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Background and Aims: Selecting embryos with the highest implantation potential is crucial to in vitro fertilization (IVF) success. The day of biopsy, Day 5 (D5) or Day 6 (D6), and embryo quality have been suggested as influential factors in determining the clinical outcomes of single euploid blastocyst transfers. However, evidence supporting the superiority of D5 over D6 blastocysts remains inconclusive. This study aims to compare clinical outcomes following transfer of euploid blastocysts of varying quality biopsied on day 5 versus day 6.

Methods: A retrospective cohort study was conducted at an Assisted Reproductive Center, analyzing 774 patients with Day 5 biopsies and 155 patients with Day 6 biopsies who underwent embryo transfer between January 2019 and February 2022.

Results: The live birth rate was significantly lower in the euploid D6 group than in the euploid D5 group (38.71% vs. 55.04%, RR=0.70, 95% CI=0.57-0.87). The outcomes were significantly influenced by the quality of the embryos. Excellent embryos yielded live birth rates of 62.14% and 53.61% for D5 and D6 biopsies, respectively, while good embryos demonstrated live birth rates of 45.18% (D5) and 32.21% (D6). For fair embryos, the live birth rates were 28.64% (D5) and 19.32% (D6). The outcome difference was statistically significant across embryo quality categories (p<0.05). The adjusted risk ratios of clinical outcomes indicated that excellent euploid Day 5 embryos consistently outperformed other types of embryos.

Conclusions: Our study supports that the biopsy day and embryo quality are crucial factors in determining the success of single euploid blastocyst transfers. Excellent euploid Day 5 transfers yielded superior outcomes, providing valuable insights for clinicians and patients when selecting embryos for transfer in IVF cycles.

Background and Aims: Follitropin delta is the third recombinant FSH (rFSH) preparation developed with an individualized dosing regimen based on patient’s body weight and AMH level. According to the existing report, a daily dose of follitropin delta provides an equivalent ovarian response to that of follitropin alfa. However, the effect of follitropin delta on the resulting embryo and biochemical pregnancy remains to be elucidated. Hence, the present study aims to evaluate the effect of follitropin delta on embryo quality and biochemical pregnancy rates compared with that of follitropin alfa in an in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle.

Methods: A retrospective cohort study was conducted between January and December 2022 at Melati Clinic, Harapan Kita Women and Children Hospital. A total of 59 IVF/ICSI cycles stimulated with follitropin alfa and 26 IVF/ICSI cycles treated with follitropin delta were subsequently analyzed.

Results: After analysis, no significant difference was observed regarding the embryo quality of both treatments (P>0.05). The median of the good, moderate, and poor embryos in the follitropin alfa and follitropin delta group was 2 vs. 3, 1 vs. 2, and 2 vs. 2, respectively. Similarly, the biochemical pregnancy rate between the follitropin alfa and follitropin delta group was comparable (25% vs. 15%, P>0.05).

Conclusions: In conclusion, our study suggests that stimulation with follitropin delta in IVF/ICSI cycles yields a similar embryo quality and biochemical pregnancy rates to those of follitropin alfa.

Background and Aims: Extracytoplasmic oocyte abnormalities such as Large Perivitelline Space (LPVS) and Fragmented Polar Body (FrPB) are frequently detected in human oocytes during IVF procedures. The purpose of this research is to determine the relationship of LPVS, FrPB, and their combination on embryo quality and pregnancy loss.

Method: The 36 positive pregnancy cases from under 40 years old patients that underwent ICSI using normospermia at RS Pondok Indah IVF Centre were observed. Patients were stimulated with r-FSH utilizing an antagonist protocol for 10-11 days, then r-HCG was administered as a trigger 36 hours before retrieval. Oocytes were classified as follows: (a) normal, (b) large perivitelline space (LPVS), (c) polar body fragmentation (FrPB), and (d) a combination of LPVS and FrPB. The Shapiro-Wilk and Kruskal-Wallis tests were used to determine the effect between each of the categories of oocyte with D3 and D5 embryo quality, along with pregnancy loss.

Results: The results indicate that there was no significant distinction among the groups in terms of embryo quality on D3 and D5, as well as pregnancy loss (p=0.187, 0.881, and 0.561, respectively).

Conclusion: It could have been concluded that LPVS, FrPB, and their combination have no impact on embryo quality and pregnancy loss.