JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):235
Poster Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263846
P-223. The Effect of Total Gonadotropin Dose per Retrieved Oocyte on Laboratory Outcomes in Assisted Reproduction Cycles
Gustavo Teles1, Melissa Cavagnoli1, Vitoria Ambrosio1, Maria Augusta Tamm1, Ana Micucci1, Edson Borges Jr, Maite Del Collado3
1 Clínica Hope Reprodução Humana - São Paulo – SP- Brasil
2 Fertility-FertGroup Medicina Reprodutiva - São Paulo – SP -Brasil
3 Science For Everymind - São Paulo – SP -Brasil
Objective: To date, the potential negative effect of high gonadotropin doses on oocyte quality and competence remains widely debated, especially in conventional controlled ovarian stimulation protocols that use higher hormone doses. This study aimed to evaluate the effect of total gonadotropin dose per retrieved oocyte on oocyte quality and competence assessed by artificial intelligence, morphokinetics, and embryo ploidy rates
Methods: This retrospective cohort study included assisted reproduction cycles performed between 2020 and 2024. To investigate the association between gonadotropin dose and laboratory outcomes, the total gonadotropin dose per oocyte retrieved was categorized into tertiles: Low (<269.77 IU; 82 cycles, 788 oocytes), Medium (269.77–692.62 IU; 124 cycles, 565 oocytes), and High (>692.62 IU; 107 cycles, 237 oocytes). Oocyte quality was assessed using the artificial intelligence-based tool, Magenta Score (MS). Embryonic morphokinetics, KIDScore, laboratory outcomes, and ploidy rates were also analyzed. Baseline variables were compared between groups using Chi-square or Fisher's Exact test for categorical variables, and Analysis of Variance (ANOVA) followed by Tukey's post-hoc test for continuous variables. Generalized Linear Models (GzLM) adjusted for patient age and ovarian reserve were used for outcome analysis. After oocyte quality assessment by MS, cycles with male factor infertility were excluded to reduce confounding. All analyses were performed using R software (version 4.5.1), with a significance level set at 5% (p<0.05).
Results: Among baseline data, significant differences were observed in female age (Low: 36.52±0.35 vs. Medium: 37.88±0.28 vs. High: 38.69±0.32 years), anti-Müllerian hormone (AMH) levels (Low: 3.13±0.27 vs. Medium: 1.49±0.09 vs. High: 0.79±0.07 ng/mL), and antral follicle count (AFC) (Low: 18.83±0.91 vs. Medium: 10.16±0.38 vs. High: 6.54±0.31). After data adjustment, no significant differences in oocyte quality, as assessed by MS, were observed between the groups (Low: 5.91±0.19; Medium: 5.96±0.18; High: 5.84±0.26). The metaphase II (MII) oocytes rate (Low: 76.51%±3.16; Medium: 73.66%±2.30; High: 77.76%±2.57), fertilization rate (Low: 76.66%±3.55; Medium: 70.72% ±02.58; High: 71.61%±2.90), blastocyst formation rate (Low: 55.17±4.78; Medium: 61.54 ±3.48; High: 53.61%±3.91; p=0.087), euploid rates per biopsied blastocyst (Low: 36.94%±6.03; Medium: 30.97%±04.88; High: 34.06%±0.0592) or euploid rates per injected oocyte (Low: 16.21%±3.45; Medium: 18.00%±2.79; High: 16.58±3.38) were similar across groups. However, the proportion of Day 5 blastocysts differed significantly among the groups, with an increased rate in the Medium group compared to the High group (Low: 72.64%±6.11; Medium: 77.57%±4.45; High: 58.88%±5.09; p=0.002). No significant differences were observed among the groups in any of the individual morphokinetic time points (t2, t3, t4, t5, t6, t7, t8, tB, tM, tPNa, tPNf, and tSB). However, significant differences were found in specific cell cycle durations. S1, CC2, and CC3 durations were significantly shorter in the low group (1.89±0.12; 7.69±0.51; and 8.61±0.65) compared to the medium group (2.38±0.12; 9.59±0.48; and 11.61±0.62), while the high group showed intermediate values for all three parameters (2.09±0.19; 8.66±0.75; and 9.66±0.97). Still, no differences were observed in the embryonic KIDScore among the groups (Low: 4.08±0.22; Medium: 4.33±0.24; and High: 4.99±0.35 in the high group).
Conclusion: These findings suggest that higher gonadotropin doses may be associated with a marginal impairment in embryonic developmental dynamics, although oocyte and embryo competence, as well as ploidy, appear to remain largely unaffected.