Factors influencing oocyte yield and embryo quality in donor IVF cycles: a retrospective cohort study.
Lin. Pin-Yao PY; Lee. Chun-I CI; Chen. Hsiu-Hui HH; Huang. Chun-Chia CC; Chen. Ming-Jer MJ; Yu. Tzu-Ning TN; Lee. Tsung-Hsien TH; Lee. Maw-Sheng MS
Abstract
Achieving an optimal balance between oocyte yield and embryo quality is central to donor IVF. Although anti-Müllerian hormone (AMH) predicts oocyte quantity, donor characteristics and stimulation parameters may influence embryo developmental competence. We aimed to identify clinical and protocol-related factors associated with oocyte yield and embryo quality in a large donor cohort. We retrospectively analyzed 584 donor IVF cycles at a single center (Jan 1, 2018-Dec 31, 2023). Donor variables included age, AMH, BMI (body mass index), and baseline hormones. Stimulation used gonadotropin-releasing hormone (GnRH) antagonist (27.1%) or progestin-primed ovarian stimulation (PPOS)(72.9%); recombinant human luteinizing hormone (LH) was used in 86% of cycles; final maturation was GnRH agonist (GnRHa) (59.4%) or dual trigger (40.6%). Outcomes were oocyte yield and embryo quality metrics (maturation, two-pronuclear (2PN) fertilization, Day 3 good-quality embryo rate, blastocyst formation rate, and top-quality blastocyst rate). Multivariable linear regression and propensity score matching (PSM) compared protocols and LH supplementation. Donors were 25.6 ± 3.7 years with AMH 6.1 ± 2.9 ng/mL and BMI 21.6 ± 2.8 kg/m². Per cycle: 27.1 ± 11.1 oocytes, 20.8 ± 8.3 MII (maturation 78.2 ± 13.4%), 2PN fertilization 73 ± 18%, Day 3 good-quality embryos 10.6 ± 6.0 (69.5 ± 23.5%), blastocysts 9.5 ± 5.5 (56.7 ± 22.5%), and top-quality blastocysts 6.1 ± 4.2 (36.5 ± 20.1%). First transfers (n=491) yielded 55.4% clinical pregnancy and 44.4% live birth; miscarriage 12.2%. AMH independently predicted oocyte number; higher BMI was associated with lower fertilization. PPOS produced lower Day 3 good-quality embryo (67.9% vs 72.8%) and top-quality blastocyst rates (59.7% vs 74.1%) versus antagonist in PSM, with similar blastocyst formation rate (64.0% vs 60.9%). LH supplementation modestly increased fertilization (74.4% vs 69.5%) without downstream differences. Dual trigger was associated with reduced blastocyst formation rate but a higher proportion of top-quality blastocysts. In donor IVF, AMH is the principal predictor of oocyte yield, whereas BMI, stimulation protocol, and trigger method influence embryo quality. Despite protocol-dependent morphology differences, pregnancy and live birth rates remained high. Findings support individualized stimulation strategies that consider donor profile and protocol effects to optimize efficiency and outcomes.
Study Information
pubmed
2025
2025-10-31T00:00:00.000Z
10.3389/fendo.2025.1649523
39