Complete embryo developmental arrest and its prognostic significance in IVF

Abstract

Structured Abstract Objective To identify the rate of repeated embryo arrest in the subsequent IVF cycle for those with prior complete embryo developmental arrest (EDA) in their index cycle. Design Retrospective cohort study with exposure groups matched via propensity scoring (1:2 ratio). Subjects All patients who underwent two consecutive ovarian stimulation cycles for IVF within a year, resulting in at least two or more 2-pronuclei embryos between January 2017 and April 2025. Exposure Patients were categorized by the embryology outcomes of the index cycle: (1) complete EDA group (0% blastocyst formation rate) and (2) comparison group (one or more blastocysts cryopreserved). Main Outcome Measures Primary outcome measure was blastulation rate in the subsequent IVF cycle. Secondary outcomes included total number of oocytes retrieved, total mature oocytes, total fertilized oocytes, total blastocysts, and euploidy rate. Doubly robust estimation was employed with multivariable log-binomial regression models to test the association of complete EDA with blastulation outcomes in the matched sample. Results Prior to matching, 501 and 3,412 patients were identified in the EDA and comparison groups, respectively. The EDA group was significantly older (p