Day 3 morphology is a poor predictor of blastocyst quality in extended culture

Purpose To identify the correlation between different cycles, patient factors and blastocyst characteristics. Methods The study included 420 patients undergoing ICSI cycles and 2781 graded blastocysts, which took into account the blastocyst quality. The correlations between the blastocyst parameters and the patient and cycle characteristics were assessed. Results The blastocyst development was negatively correlated with the maternal age, BMI and dose of FSH. The ICM was negatively correlated with the FSH dose, whereas the TE quality was influenced by the FSH dose, the maternal age and the number of retrieved oocytes. The embryo morphology on days two and three may predict the blastocyst developmental competence. Conclusions Older patients and patients with high BMI should not be included in extended embryo culture programmes. The extended culture may not favour embryos with poor morphology on days two and three of development. Additionally, a lower ovarian stimulation and decreased oocyte yields may lead to the development of high-quality blastocysts.

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Patient selection criteria for blastocyst transfers in extended embryo culture programs

Braga

Setti

Figueira

et al. 2012

“…According to Van Royen et al (26) and Neubourg et al (27), embryos with four or five blastomeres on day 2 and seven or more cells on day 3, with no (29) did a retrospective comparison with day 5/6, and found a lack of embryo quality correlation between stages. Half of embryos chosen for use on day 3 were chosen again on day 5/6 (28,29).…”

Section: Discussionmentioning

confidence: 99%

The impact of pronuclear orientation to select chromosomally normal embryos

Borges

Rossi

Farah

et al. 2005

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.

“…Graham and colleagues [22] showed that fewer than half of the embryos that were selected on day three for transfer were reselected on day five. Rjinders and Jansen [23] also reported that only 51 % of the embryos transferred on day five had been selected 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.