The predictive value of day 3 embryo morphology regarding blastocyst formation, pregnancy and implantation rate after day 5 transfer following in-vitro fertilization or intracytoplasmic sperm injection

Purpose : To find an effective method to select embryos from ICSI with better chromosomal status when preimplantation-genetic-diagnosis (PGD) is not applied. Methods : Several morpholological evaluations were done in same embryos. Embryos from ICSI were classified on day 1 according to pronuclear-nucleoli arrangement. On day 3, classification was done according to number, fragmentation, size and shape of cells. In some patients, embryos exhibiting good quality on day 3 (at least six regular blastomeres with cell fragmentation lower than 20%) were also submitted to PGD, irrespective to pronuclearnucleoli morphology. Results : Forty-two per cent of normally fertilized embryos showed pronuclear-nucleoli-goodmorphology; from those, 86% were also classified as good quality on day 3. Good-quality embryos submitted to PGD have shown lower chromosomal abnormality rates when also classified as pronuclear-nucleoli-good-morphology. Conclusions : Pronuclear-nucleoli morphology seems to be correlated with PGD results. This criterion may prove useful for pre-select embryos with normal chromosomal package when PGD is not applied.

“…However, selection based on morphology is highly controversial in literature, where some of them say that embryos with a compromised morphology still give viable pregnancies (28,41).…”

Section: Discussionmentioning

confidence: 99%

The impact of pronuclear orientation to select chromosomally normal embryos

Borges

Rossi

Farah

et al. 2005

“…These were higher than those reported in most blastocyst studies even though only 0.88, 0.80, and 0.61 more embryos were cultured for Groups I, II, and III, respectively, than the number transferred. Pregnancy and implantation rates with blastocyst transfer have ranged from 21 to 77% and 9-62%, respectively (2,5,6,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). With blastocyst transfer, all embryos are retained in culture to ensure at least two high-quality blastocysts are available for transfer.…”

Section: Discussionmentioning

confidence: 99%

“…With current cryopreservation techniques, human embryos survive and implant at higher rates when cryopreserved at the PN-S (8-10) compared with the cleavage or blastocyst stages (6,19,29,30). The cohort of fertilized oocytes from a retrieval cycle has better nuclear synchrony at the PN-S than do the embryos as they progress to later stages of development.…”

Section: Discussionmentioning

confidence: 99%

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Selection of Embryos for Day-3 Transfer at the Pronuclear-Stage and Pronuclear-Stage Cryopreservation Results in High Delivery Rates in Fresh and Frozen Cycles

Hammitt

Sattler

Manes

et al. 2004

Purpose : Evaluate IVF-ET outcome data for a unique culture and cryopreservation strategy. Methods : Retrospective study of 92 patients. Embryos for day-3 transfer were selected at pronuclear-stage; all extra zygotes were cryopreserved at pronuclear-stage. Results : Delivery rates for Anonymous Oocyte Donation (Group I), patients <35 years (Group II), and 35-38 years (Group III) were 52.9%, 61.5%, and 51.7% for fresh and 38.5%, 33.3%, and 40.0% for frozen transfer. Deliveries per retrieval were 82.3%, 71.8%, and 58.6%. Only 0.88, 0.80, and 0.61 more zygotes were cultured than what were used for fresh transfer. Singleton, twin, and triplet rates were 64.6%, 31.2%, and 4.2% for fresh and 69.2%, 30.8%, and 0% for frozen. Conclusions : Selection of day-3 transfer embryos at the pronuclear-stage and cryopreservation of extra zygotes results in high delivery rates in fresh and frozen cycles. This approach optimizes deliveries per retrieval and provides many patients with more than one pregnancy per retrieval.

“…Rjinders and Jansen [23] also reported that only 51 % of the embryos transferred on day five had been selected for transfer on day three. Chen and Katerra [24] demonstrated that there is no difference, in terms of implantation and pregnancy, between whether PN morphology or early cleavage is used to select embryos for transfer on day three.…”

Section: Introductionmentioning

confidence: 99%

The combination of pronuclear and blastocyst morphology: a strong prognostic tool for implantation potential

Braga

Setti

Figueira

et al. 2013

Purpose To (i) investigate a possible association between different features of pronuclear (PN) morphology and different features of blastocyst morphology, (ii) evaluate the combination of PN and blastocyst morphologies as a predictive factor for ICSI outcomes and (iii) identify possible contributing factors to poor PN morphology. Methods This study included 908 normally fertilised zygotes reaching full blastocyst stage, obtained from 350 patients undergoing ICSI cycles, in which the implantations rates were 0 % or 100 %. The influence of PN morphology on blastocyst morphology and on the rates of pregnancy and miscarriage was investigated. Embryos were graded and split into three groups, taking into consideration both the PN and the blastocyst status. The pregnancy rate was compared among these groups. Results Inner cell mass (ICM) alterations were correlated with the number of nucleolar precursor bodies (NPB), while trophectoderm alterations were correlated with the size of the pronuclei and the distribution of the NPB. The distribution of the NPB had an impact on the chances of pregnancy. A significant difference was observed among the groups regarding the pregnancy rate. The maternal age, number of aspirated follicles and number of retrieved oocytes influenced the incidence of PN defects. Conclusions These findings suggest that a lower oocyte yield may lead to higher-quality PN zygotes. In addition, different PN features may influence further embryo development, especially the quality of the blastocyst. Moreover, the association between PN and blastocyst morphology may be used as a prognostic tool for implantation.