSI) cycles? Summary answer Use of MSS technique provides higher number of top quality blastocysts compared to density gradient centrifugation (DGC), however euploidy and live birth rates weren’t improved. What is known already Previously it has been reported that sperm DNA damage leads to poor embryo development and there is a significant association between SDF and high embryo aneuploidy rates. Recently this fact raised attention to sperm selection techniques such as MSS to enhance embryo quality, miscarriage rates and embryonic euploidy rates. Study design, size, duration This was a retrospective electronic medical record (EMR) analysis of a tertiary assisted reproduction center between 2016 and 2020. All EMR were reviewed to select eligible cases as; couples undergoing a new IVF/ICSI cycle with PGT-A (preimplantation genetic testing for aneuploidies). In total, data from 243 patients were obtained for the analysis that accounts for 688 embryos. Participants/materials, setting, methods Patients had at least 2 previous failed IVF cycles and males had at least 20% SDF. In their new cycles, MSS was offered, preceding ICSI and PGT-A. Couples who accepted the technique were assigned to MSS group (92 cycles with 310 embryos) and the rest were managed with DGC and assigned as controls (151 cycles with 378 embryos). Azoospermia cases and women with age&gt;43, uterine abnormalities, trombophilia were excluded. Biopsies were performed at blastocyst stage. Main results and the role of chance Two groups were comparable in terms of demographic data including women and men age, SDF, sperm parameters and cycle characteristics. There was no difference between groups in terms of fertilization rates (MSS 85% vs DGC 79% p = 0.9), euploidy rates (MSS 53.2% vs DGC 50.7% p = 0.3), mean no of euploid embryo per patient (MSS 1.09 vs DGC 0.95 p = 0.3), positive pregnancy test (MSS 50% vs DGC 38.4% p = 0.06), clinical miscarriage (MSS 7.6% vs DGC 6.6% p = 0.7) and live birth rates (LBR)(MSS 42.4% vs DGC 31.7% p = 0.09). Total no of blastocysts and top quality blastocysts were significantly higher in MSS group than in DGC (3.9 vs 2.5 p &lt; 0.01 and 1.6 vs 0.8 p &lt; 0.001 respectively). Limitations, reasons for caution Retrospective design, small sample size, lack of proper randomization and power analysis are the main limitations. Wider implications of the findings: Offering PGT-A to couples with unexplained repeated IVF failures and high SDF seems feasible. MSS for such cases improves embryonic division process as improved blastulation rates were documented. However, euploidy rates were not improved in MSS group revealing that other factors influence comprehensive chromosomal status of an embryo. Trial registration number Not applicable

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