The use of morphokinetics as a predictor of embryo implantation

Purpose The purpose of the study was to explore the effect of blastomere biopsy for preimplantation genetic diagnosis (PGD) on the embryos' dynamics, further cleavage, development, and implantation. Methods The study group included 366 embryos from all PGD treatments (September 2012 to June 2014) cultured in the EmbryoScope™ time-lapse monitoring system. The control group included all intracytoplasmic sperm injection (ICSI) embryos cultured in EmbryoScope™ until day 5 during the same time period (385 embryos). Time points of key embryonic events were analyzed with an EmbryoViewer™. Results Most (88 %) of the embryos were biopsied at ≥8 cells. These results summarize the further dynamic development of the largest cohort of biopsied embryos and demonstrate that blastomere biopsy of cleavage-stage embryos significantly delayed compaction and blastulation compared to the control non-biopsied embryos. This delay in preimplanation developmental events also affected postimplantation development as observed when the dynamics of non-implanted embryos (known implantation data (KID) negative) were compared to those of implanted embryos (KID positive). Conclusion Analysis of morphokinetic parameters enabled us to explore how blastomere biopsy interferes with the dynamic sequence of developmental events. Our results show that biopsy delays the compaction and the blastulation of the embryos, leading to a decrease in implantation.

Section: % Of All Biopsy Procedures Performed In Europe Betweenmentioning

confidence: 99%

Blastomere biopsy for PGD delays embryo compaction and blastulation: a time-lapse microscopic analysis

Bar-El

Kalma

Malcov

et al. 2016

“…In consequence, various new morphological and morphokinetic markers (time to cleavage, duration of cell cycle, synchronization of division or the timepoint when the embryo has reached a certain stage of development) evaluated by TLC were associated with viability and competence of the embryo. Based on a large amount of data generated by time-lapse incubators, several (multivariable) prediction models for an optimal selection were published [13][14][15][16][17]. Those embryos that reveal a deviation of these selection criteria were regularly discarded.…”

Section: Introductionmentioning

confidence: 99%

“…The aim of the study was to analyze how spermatozoa influence the outcome in terms of development to the blastocyst stage of embryos that fulfill (or not) the morphokinetic criteria according to recently postulated embryo selection models [13,14].…”

Section: Introductionmentioning

confidence: 99%

The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging—a retrospective observational study

Neyer

Zintz

Stecher

et al. 2015

Purpose Various time-lapse studies have postulated embryo selection criteria based on early morphokinetic markers. However, late paternal effects are mostly not visible before embryonic genome activation. The primary objective of this retrospective study was to investigate whether those early morphokinetic algorithms investigated by time-lapse imaging are reliable enough to allow for the accurate selection of those embryos that develop into blastocysts, while of course taking into account the correlation with the type of injected spermatozoa. Methods During a period of 18 months, a total of 461 MII oocytes from 43 couples with severe male factor infertility and previous Bexternal^IVF failures after cleavage-stage embryo transfer (ET) were fertilized by intracytoplasmic morphologically selected sperm injection (IMSI). Thereof, 373 embryos were monitored in a time-lapse incubator until ET on day 5. Blastocyst outcome in combination with three previously postulated MKc (cc2: t3-t2, 5-12 h; t3, 35-40 h; t5, 48-56 h) and the morphology of the selected sperm were analyzed. Results A significant increase in the rate of blastocysts (54.0 vs. 36.3 %; P<0.01) and top blastocysts (25.3 vs. 10.8 %; P<0.001) was observed in the group of those meeting all three morphokinetic criteria (MKc3). However, MKc3 were only met in 23.3 % of all embryos. Moreover, TBR was influenced by the type of injected spermatozoa. In both groups, TBR decreased dramatically (MKc3, 35.0 vs. 17.0 %; MKc<3, 14.2 vs. 8.4 %) when class II/III sperm instead of class I were injected. Conclusion Early morphokinetic parameters might give some predictive information but fail to serve as a feasible selective tool for the prediction of blastocyst development given the influence of the type of spermatozoa injected.

“…The zygote typically undergoes the first cleavage 20 to 27 h after insemination [2][3][4]. Using the evolving technology of timelapse imaging, it has been postulated that time intervals between cleavages, rather than fixed time limits for cell division, can predict embryo viability [5][6][7][8] . However, a consensus remains that embryos that follow the Baverage^growth curve for the normal development of the early human embryo (i.e., reach the four-cell stage by 44 h, and the eight-cell stage by 68 h) are those of highest quality [7,9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Using the evolving technology of timelapse imaging, it has been postulated that time intervals between cleavages, rather than fixed time limits for cell division, can predict embryo viability [5][6][7][8] . However, a consensus remains that embryos that follow the Baverage^growth curve for the normal development of the early human embryo (i.e., reach the four-cell stage by 44 h, and the eight-cell stage by 68 h) are those of highest quality [7,9,10]. While recent studies have investigated the value of time-lapse imaging for embryo assessment and selection [reviewed by 6] standard morphological evaluation remains an important approach for evaluating embryo quality in IVF programs, particularly for those that lack time-lapse imaging systems.…”

Section: Introductionmentioning

confidence: 99%

Is the presence of a non-cleaved embryo on day 3 associated with poorer quality of the remaining embryos in the cohort?

Machtinger

Bormann

Ginsburg

et al. 2015

Purpose Morphological evaluation is currently considered the single most important predictive measure for assessing embryo quality. The aim of this study was to investigate whether cycles with at least one non-cleaved embryo (i.e., a 1-cell embryo on day 3) have different outcomes compared with cycles in which all embryos had cleaved by day 3. Methods All autologous IVF/ICSI cycles with a fresh day 3 transfer and without using a gestational carrier performed at our center between 1/1/2010 and 12/31/2011 were analyzed retrospectively. Those cycles with at least one non-cleaved embryo on day 3 were compared with all other autologous cycles that had l00 % cleaved embryos performed during the study period. Results Eight hundred and forty two cycles were included. Of them, 144 cycles comprised the non-cleaved group, and 698 cycles comprised the cleaved group. Cycles in the non-cleaved group had more oocytes retrieved (15.4±7.1 vs. 12.5±7.1, p<0.001), more zygotes obtained (10.0±5.3 vs. 7.9±5.2, p= <0.001), but the embryos exhibited lower cleavage rates and higher rates of fragmentation and asymmetry compared with controls (p<0.001). However, spontaneous abortion rates, ectopic pregnancies rates as well as delivery rates were similar between the two groups.Conclusions Our results show that the presence of a noncleaved embryo on day 3 is associated with a more exuberant response to controlled ovarian stimulation as reflected by more oocytes retrieved. Despite the significant decrease in quality of the whole cohort in the non-cleaved group, implantation, delivery rates and number of embryos frozen were not adversely affected by the presence of a non-cleaved embryo.