Implications on IVF patient care of discarding oocytes affected by smooth endoplasmic reticulum aggregates as recommended by the Alpha/ESHRE consensus

Excerpt

The study conducted by Paffoni and colleagues in this issue of JARG discusses an important issue. Indeed, in 2011, the Alpha/ESHRE consensus [1] recommended discarding SERa + oocytes in order to prevent adverse neonatal outcomes. The authors describe here though, how applying the consensus might have a negative impact on the outcome of an IVF cycle. Patients with a SERa + cycle with few oocytes at retrieval (less than six) were shown to be at a significantly higher risk of a transfer cancellation compared to matched controls. The aim of IVF is obviously to help a couple conceive a healthy child. In view of the fact that SERa + cycles have shown to be recurrent in around 40 % of cycles [2], patients with a cycle presenting SERa and few oocytes at retrieval might nevertheless opt for the transfer of an embryo originating from a SERa + oocyte in order to avoid transfer cancellation or more so to conceive with their own gametes. Recent data do suggest that healthy babies can originate from affected oocytes [2, 3]. Moreover, patients having difficulties coping with the IVF procedure due to stress, burden of schedules or other factors might find a transfer cancellation extremely discouraging. This in turn could enhance patient drop out. …