The effects of smooth endoplasmic reticulum aggregation on b
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Smooth endoplasmic reticulum aggregation (SERa, SER+) has been reported to increase the risk of birth malformations and other abnormal outcomes, miscarriage, and perinatal complications. Other studies, however, suggest that SER+ embryos may develop into healthy infants.

Researchers investigated the effect of SER+ on birth outcomes in IVF and intracytoplasmic sperm injection.

They performed a literature search using PubMed, ScienceDirect, Cochrane, Embase, Ovid, and Scopus and found a total of 1500 relevant studies between 1978 and 2020 and conducted a meta-analysis to study the effects of SER+ on live births, birth weight, and the number of metaphase II (MII) oocytes retrieved per cycle. Eleven eligible studies were included.

--If the SER+ zygote was evaluated again at the embryo transfer (ET) stage, SER+ did not affect birth or infant body weight.

--Stimulated ovaries producing too many oocytes per cycle were positively correlated with SER+.

--SER+ was positively correlated with oocyte maturation rate, and observed heterogeneity in a previous meta-analysis was likely due to maternal age.

--The data also showed that SER+ cycles produced more oocytes but achieved the same number of births from ET.

The use of SER+ MII oocytes is rare, with the collection of many oocytes in 1 cycle potentially inducing SER+. SER+ may be more common than they originally thought, as some SER+ is found in all oocytes. Although SER+ positively affected oocyte maturation rate, it did not affect births.

Investigators hypothesized that this is because the best embryos are chosen at every step of the process, and the oocytes with the poorest characteristics are removed. They, therefore, suggest a standard method for measuring SER+. Although embryos produced from SER+ cycles can be used, they should only be transferred when no other suitable embryos are available over several cycles.

BMC Pregnancy and Childbirth