CONTEXT: Our center's quality improvement optimization process on many occasions anecdotally suggested that oocyte assessments might enhance embryo assessment in predicting pregnancy chances with @entity52 ( @entity52 ). OBJECTIVE: To prospectively compare a morphologic oocyte grading system to standard day-3 morphologic embryo assessment. DESIGN, SETTING, @entity1 : We prospectively investigated in a private academically-affiliated @entity249 center 94 consecutive @entity52 cycles based on 6 criteria for oocyte quality: morphology, cytoplasm, perivitelline space (PVS), @entity4091 ( @entity4091 ), polar body (PB) and oocyte size, each assigned a value of -1 (worst), 0 (average) or +1 (best), so establishing an average total oocyte score ( @entity262 ). Embryo assessment utilized grade and cell numbers of each embryo on day-3 after oocyte retrieval. Clinical pregnancy was defined by presence of at least one intrauterine gestational sac. INTERVENTIONS: Standard @entity52 cycles in infertile @entity1 . MAIN OUTCOME MEASURES: Predictability of pregnancy based on oocyte and embryo-grading systems. RESULTS: Average age for all @entity1 was 36.5    7.3 years; mean oocyte yield was 7.97   5.76; @entity1 specific total oocyte score (PTOS) was -1.05    2.24. PTOS, adjusted for @entity1 age, was directly related to odds of increased embryo cell numbers (OR 1.12, P = 0.025), embryo grade (OR 1.19, P < 0.001) and clinical pregnancy [OR 1.58 (95%CI 1.23 to 2.02), P < 0.001]. Restricting the analysis to day three embryos of high quality (8-cell/ good grades), @entity262 was still predictive of clinical pregnancy (OR 2.08 (95%CI 1.26 to 3.44, P = 0.004). Among the 69 @entity1 with embryos of Grade 4 or better available for transfer 23 achieved Clinical Pregnancy. When the analysis was restricted to the 69 transfers with good quality embryos (>=  Grade 4) @entity262 ( @entity262 ) (AUC  SE 0.863  0.044, oocyte score) provided significantly greater predictive value for clinical pregnancy compared to the embryo grade alone (AUC 0.646    0.072, embryo grade) p = 0.015. CONCLUSIONS: Oocyte-scoring, thus, provides useful clinical information especially in good prognosis @entity1 with large numbers of high quality embryos. This finding appears of particular importance at a time when many @entity52 centers are committing sizable investments to closed incubation systems with time-lapse photography, which are exclusively meant to define embryo morphology.

Oocyte Scoring Enhances Embryo-Scoring in Predicting Pregnancy Chances with XXXX Where It Counts Most.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'PATIENTS', 'Patient'] @entity249 :: ('MESH:D007246', 'Disease') :: ['infertility'] @entity262 :: ('MESH:D034721', 'Disease') :: ['TOS', 'the Oocyte Scoring System'] @entity4091 :: ('MESH:D006562', 'Disease') :: ['ZP', 'zona pellucida'] @entity52 :: ('MESH:C566179', 'Disease') :: ['IVF', 'in vitro fertilization']
@entity52 :: (MESH:C566179,Disease) :: ['IVF']
