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. 2025 Apr 13;17(4):e82160.
doi: 10.7759/cureus.82160. eCollection 2025 Apr.

Polar Body Biopsy Helps in Reducing the Total Pregnancy Loss Rates in Intracytoplasmic Sperm Injection Cycles

Ensar Hajder  1 , Simon Eickhoff  2   3 , Andreas Winter  4 , Nino Jangulashvili  5 , Elmira Hajder  6 , Cornelius Doehmen  7 , Ezz Al Din Alazzeh  8
Affiliations

Polar Body Biopsy Helps in Reducing the Total Pregnancy Loss Rates in Intracytoplasmic Sperm Injection Cycles

Ensar Hajder et al. Cureus. .

Abstract

Objective: To evaluate the effect of polar body biopsy (PBB) on pregnancy and pregnancy loss outcomes in intracytoplasmic sperm injection (ICSI) cycles.

Methodology: This is a retrospective case-control study that analyzed 147 ICSI embryo transfer (ET) cycles. The study included 82 subfertile patients (31 patients with ICSI and PBB therapy = case group; 51 patients with ICSI without the PBB therapy = control group). We conducted a statistical analysis of all pregnancies and births resulting from fresh and thawed ICSI cycles, with and without the use of PBB after a single embryo transfer (SET) of a blastocyst (BL). Our main outcome measures were the pregnancy and pregnancy outcome rates after ICSI with and without the PBB.

Result: The implantation rate in the ICSI with PBB group was lower than in the ICSI without PBB group, but there were no significant differences (11 = 17.50% vs. 21 = 25.00%, RR = 0.63, 95% CI: 0.28-1.44, p = 0.37). The yolk sac detection rate in the ICSI with PBB group was lower than in the ICSI without PBB group, but there were no significant differences (8 = 12.70% vs. 16 = 19.00%, RR = 0.62, 95% CI: 0.25-1.55, p = 0.65). The fetal heartbeat rate in the ICSI with PBB group was lower than in the ICSI without PBB group, but there were no significant differences (7 = 11.10% vs. 12 = 14.30%, RR = 0.75, 95% CI: 0.28-2.03, p = 0.75). The live birth rate in the ICSI with PBB group was higher than in the ICSI without PBB group, but there were no significant differences (5 = 7.90% vs. 5 = 6.00%, RR = 1.36, 95% CI: 0.37-4.92, p = 0.88). The total pregnancy loss rate was significantly lower in the ICSI with PBB group than in the ICSI without PBB group (6 = 9.50% vs. 19 = 22.60%, RR = 0.36, 95% CI: 0.14-0.96, p = 0.04).

Conclusion: A bigger patient sample is needed for further evaluation, but based on our findings, we recommend the PBB in the cases of apparent or suspected genetic, maternal diseases and/or aneuploidies and for improving general ICSI outcomes, through the reduction of pregnancy loss rates. This information can support reproductive professionals and embryologists who are looking to invest in new solutions for their centers and labs.

Keywords: assisted reproductive technology (art); blastocyst; blastocyst biopsy; in vitro fertilization (ivf); intracytoplasmic sperm injection (icsi); live birth rate; miscarriage; polar body biopsy; preimplantation genetic diagnosis (pgd); single embryo transfer (set).

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Committee Duesseldorf issued approval 134/2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Study algorithm
Figure 2
Figure 2. Polar body biopsy (PBB) procedure
1 – Fertilized oocyte 10 hours after ICSI with two polar bodies (PB) at 1 o'clock in the perivitelline space, 2 – assisted hatching of zona pellucida with a RI Saturn 5 laser system (Cooper surgical), 3/4 – withdrawal of the two PB with a pipelle, 5 – no visible damage to the embryo structure after the withdrawal of the PB, 6 – two visible PB after the withdrawal in the medium.
See this image and copyright information in PMC

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