Embryo quality but not pronuclear score is associated with clinical pregnancy following IVF

Abstract

Purpose The association between pronuclear (PN) scoring of embryos from assisted reproductive technology (ART) and clinical pregnancy remains controversial. We hypothesized that embryos with PNs scored on the day of fertilization check offer better embryo selection on day 3 and higher CPR compared to non-PN scored embryos. Methods Patients (19-46 years) undergoing IVF/ICSI cycles at Montefiore's Institute for Reproductive Medicine and Health between January 2006 and December 2009 were included in our study. We analyzed fresh day 3 cycles only with autologous oocytes and partner's fresh sperm (n=344). A total of 1,899 embryos were included. We compared CPR from non-PN scored embryos (Group 1, n=835) with PN scored embryos (Group 2, n=1,064). Composite scores by patient were developed based on embryo disposition. We also assessed traditional embryo grading derived from cell number, fragmentation and cell symmetry. Data analysis included chi square and t test to determine if PN scoring was associated with improved CPR, and to compare the additional variables.Results CPR between Group 1 and Group 2 were not different (p=0.91). CPR was significantly associated with female age, number of mature oocytes retrieved, number of day 3 embryos and grade of embryos transferred on day 3 (p<0.05). Conclusion PN scoring was not associated with improved CPR in day 3 embryo transfers. Mean grade of transferred embryos continues to be a well-established, independent predictor of CPR. We conclude that further refinement of embryo grading by PN scoring is not beneficial.

Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers

“…Hormonal and secreted factors produced by both the embryo and the endometrium (41,45,75,79–81), morphological differences (82–90) and genetic and epigenetic alterations not detected by PGS all potentially represent implantation and survival barriers. A more comprehensive understanding of these barriers is not likely be addressed by additional clinical studies of EnT or EnP alone.…”

The effect of serum and follicular fluid amyloid-associated protein levels on in vitro fertilization outcome in patients with polycystic ovary syndrome

“…Recombinant hCG (250 μg sc., Ovitrelle, Serono, Istanbul, Turkey) was administered when at least three follicles showed a mean diameter of 18 mm, and oocyte retrieval was done 36 h after the hCG injection by the guidance of transvaginal ultrasonography, and ICSI was used for all IVF-ET patients. Fresh single-embryo transfers performed on day 3 to all women [14]. Luteal support was given by vaginal progesterone (Crinone 8 % gel, Serono, Istanbul), and supplementation was started on hCG administration day [15].…”

“…Few authors researched the relation between PCOS and serum AA protein documenting different results with increased serum levels in PCOS [2,12,13] or no difference with the controls [1]. Up to our knowledge, there is only one report in the literature studying the levels of AA protein in follicular fluid (FF) of women undergoing controlled ovarian stimulation for in vitro fertilization [14]. Therefore in this study, we aimed to investigate serum and follicular fluid levels of AA protein in nonhyperandrogenic, non-obese patients with PCOS.…”

Prediction of the in vitro developmental competence of early‐cleavage‐stage human embryos with time‐lapse imaging and oxygen consumption rate measurement

“…Among the different evaluated parameters, pronuclei (PN) scoring has been a subject of debate. Although some studies have shown a prognostic effect of PN scoring, one study concluded that further refinement of embryo grading by PN scoring is not beneficial . Over the last decade, an ET at the blastocyst stage has been used more frequently to select the best embryo and to decrease the number of transferred embryos.…”

“…Although some studies have shown a prognostic effect of PN scoring, 5,6 one study concluded that further refinement of embryo grading by PN scoring is not beneficial. 7 Over the last decade, an ET at the blastocyst stage has been used more frequently to select the best embryo and to decrease the number of transferred embryos. However, the transfer of embryos at the blastocyst stage is occasionally avoided and they are transferred at an earlier stage, especially when patients have few embryos or when embryos might not tolerate expanded culture conditions.…”