The effect of GnRH analogues on oocyte morphology and subsequent embryo development following intra cytoplasmic sperm injection (ICSI)

A competent, morphologically normal gamete (oocyte or sperm) is essential for successful fertilization, the development of a good-quality embryo, and implantation. Intracytoplasmic sperm injection (ICSI) allows direct microscopic assessment of gamete quality and the study of factors that may affect gamete quality and development. The aim of this study was to assess the effect of different gonadotropin-releasing hormone (GnRH) analogue protocols (antagonist vs agonist) on oocyte maturity, morphology, quality, and embryo development. Fifty-three subfertile women were included. Participant age ranged from 18–37 years and body mass index (BMI) from 18.9–24.9 kg/m². All underwent ICSI using GnRH antagonist and agonist protocols. Microscopic evaluation of oocyte and embryo quality was performed and compared between groups. Among all parameters studied (total retrieved oocytes; oocyte quality and morphology; embryo quality; fertilization and cleavage rates), only the total number of good-quality embryos was significantly higher and the total number of poor-quality embryos was significantly lower in the GnRH antagonist group. Thus, the GnRH antagonist significantly increases the rate of developing good-quality embryos and reduces the rate of poor-quality embryos, despite producing a nonsignificantly higher number of immature and morphologically abnormal oocytes, which appear to have no impact on embryo quality or subsequent development.