Effect of follicular size on the day of trigger on OOCYTE and EMBRYO quality in clomiphene citrate protocol- A comparitive retrospective study

Abstract

Objective: To compare the effect of follicular size on the day of trigger on the oocyte and embryo quality in clomiphene citrate protocol in patients undergoing IVF/ICSI. Materials and Methods: A Retrospective comparative analysis was done in patients who underwent IVF/ICSI with clomiphene citrate protocol between 2016-2018 in craft hospital and research centre kodungallur Kerala. 242 patients who met the inclusion criteria of primary/secondary infertility, <40yrs old, normal male factor. Excluding > 4oys old, endometriosis, PCOS, male factor infertility. Group A: included 83 patients with lead follicle measuring 21-23 mm on the day of trigger. Group B: Included 159 patients with lead follicle measuring 17-19mm on the day of trigger. Inj ovitrille 250 mcg was given as a trigger. Oocytes retrieved after 36hrs by transvaginal approach. Both groups were compared for number of oocytes retrieved, number of mature oocytes, number of Day 3 good embryos. Statistical analysis was done by independent sample T-test for all variables. Results: No statistical difference between age and AFC in both groups. Statistical difference in number of oocytes retrieved (p value -0.055). No statistical difference in number of mature oocytes and number of day 3 embryos. Conclusion: Women who underwent IVF/ICSI with clomiphene citrate protocol with a lead > 20mm had less number of oocytes retrieved when compared to <20mm lead follicle on the trigger day and had similar number of mature oocyte and day 3 embryos. No beneficial effect by waiting for the lead follicle to reach beyond 20mm in size.