الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
With the improvement of ICSI techniques, there has been a big dilemma which can be summarized in the following question ‘does adding poor quality embryo(s) to good quality embryo(s) affect ICSI outcome as regard the clinical pregnancy rate and implantation rate on day three?’
To break the dilemma of whether poor quality embryos have the potential to harm the good quality ones if transferred in the same fresh cycle, we started our study and this was our main aim.
Although there are some studies that proved that the poor-quality embryo can impair the implantation of high quality ones, our study proved otherwise.
140 patients were included in our study,70 transferring good quality embryo(s) with poor quality embryos in the same cycle (group A) and 70 transferring good quality embryos only.
All patients met the inclusion criteria and were consented for ICSI procedures, and the number of embryos transferred.
All the patients were stimulated using the antagonist protocol and were observed for clinical pregnancy rate as the primary outcome of the study, and for the implantation rate as the secondary outcome of the study.
All confounding factors were adjusted, and the clinical pregnancy rate was 38.6 percent in group (A)&45.7 percent in group (B). This means that no significant statistical differences were found between the 2 studied groups (p=.392).
The implantation rate in group (A) 33.30-100.0 % and it was 50.0-100.0 % in group (B) This means that no significant statistical differences were found between the 2 studied groups (p=0.152).
In addition, studies have revealed that DET are accompanied by elevated clinical conception & live birth rate in comparison with SET. Roberts et al. documented that SETs have 1/3 lower live birth rates than DETs in fresh cycles. In agreement with this finding, Baruffi et al. exhibited that fresh DET cycles have increased ongoing conception and live births rate in comparison with SET.
Thus, several IVF centres, increased the numbers of embryos transferred if the quality of embryos is reduced at the stage of cleavage . It is not known if the poor-quality embryo transfer with the good quality embryos is safe or it may cause a significant harm on the implantation and pregnancy rate of the good embryo? A strong interaction might be present between preimplantation embryos through paracrine factors that may influence the development as well as the growth of the nearby embryos.
Besides, the existence of poor-quality embryos in the same culture was documented to reduce the overall blastulation rates of all embryos.
This stimulated us to start this study to illustrate if there is a difference between the transfers of a poor-quality embryo in conjunction with the good quality embryos on day three on the ICSI outcome.
So transferring poor quality embryos together with good quality embryos doesn’t significantly affect ICSI outcomes on day three.
The implantation rate in group (A) 33.30-100.0 % and it was 50.0-100.0 % in group (B) This means that no significant statistical differences were found between the 2 studied groups (p=0.152).
Transferring poor quality embryos together with good quality embryos doesn’t affect ICSI outcome on day three.