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Open Access 01-12-2013 | Review

Pronuclear morphology evaluation in in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) cycles: a retrospective clinical review

Authors: Alessia Nicoli, Francesco Capodanno, Ilaria Rondini, Barbara Valli, Maria Teresa Villani, Daria Morini, Leonardo De Pascalis, Stefano Palomba, Giovanni Battista La Sala

Published in: Journal of Ovarian Research | Issue 1/2013

Abstract

Background

The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy. The evaluation of the pronuclear and nucleolar characteristics of human zygote have been proposed as an indicator of embryo development and chromosomal complement. The aim of the current study was to assess the role of pronuclear morphology evaluation in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) cycles.

Methods

Retrospective clinical analysis on 755 non-elective transfers of only one embryo (ET). Embryo assessment was performed in days 1 and 2. Clinical and biological data were recorded and analyzed according to embryo and/or pronuclear morphology.

Results

Both pronuclear and embryo morphology were significantly related to clinical pregnancy and live-birth rates. No significant difference in clinical pregnancy and live-birth rates was detected when the pronuclear and embryo morphology assessments were combined. Embryo morphology and maternal age were the only independent predictors of favorable outcome by logistic regression analysis.

Conclusions

Pronuclear evaluation is effective to select the best zygotes if ET is performed at day 1, whereas it did not improve the clinical outcomes when combined with embryo morphology evaluation in day 2.

Alpha Scientist in Reproductive Medicine and ESHRE Special Interest Group of Embryology: The Istambul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod 2011, 26: 1270–1283.CrossRef

Hardarson T, Ahlström A, Rogberg L, Botros L, Hillensjö T, Westlander G, et al.: Non-invasive metabolomic profiling of Day 2 and 5 embryo culture medium: a prospective randomized trial. Hum Reprod 2012, 27: 89–96. 10.1093/humrep/der373PubMedCrossRef

Uyar A, Seli E: Embryo assessment strategies and their validation for clinical use: a critical analysis of methodology. Curr Opin Obstet Gynecol 2012, 24: 141–150. 10.1097/GCO.0b013e328352cd17PubMedCrossRef

Gianaroli L, Magli MC, Ferraretti AP, Fortini D, Greco N: Pronuclear morphology and chromosomal abnormalities as scoring criteria for embryo selection. Fertil Steril 2003, 80: 341–349. 10.1016/S0015-0282(03)00596-XPubMedCrossRef

Scott L: Pronuclear scoring as a predictor of embryo development. Reprod Biomed Online 2003, 6: 201–214. 10.1016/S1472-6483(10)61711-7PubMedCrossRef

Payne JF, Raburn DJ, Couchman GM, Price TM, Jamison MG, Walmer DK: Relationship between pre-embryo pronuclear morphology (zygote score) and standard day 2 or 3 embryo morphology with regard to assisted reproductive technique outcomes. Fertil Steril 2005, 84: 900–909. 10.1016/j.fertnstert.2005.04.047PubMedCrossRef

Chen C, Kattera S: Comparison of pronuclear zygote morphology and early cleavage status of zygotes as additional criteria in the selection of day 3 embryos: a randomized study. Fertil Steril 2006, 85: 347–352. 10.1016/j.fertnstert.2005.07.1319PubMedCrossRef

Gianaroli L, Magli MC, Ferraretti AP, Lappi M, Borghi E, Ermini B: Oocyte euploidy, pronuclear zygote morphology and embryo chromosomal complement. Hum Reprod 2007, 22: 241–249.PubMedCrossRef

Alvarez C, Taronger R, García-Garrido C, de González MG: Zygote score and status 1 or 2 days after cleavage and assisted reproduction outcome. Int J Gynaecol Obstet 2008, 101: 16–20. 10.1016/j.ijgo.2007.10.021PubMedCrossRef

10.

Maille L, Bergere M, Lemoine E, Camier B, Prevost JF, Bourdrel JM, Hammoud I, Selva J, Vialard F: Pronuclear morphology differs between women more than 38 and women less than 30 years of age. Reprod Biomed Online 2009, 18: 367–373. 10.1016/S1472-6483(10)60095-8PubMedCrossRef

11.

Zamora RB, Sánchez RV, Pérez JG, Díaz RR, Quintana DB, Bethencourt JC: Human zygote morphological indicators of higher rate of arrest at the first cleavage stage. Zygote 2010, 27: 1–6.

12.

James AN, Hennessy S, Reggio B, Wiemer K, Larsen F, Cohen J: The limited importance of pronuclear scoring of human zygotes. Hum Reprod 2006, 21: 1599–1604. 10.1093/humrep/del013PubMedCrossRef

13.

Nicoli A, Valli B, Di Girolamo R, Di Tommaso B, Gallinelli A, La Sala GB: Limited importance of pre-embryo pronuclear morphology (zygote score) in assisted reproduction outcome in the absence of embryo cryopreservation. Fertil Steril 2007, 88: 1167–1173. 10.1016/j.fertnstert.2007.01.066PubMedCrossRef

14.

Weitzman VN, Schnee-Riesz J, Benadiva C, Nulsen J, Siano L, Maier D: Predictive value of embryo grading for embryos with known outcomes. Fertil Steril 2010, 93: 658–662. 10.1016/j.fertnstert.2009.02.032PubMedCrossRef

15.

Bar-Yoseph H, Levy A, Sonin Y, Alboteanu S, Levitas E, Lunenfeld E, Har-Vardi I: Morphological embryo assessment: reevaluation. Fertil Steril 2011, 95: 1624–1628. 10.1016/j.fertnstert.2011.01.034PubMedCrossRef

16.

World Health Organization: Laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4th edition. New York: Cambridge University Press; 1999.

17.

Nicoli A, Capodanno F, Moscato L, Rondini I, Villani MT, Tuzio A, La Sala GB: Analysis of pronuclear zygote configurations in 459 clinical pregnancies obtained with assisted reproductive technique procedures. Reprod Biol Endocrinol 2010, 8: 77. 10.1186/1477-7827-8-77PubMedCentralPubMedCrossRef

18.

Palermo G, Joris H, Devroey P, Van-Steirteghem AC: Pregnancies after intracytoplasmic injection of a single spermatozoon into an oocyte. Lancet 1992, 340: 17–18. 10.1016/0140-6736(92)92425-FPubMedCrossRef

19.

Scott L, Alvero R, Leondires M, Miller B: The morphology of human pronuclear embryos is positively related to blastocyst development and implantation. Hum Reprod 2000, 15: 2394–2403. 10.1093/humrep/15.11.2394PubMedCrossRef

20.

Salumets A, Hydén-Granskog C, Suikkari AM, Tiitinen A, Tuuri T: The predictive value of pronuclear morphology of zygotes in the assessment of human embryo quality. Hum Reprod 2001, 16: 2177–2181. 10.1093/humrep/16.10.2177PubMedCrossRef

21.

Racowsky C, Ohno-Machado L, Kim J, Biggers JD: Is there an advantage in scoring early embryos on more than one day? Hum Reprod 2009, 24: 2104–2113. 10.1093/humrep/dep198PubMedCentralPubMedCrossRef

22.

Guerif F, Le Gouge A, Giraudeau B, Poindron J, Bidault R, Gasnier O, Royere D: Limited value of morphological assessment at days 1 and 2 to predict blastocyst development potential: a prospective study based on 4042 embryos. Hum Reprod 2007, 22: 1973–1981. 10.1093/humrep/dem100PubMedCrossRef

23.

Montag M, Liebenthron J, Köster M: Which morphological scoring system is relevant in human embryo development? Placenta 2011, 32: S252-S256.PubMedCrossRef

Title: Pronuclear morphology evaluation in in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) cycles: a retrospective clinical review
Authors: Alessia Nicoli
Francesco Capodanno
Ilaria Rondini
Barbara Valli
Maria Teresa Villani
Daria Morini
Leonardo De Pascalis
Stefano Palomba
Giovanni Battista La Sala
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Journal of Ovarian Research / Issue 1/2013
Electronic ISSN: 1757-2215
DOI: https://doi.org/10.1186/1757-2215-6-1

At a glance: The STEP trials

Springer Medicine

Pronuclear morphology evaluation in in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) cycles: a retrospective clinical review

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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