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• W2041639500 abstract "Objective: Published literature remains inconclusive as to the significance, and predictors of zona pellucida thickness. Current treatment strategies involve the use of assisted hatching (AH) for women of older reproductive age and/or with elevated FSH levels. This strategy assumes that these women are at increased risk for thickened zona pellucida and would benefit from AH. To test the hypothesis that zona pellucida thickness correlates with maternal age, day 3 follicle-stimulating hormone (FSH), and/or average peak estradiol per follicle, we performed a retrospective analysis of all embryos transferred between November 2001 and May 2002 at the University of California, San Francisco Center for Reproductive Medicine. Design: A retrospective analysis. All patients, going through their first IVF cycle, were eligible. Patients who used donor eggs, and patients who did not undergo embryo transfer in their index cycle were excluded. A total of 91 patients were included in the study. Each patient had between one and six embryos transferred on Day 3 after oocyte retrieval. With a sample size of 91 patients, the power of this study was 90% to detect correlations of 0.3 or greater. Materials and Methods: Each transferred embryo included in the data set was photographed using a Nikon Diaphot inverted microscope and a Sony VP 895MD printer at either 10x or 20x magnification. Digital photographs were measured using Mitutoyo Digit Dial Calipers. The average zona thickness was calculated by making four equidistant measurements from the inside to the outside of the zona pellucida of each embryo at 12, 3, 6, and 9 o’clock positions. A zona thickness score was calculated from the average of transferred individual embryo zona thicknesses. All data were analyzed using Stata version 8.0 for Macintosh. Using Pearson correlations and locally weighted least squares (lowest) fits to the data, average zona thickness scores were compared with maternal age, day 3 FSH, and the peak estradiol divided by the number of follicles greater than 13 mm diameter (peak E2/follicle) on the day of hCG trigger. Implantation rates (IR) were also evaluated. An exact correlation between zona thickness and IR is not possible due to the inability to identify the specific embryo responsible for implantation. Results: Zona pellucida thickness scores were not found to correlate with maternal age, day 3 FSH, or peak E2/follicle. Additionally, no correlation was found between the individual patient variation in zona pellucida thickness and maternal age, day 3 FSH or peak E2/follicle. In evaluating all eligible patients, zona thickness score does not predict implantation rates in individual patients. These findings were also true in patients less than 38 years of age, who do not routinely undergo assisted hatching in our program. Conclusions: These findings suggest that neither maternal age, day 3 FSH nor peak E2/follicle is an accurate surrogate for zona pellucida thickness. Additionally, it unlikely that average zona pellucida thickness can be used to predict outcome when multiple embryos are transferred. These data raise questions about the identification of which patient populations may be most aided by assisted hatching techniques." @default.
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• W2041639500 date "2003-09-01" @default.
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• W2041639500 title "Correlation between patient age, day 3 FSH levels and zona pellucida thickness" @default.
• W2041639500 doi "https://doi.org/10.1016/s0015-0282(03)01445-6" @default.
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