ИСТИНА

Context. During preimplantation development, the embryo dynamically interacts with the walls of the fallopian tube and the villi of the mucosa. The conditions of embryo development in assisted reproduction programs are different from natural. Thus, embryo culturing under mechanical microvibration can improve embryonic development and pregnancy outcomes. Objective. The aim of the prospective cohort pilot study was to assess the influence of the human embryo mechanical microvibration on the clinical pregnancy rate in IVF cycles. Methods. Ovarian stimulation was performed by the short protocol with gonadotropin-releasing hormone antagonists. The embryo assessment was carried out according to Gardner's schale (Gardner DK, 1999). Pregnancy rate was evaluated by the β-hCG blood level after 14 days since embryo transfer. Differences were considered significant when p-value < 0.1 due to the pilot character of the study. Patient(s). We included 618 IVF couples in the study. Embryos from 129 couples were cultured under microvibration (group 1) and from 489 couples – under normal conditions (group 2). The mean age of the patients was the same in both groups (34.1 ± 5.0 vs 34.4 ± 5.2). Intervention(s). In the group 1 the incubator was placed on the microvibration platform ArisTT180-s (K&S Advanced Systems Ltd, Israel) in the mode of active vibration (40 Hz for 30 seconds with an interval of 30 minutes). The study was IRB-approved. Main Outcome Measure(s). We measured oocyte number and maturity, fertilization, blastulation and pregnancy rates. Result(s). The number of retrieved oocytes was 7 (4 – 12) and 7 (4 – 11), respectively (p = 0.121). The number of mature oocytes was 6 (3 – 9) and 5 (3 – 8.75), respectively (p = 0.112). Fertilization rate was slightly higher in the microvibration rate (86.7% vs 83.2%, p = 0.012). The indications for the double embryo transfer in the most cases were the late reproductive age and the multiple ineffective IVF attempts. The blastocyst transfer rate was the same (51.2% vs 54.6%, p = 0.275). The pregnancy rate was higher in the microvibration group (30.2%) than in the control group (24.1%, p = 0.098). Conclusions. The use of controlled mechanical microvibration during embryo culturing leads to the significant (6.1%) increase of the pregnancy outcome in the IVF cycles. However, further research is needed to implement this method into the clinical practice with an assessment of the short-term and long-term outcomes.