Deconstructing the myth of poor prognosis for fast-cleaving embryos on day 3. Is it time to change the consensus?
Adult
Birth Rate
Blastocyst
/ physiology
Consensus
Embryo Culture Techniques
/ methods
Embryo Implantation
/ physiology
Embryo Transfer
/ methods
Embryonic Development
/ physiology
Female
Fertilization in Vitro
/ methods
Humans
Middle Aged
Pregnancy
Pregnancy Rate
Preimplantation Diagnosis
/ methods
Prognosis
Retrospective Studies
Young Adult
Blastocyst rate
Cell number
Euploidy rate
Fast-cleaving embryos
Implantation rate
Live birth rate
Journal
Journal of assisted reproduction and genetics
ISSN: 1573-7330
Titre abrégé: J Assist Reprod Genet
Pays: Netherlands
ID NLM: 9206495
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
31
05
2019
accepted:
26
08
2019
pubmed:
4
9
2019
medline:
1
5
2020
entrez:
4
9
2019
Statut:
ppublish
Résumé
To determine the developmental competence of fast-cleaving D3 embryos. Retrospective study including 4028 embryos from 513 PGT-A cycles performed between July 2014 and June 2017. Embryos were cultured in time-lapse incubators and biopsied at blastocyst stage. Embryos were classified in groups according to the number of cells on D3 (from 2-cell to ≥13 -cell and compacted). A generalized linear mixed model adjusted for confounding factors was performed to assess the chance to give rise to an euploid blastocyst in each group compared with the chance of 8-cell embryos. Implantation and live birth rates were also analyzed. The statistical analysis showed that embryos with 9 to 11 cells had a slightly lower euploid blastocyst rate than 8-cell embryos (OR (95% CI) 0.77 (0.61-0.96)) while embryos with more than 11 cells were found to be just as likely to give rise to an euploid blastocyst as the 8-cell embryos (OR (95% CI) 1.20 (0.92-1.56)). Conversely, slow-cleaving embryos had a significantly lower euploid blastocyst rate than 8-cell embryos (OR (95% CI) 0.31 (0.24-0.39)). Moreover, euploid blastocysts derived from fast-cleaving embryos and from 8-cell embryos exhibit similar live birth rates. No significant differences were found in the chance to give rise a live birth between 8-cell and 9- to 11-cell embryos (OR (95% CI) 1.23 (0.70-2.15)) and > 11-cell embryos (OR (95% CI) 1.09 (0.57-2.09)). Embryos with more than 11 cells exhibit similar developmental competence to 8-cell embryos. Their poor prognosis should be reconsidered.
Identifiants
pubmed: 31478159
doi: 10.1007/s10815-019-01574-y
pii: 10.1007/s10815-019-01574-y
pmc: PMC6885468
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2299-2305Références
Racowsky C, Jackson KV, Cekleniak NA, Fox JH, Hornstein MD, Ginsburg ES. The number of eight-cell embryos is a key determinant for selecting day 3 or day 5 transfer. Fertil Steril. 2000;73:558–64.
doi: 10.1016/S0015-0282(99)00565-8
Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26:1270–83.
doi: 10.1093/humrep/der037
Cuevas Saiz I, Pons Gatell MC, Cuadros Vargas M, Delgado Mendive A, Rives Enedáguila N, Moragas Solanes M, et al. The embryology interest group: updating ASEBIR’s morphological scoring system for early embryos, morulae and blastocysts. Med Reprod Embriol Clín. 2018;5:42–54.
Racowsky C, Stern JE, Gibbons WE, Behr B, Pomeroy KO, Biggers JD. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil Steril. 2011;95:1985–9.
doi: 10.1016/j.fertnstert.2011.02.009
Shapiro BS, Harris DC, Richter KS. Predictive value of 72-hour blastomere cell number on blastocyst development and success of subsequent transfer based on the degree of blastocyst development. Fertil Steril. 2000;73:582–6.
doi: 10.1016/S0015-0282(99)00586-5
Langley MT, Marek DM, Gardner DK, Doody KM, Doody KJ. Extended embryo culture in human assisted reproduction treatments. Hum Reprod. 2001;16:902–8.
doi: 10.1093/humrep/16.5.902
Luna M, Copperman AB, Duke M, Ezcurra D, Sandler B, Barritt J. Human blastocyst morphological quality is significantly improved in embryos classified as fast on day 3 (>or=10 cells), bringing into question current embryological dogma. Fertil Steril. 2008;89:358–63.
doi: 10.1016/j.fertnstert.2007.03.030
Kong X, Yang S, Gong F, Lu C, Zhang S, Lu G, et al. The relationship between cell number, division behavior and developmental potential of cleavage stage human embryos: a time-lapse study. PLoS One. 2016;11:e0153697.
doi: 10.1371/journal.pone.0153697
Magli MC, Gianaroli L, Ferraretti AP, Lappi M, Ruberti A, Farfalli V. Embryo morphology and development are dependent on the chromosomal complement. Fertil Steril. 2007;87:534–41.
doi: 10.1016/j.fertnstert.2006.07.1512
Finn A, Scott L, O’Leary T, Davies D, Hill J. Sequential embryo scoring as a predictor of aneuploidy in poor-prognosis patients. Reprod BioMed Online. 2010;21:381–90.
doi: 10.1016/j.rbmo.2010.05.004
Kroener LL, Ambartsumyan G, Pisarska MD, Briton-Jones C, Surrey M, Hill D. Increased blastomere number in cleavage-stage embryos is associated with higher aneuploidy. Fertil Steril. 2015;103:694–8.
doi: 10.1016/j.fertnstert.2014.12.090
Barri PN, Martinez F, Coroleu B, Tur R. The role of GnRH antagonists in assisted reproduction. Reprod BioMed Online. 2002;5(Suppl 1):14–9.
doi: 10.1016/S1472-6483(11)60212-5
Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. Jansen R Mortimer Eds Reprod certain Infertil genet 1999. Carnforth: Parthenon Press; 1999. p. 378–388.
Veiga A, Sandalinas M, Benkhalifa M, Boada M, Carrera M, Santaló J, et al. Laser blastocyst biopsy for preimplantation diagnosis in the human. Zygote. 1997;5:351–4.
doi: 10.1017/S0967199400003920
Kuwayama M, Vajta G, Ieda S, Kato O. Comparison of open and closed methods for vitrification of human embryos and the elimination of potential contamination. Reprod BioMed Online. 2005;11:608–14.
doi: 10.1016/S1472-6483(10)61169-8
MacKenna A, Crosby J, Zegers-Hochschild F. Embryo early cleavage, number of blastomeres and morphology at day three as factors to predict blastocyst development. JBRA Assist Reprod. 2013;17:158–61.
doi: 10.5935/1518-0557.20130053
Meseguer M, Herrero J, Tejera A, Hilligsøe KM, Ramsing NB, Remohí J. The use of morphokinetics as a predictor of embryo implantation. Hum Reprod. 2011;26:2658–71.
doi: 10.1093/humrep/der256
Motato Y, de los Santos MJ, Escriba MJ, Ruiz BA, Remohí J, Meseguer M. Morphokinetic analysis and embryonic prediction for blastocyst formation through an integrated time-lapse system. Fertil Steril. 2016;105:376–384.e9.
doi: 10.1016/j.fertnstert.2015.11.001
Giorgetti C, Terriou P, Auquier P, Hans E, Spach JL, Salzmann J, et al. Embryo score to predict implantation after in-vitro fertilization: based on 957 single embryo transfers. Hum Reprod. 1995;10:2427–31.
doi: 10.1093/oxfordjournals.humrep.a136312
Ziebe S, Petersen K, Lindenberg S, Andersen AG, Gabrielsen A, Andersen AN. Embryo morphology or cleavage stage: how to select the best embryos for transfer after in-vitro fertilization. Hum Reprod. 1997;12:1545–9.
doi: 10.1093/humrep/12.7.1545
Petersen BM, Boel M, Montag M, Gardner DK. Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on day 3. Hum Reprod Oxf Engl. 2016;31:2231–44.
doi: 10.1093/humrep/dew188
Carrasco B, Arroyo G, Gil Y, Gómez MJ, Rodríguez I, Barri PN, et al. Selecting embryos with the highest implantation potential using data mining and decision tree based on classical embryo morphology and morphokinetics. J Assist Reprod Genet. 2017;34:983–90.
doi: 10.1007/s10815-017-0955-x
Sunde A, Brison D, Dumoulin J, Harper J, Lundin K, Magli MC, et al. Time to take human embryo culture seriously. Hum Reprod. 2016;31:2174–82.
doi: 10.1093/humrep/dew157
Rubio I, Galán A, Larreategui Z, Ayerdi F, Bellver J, Herrero J, et al. Clinical validation of embryo culture and selection by morphokinetic analysis: a randomized, controlled trial of the EmbryoScope. Fertil Steril. 2014;102:1287–1294.e5.
doi: 10.1016/j.fertnstert.2014.07.738
Kovacic B, Vlaisavljević V. Influence of atmospheric versus reduced oxygen concentration on development of human blastocysts in vitro: a prospective study on sibling oocytes. Reprod BioMed Online. 2008;17:229–36.
doi: 10.1016/S1472-6483(10)60199-X
Kirkegaard K, Hindkjaer JJ, Ingerslev HJ. Effect of oxygen concentration on human embryo development evaluated by time-lapse monitoring. Fertil Steril. 2013;99:738–744.e4.
doi: 10.1016/j.fertnstert.2012.11.028