Author: Richard Sherbahn, MD

Study title: Assessment of effect of follicular fluid temperature at egg retrieval on blastocyst development, implantation and live birth rates

Objective: To study the influence of follicular fluid temperature during the egg retrieval procedure on blastocyst development and implantation and live birth success rates.

Design: Retrospective review of embryo development and implantation and live birth rates according to recorded follicular fluid temperatures at the egg retrieval.

Follicular fluid is recovered from the follicles in the ovaries when we aspirate the eggs

Materials and Methods: Our ability to maintain an ideal temperature for the oocytes during the time of the egg retrieval procedure was measured and recorded using thermocouple temperature sensors.

All (1659) IVF cycles with a female partner under age 43 that had follicular fluid temperature recorded between January 2002 and April 2009 were included in the study.

The cases were split into 3 groups for analysis:

The “Ideal” temperature group had readings between 36.4 and 36.9 degrees Centigrade
The “Low” group had readings below 36.4
The “High” group had temperatures above 36.9

IVF outcome parameters were evaluated including:

Day 5 blastocyst formation rate (% of fertilized embryos that were blastocysts on day 5
Implantation rates
Live birth rates
Statistical analysis utilized Student's t-test and chi-square statistics

Results: IVF cases with follicular fluid temperatures between 36.4 and 36.9 degrees Centigrade during egg retrieval had higher rates of blastocyst development, rates of embryo implantation and live birth success rates compared to cases that had lower or higher temperatures. Results shown in tables below.

Conclusions: Eggs are sensitive to temperature fluctuations. Maintaining egg temperatures in an ideal range during a retrieval procedure can improve embryo development and IVF success rates.

IVF Outcome by Follicular Fluid Temperatures - Ideal vs. Low
Means +/- SD	Ideal Temperature Range 36.4 - 36.9		Low Temperature Range <36.4		P value
Age	32.8 +/- 4.2		33.6 +/- 4.3		NS
Age range	20 - 42		21 - 42
Number ET	2.1 +/- 0.6		2.1 +/- 0.7		NS
Blast development rate	2331/5684	41.0%	1408/4165	33.8%	P < 0.0001
Implantation Rate	761/1898	40.1%	482/1406	34.3%	P = 0.0006
Live Birth Rate Per Retrieval	484/917	52.8%	293/665	44.1%	P = 0.0006

IVF Outcome by Follicular Fluid Temperatures - Ideal vs. High
Means +/- SD	Ideal Temperature Range 36.4 - 36.9		High Temperature Range >36.9		P value
Age	32.8 +/- 4.2		33.4 +/- 4.5		NS
Age range	20 - 42		22 - 42
Number ET	2.1 +/- 0.6		2.2 +/- 0.7		NS
Blast development rate	2331/5684	41.0%	139/457	30.4%	P < 0.0001
Implantation Rate	761/1898	40.1%	39/170	22.9%	P < 0.0001
Live Birth Rate Per Retrieval	484/917	52.8%	29/77	37.7%	P = 0.015

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