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In France, nearly 3% of children are conceived by the technique of Assisted Reproductive Medicine, of which nearly 70% by in vitro fertilization (IVF). The rates of clinical pregnancy by oocyte retrieval or embryo transfer have not changed much. The use of mono-embryo transfer reduces the risk of multiple pregnancies and associated obstetric complications. The choice of embryo to transfer or freeze is a key element in improving the chances of success of IVF. It is usually based on conventional morphological criteria (reference method) that are punctual, qualitative and subjective. However, embryo morphology at early stages has little predictive value for obtaining a late-stage embryo and its chances of implantation. The recent use of time-lapse technology during embryonic culture makes it possible to associate morphological criteria with continuous monitoring of the kinetics of embryonic development. The choice of the embryo to be transferred is then made according to morphokinetic criteria (conventional morphological criteria to which are added the data of the kinetics of embryonic development).
Two recent retrospective studies give contradictory results, the first shows higher birth rates in the group of embryos selected according to conventional morphological criteria, the second concludes that morphokinetic analysis is superior. Morphokinetic criteria would also be more objective and reproducible. However, the use of morphokinetic parameters remains controversial in the literature.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conventional morphology arm (reference method) | Active Comparator |
| |
| Morphokinetic arm | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Morphokinetic | Other | The embryos will be observed at a fixed time and according to morphological criteria (Alpha Specialist Group in Reproductive Medicine and ESHRE, 2011). and all the films obtained will be analyzed. Embryos will be classified according to morphokinetic criteria (Ciray et al., 2014). |
| Measure | Description | Time Frame |
|---|---|---|
| The primary endpoint of this study will be the live birth rate by fresh embryo transfer(s). | 36 months |
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Inclusion Criteria:
For the couple:
For the conditions of realization of the ICSI attempt:
For the man:
Exclusion Criteria:
For the couple:
For the conditions of realization of the ICSI attempt:
- In vitro fertilization attempt with the micro-injection of testicular spermatozoa, epididymal, previously frozen or resulting from a retrograde ejaculation.
For the man:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU CAEN | Caen | 14033 | France | |||
| Chu Rouen |
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|
| Rouen |
| 76031 |
| France |