Abstract
BackgroundThe 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.MethodsRetrospective 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.ResultsBoth 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.ConclusionsPronuclear 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.
Highlights
The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy
The selection of the best embryo(s) to transfer is a crucial point in in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) procedures to maintain a high performance in terms of pregnancy rate and to reduce the risk of multiple pregnancies
Previous data have suggested that zygote-score could be an efficient tool for embryo selection if combined with embryo morphology evaluation on days 2 and 3 [10,11]
Summary
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 selection of the best embryo(s) to transfer is a crucial point in in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) procedures to maintain a high performance in terms of pregnancy rate and to reduce the risk of multiple pregnancies. The study of the pronuclear and nucleolar characteristics of human zygote has been proposed as an indicator of embryo development and competence [4,5,6,7,8,9,10]. Other Authors suggested that embryo morphology has a better prognostic value than zygote-score in embryo selection [12,13,14], and that pronuclear scoring system has any advantage to evaluate embryo quality [15]
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