The use of morphokinetic parameters to select all embryos with full capacity to implant

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Abstract

Purpose

Embryo kinetics analysis is an emerging tool for selecting embryo(s) for transfer. The aim of the present study was to determine morphokinetic parameters easily usable in the laboratory and predictive of embryo development and, most importantly, of embryo competence in producing a clinical pregnancy after day 5 transfer.

Methods

A retrospective time-lapse monitoring analysis of morphokinetic parameters for 72 fully implanted embryos (group A) were compared to 106 non-implanted embryos (group B), and to 66 embryos with arrested development from the same pool of group A. All the embryos were from 78 patients undergoing ICSI treatment and day 5 embryo transfers.

Results

A day 3 embryo will develop into a viable blastocyst if the following ranges of morphokinetic parameters are met: t1 (between 18.4 h and 30.9 h post-ICSI), t2 (21.4–34.8 h), t4 (33.1–57.2 h), t7 (46.1–82.5 h), t8 (46.4–97.8 h), tC-tF (7.7–22.9 h) and s3 (0.7–30.8 h). On day 5 embryos with the highest probability to implant are those with a cc3 between 9.7 h and 21 h.

Conclusions

Morphokinetic parameters are helpful to make appropriate decisions for the disposition of each embryo. It is recommended that each laboratory should determine its own ranges of in vitro development (IVD-MKP) and implantation-associated (IMP-MKP) morphokinetic parameters.

Related collections

Most cited references 15

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Many variations in oocyte and embryo grading make inter-laboratory comparisons extremely difficult. This paper reports the proceedings of an international consensus meeting on oocyte and embryo morphology assessment. Background presentations about current practice were given. The expert panel developed a set of consensus points to define the minimum criteria for oocyte and embryo morphology assessment. It is expected that the definition of common terminology and standardization of laboratory practice related to embryo morphology assessment will result in more effective comparisons of treatment outcomes. This document is intended to be referenced as a global consensus to allow standardized reporting of the minimum data set required for the accurate description of embryo development.

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Non-invasive imaging of human embryos before embryonic genome activation predicts development to the blastocyst stage.

Connie Wong, Kevin E. Loewke, Nancy L. Bossert … (2010)

We report studies of preimplantation human embryo development that correlate time-lapse image analysis and gene expression profiling. By examining a large set of zygotes from in vitro fertilization (IVF), we find that success in progression to the blastocyst stage can be predicted with >93% sensitivity and specificity by measuring three dynamic, noninvasive imaging parameters by day 2 after fertilization, before embryonic genome activation (EGA). These parameters can be reliably monitored by automated image analysis, confirming that successful development follows a set of carefully orchestrated and predictable events. Moreover, we show that imaging phenotypes reflect molecular programs of the embryo and of individual blastomeres. Single-cell gene expression analysis reveals that blastomeres develop cell autonomously, with some cells advancing to EGA and others arresting. These studies indicate that success and failure in human embryo development is largely determined before EGA. Our methods and algorithms may provide an approach for early diagnosis of embryo potential in assisted reproduction.

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The impact of pronuclei morphology and dynamicity on live birth outcome after time-lapse culture.

T Hoest, A Mikkelsen, A Azzarello (2012)

Can the pronuclei (PN) morphology and the time of PN breakdown (PNB) predict the potential of embryos to result in live birth? In comparison to embryos resulting in no live birth, PNB occurred significantly later in embryos resulting in live birth and never earlier than 20 h 45 min. None of the tested scoring systems were shown to predict the live birth outcome in a time-lapse set-up. The PN morphology is supported as a prominent embryo selection parameter in single light microscopy observations, although controversial results have been reported. This was a prospective study of 159 embryos, all of which were later transferred. The PN morphology of 46 embryos which resulted in live birth was compared with that of 113 embryos which resulted in no live birth. From 1 March 2010 to 30 August 2011, 130 couples underwent fertility treatment by ICSI. Embryo culture was performed in a time-lapse set-up from fertilization to intrauterine transfer. PN morphological assessment was performed on every embryo replaced, using six different scoring systems at different times. No embryo with PNB earlier than 20 h 45 min resulted in live birth. All six PN assessment models showed no significant distribution of scores (P = NS) between the live birth and no live birth groups at 16 h post-fertilization (PF), 18 h PF and 40 min before PNB. The outcomes of assessments changed significantly (P < 0.001) over time and the time of PNB was found to be the optimal stage to evaluate the PN morphology. The study includes only embryos reaching the 4-cell stage after ICSI, and transferred at 44 h PF. The PN morphology changes over time, indicating that the single light microscopy observation approach is deficient in comparison to time-lapse. Although the assessment of the PN morphology does not improve embryo selection, the timing of PNB should be included in embryo selection parameters.

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Author and article information

Contributors

: s.chamayou@yahoo.fr

Journal

Journal ID (nlm-ta): J Assist Reprod Genet

Journal ID (iso-abbrev): J. Assist. Reprod. Genet

Title: Journal of Assisted Reproduction and Genetics

Publisher: Springer US (Boston )

ISSN (Print): 1058-0468

ISSN (Electronic): 1573-7330

Publication date (Electronic): 13 April 2013

Publication date PMC-release: 13 April 2013

Publication date (Print): May 2013

Volume: 30

Issue: 5

Pages: 703-710

Affiliations

[ ]Unità di Medicina della Riproduzione, Fondazione HERA, Via Barriera del Bosco n. 51/53, 95030 Sant’Agata Li Battiati, CT Italy

[ ]Yale University Fertility Centre, 150 Sargent Drive, New Haven, CT 06511 USA

[ ]Department of Political and Social Sciences, University of Catania, Catania, Italy

Article

Publisher ID: 9992

DOI: 10.1007/s10815-013-9992-2

PMC ID: 3663978

PubMed ID: 23585186

SO-VID: 58d13fb9-f3bb-4361-9505-c3eae3b2c2f9

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

History

Date received : 3 January 2013

Date accepted : 28 March 2013

Custom metadata

ScienceOpen disciplines: Genetics

Keywords: development,embryo competence,embryo kinetic,morphokinetic parameter,morphology,time-lapse monitoring

Data availability:

ScienceOpen disciplines: Genetics

Keywords: development, embryo competence, embryo kinetic, morphokinetic parameter, morphology, time-lapse monitoring

The use of morphokinetic parameters to select all embryos with full capacity to implant

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