Evaluation of fragmented embryos implantation potential using time-lapse technology.
embryo selection
fragmentation
in vitro fertilization (IVF)
morphokinetics
time-lapse
Journal
The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Titre abrégé: J Obstet Gynaecol Res
Pays: Australia
ID NLM: 9612761
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
05
12
2022
accepted:
09
03
2023
medline:
5
6
2023
pubmed:
24
3
2023
entrez:
23
3
2023
Statut:
ppublish
Résumé
To examine the implantation potential of fragmented embryos that underwent morphokinetic evaluation in a time-lapse incubator. A retrospective study analyzing 4210 Day 5 embryos which were incubated in a time-lapse incubator, between 2013 and 2019. Embryos with more than 5% fragmentation (379 embryos) were included in the study. Embryos selected using the general model and re-examined by our in-house model. Embryo fragmentation percentage was documented from the first cell-division (start fragmentation) to its maximal percentage (final fragmentation), and the ratio between them (fragmentation worsening). Data were analyzed with relation to embryo development, embryos transfer or freezing, clinical pregnancy, and live birth rates. Embryo fragmentation and morphokinetics were found to be independent variables for clinical pregnancy achievements. A higher fragmentation worsening was noted among discarded embryos compared to transferred or frozen embryos (p < 0.0001). Advanced maternal age had a significant negative effect on fragmentation (p < 0.001). Missed abortion rates were similar in fragmented embryos that implanted compared with the overall population. Live birth rates were comparable among embryos which were selected for transfer or freezing by their morphokinetics and had different severity of fragmentation. Our study shows that fragmented embryos have a potential to implant and therefore should be selected for transfer. Laboratories which do not use time-lapse incubators for embryo selection, should consider transferring fragmented embryos, since they have an acceptable chance for live birth. Calculation of fragmentation worsening may enhance our ability to predict embryo development. Further research with analysis of more fragmented embryo maybe beneficial. This study was approved by the local ethics committee No. 0010-19 CMC on April 18th, 2019.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1560-1570Informations de copyright
© 2023 Japan Society of Obstetrics and Gynecology.
Références
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.
Della Ragione T, Verheyen G, Papanikolaou EG, Van Landuyt L, Devroey P, Van Steirteghem A. Developmental stage on day-5 and fragmentation rate on day-3 can influence the implantation potential of top-quality blastocysts in IVF cycles with single embryo transfer. Reprod Biol Endocrinol. 2007;5:2.
Racowsky C, Combelles CM, Nureddin A, Pan Y, Finn A, Miles L, et al. Day 3 and day 5 morphological predictors of embryo viability. Reprod Biomed Online. 2003;6:323-31.
Rhenman A, Berglund L, Brodin T, Olovsson M, Milton K, Hadziosmanovic N, et al. Which set of embryo variables is most predictive for live birth? A prospective study in 6252 single embryo transfers to construct an embryo score for the ranking and selection of embryos. Hum Reprod. 2015;30:28-36.
Jurisicova A, Varmuza S, Casper RF. Programmed cell death and human embryo fragmentation. Mol Hum Reprod. 1996;2:93-8.
Jurisicova A, Antenos M, Varmuza S, Tilly JL, Casper RF. Expression of apoptosis-related genes during human preimplantation embryo development: potential roles for the Harakiri gene product and Caspase-3 in blastomere fragmentation. Mol Hum Reprod. 2003;9:133-41.
Fujimoto VY, Browne RW, Bloom MS, Sakkas D, Alikani M. Pathogenesis, developmental consequences, and clinical correlations of human embryo fragmentation. Fertil Steril. 2011;95:1197-204.
Chavez SL, Loewke KE, Han J, Moussavi F, Colls P, Munne S, et al. Dynamic blastomere behaviour reflects human embryo ploidy by the four-cell stage. Nat Commun. 2012;3:1251.
Stensen MH, Tanbo TG, Storeng R, Åbyholm T, Fedorcsak P. Fragmentation of human cleavage-stage embryos is related to the progression through meiotic and mitotic cell cycles. Fertil Steril. 2015;103:374-81.e4.
Prados FJ, Debrock S, Lemmen JG, Agerholm I. The cleavage stage embryo. Hum Reprod. 2012;27(Suppl 1):i50-71.
Ziebe S, Bangsbøll S, Schmidt KLT, Loft A, Lindhard A, Nyboe AA. Embryo quality in natural versus stimulated IVF cycles. Hum Reprod. 2004;19:1457-60.
Wu DH, Reynolds K, Maxwell R, Lindheim SR, Aubuchon M, Thomas MA. Age does not influence the effect of embryo fragmentation on successful blastocyst development. Fertil Steril. 2011;95:2778-80.
Yang S-H, Wu C-H, Chen Y-C, Yang C-K, Wu T-H, Chen P-C, et al. Effect of morphokinetics and morphological dynamics of cleavage stage on embryo developmental potential: A time-lapse study. Taiwan J Obstet Gynecol. 2018;57:76-82.
Alikani M, Cohen J, Tomkin G, Garrisi GJ, Mack C, Scott RT. Human embryo fragmentation in vitro and its implications for pregnancy and implantation. Fertil Steril. 1999;71:836-2.
Ziebe S, Loft A, Petersen JH, Andersen AG, Lindenberg S, Petersen K, et al. Embryo quality and developmental potential is compromised by age. Acta Obstet Gynecol Scand. 2001;80:169-74.
Mizobe Y, Oya N, Iwakiri R, Yoshida N, Sato Y, Miyoshi K, et al. Effects of early cleavage patterns of human embryos on subsequent in vitro development and implantation. Fertil Steril. 2016;106:348-353.e2.
Le Bras A, Hesters L, Gallot V, Tallet C, Tachdjian G, Frydman N. Shortening gametes co-incubation time improves live birth rate for couples with a history of fragmented embryos. Syst Biol Reprod Med. 2017;63:331-7.
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.
Kovacs P, Matyas S, Forgacs V, Sajgo A, Molnar L, Pribenszky C. Non-invasive embryo evaluation and selection using time-lapse monitoring: results of a randomized controlled study. Eur J Obstet Gynecol Reprod Biol. 2019;233:58-63.
Fishel S, Campbell A, Montgomery S, Smith R, Nice L, Duffy S, et al. Live births after embryo selection using morphokinetics versus conventional morphology: a retrospective analysis. Reprod Biomed Online. 2017;35:407-16.
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. 2016;31:2231-44.
Reignier A, Girard J-M, Lammers J, Chtourou S, Lefebvre T, Barriere P, et al. Performance of day 5 KIDScore™ morphokinetic prediction models of implantation and live birth after single blastocyst transfer. J Assist Reprod Genet. 2019;36:2279-85.
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.
Blais I, Koifman M, Feferkorn I, Dirnfeld M, Lahav-Baratz S. Improving embryo selection by development of a laboratory-adaptedtime-lapse model. Fertil Steril Sci. 2021;2:176-97.
Ciray HN, Campbell A, Agerholm IE, Aguilar J, Chamayou S, Esbert M, et al. Proposed guidelines on the nomenclature and annotation of dynamic human embryo monitoring by a time-lapse user group. Hum Reprod. 2014;29:2650-60.
technote_kidscore-d5.3_v3_v2.pdf. Technote - KIDScore D5 v.3 Decision Support Tool. Vitrolife [Internet]. 2019 [cited 2019 Nov 7];v.2 INT. Available from: https://www.vitrolife.com/globalassets/support-documents/tech-notes/kidscore-d3-decision-support-tool-v.3_int.pdf
Johansson M, Hardarson T, Lundin K. There is a cutoff limit in diameter between a blastomere and a small anucleate fragment. J Assist Reprod Genet. 2003;20:309-13.
Keltz MD, Skorupski JC, Bradley K, Stein D. Predictors of embryo fragmentation and outcome after fragment removal in in vitro fertilization. Fertil Steril. 2006;86:321-4.
Derrick R, Hickman C, Oliana O, Wilkinson T, Gwinnett D, Whyte LB, et al. Perivitelline threads associated with fragments in human cleavage stage embryos observed through time-lapse microscopy. Reprod Biomed Online. 2017;35:640-5.
Ebner T, Yaman C, Moser M, Sommergruber M, Pölz W, Tews G. Embryo fragmentation in vitro and its impact on treatment and pregnancy outcome. Fertil Steril. 2001;76:281-5.
Hardarson T, Löfman C, Coull G, Sjögren A, Hamberger L, Edwards RG. Internalization of cellular fragments in a human embryo: time-lapse recordings. Reprod Biomed Online. 2002;5:36-8.
Yu C-H, Zhang R-P, Li J, Zhou-Cun A. A predictive model for high-quality blastocyst based on blastomere number, fragmentation, and symmetry. J Assist Reprod Genet. 2018;35:809-16.
Yang ST, Shi JX, Gong F, Zhang SP, Lu CF, Tan K, et al. Cleavage pattern predicts developmental potential of day 3 human embryos produced by IVF. Reprod Biomed Online. 2015;30:625-34.
Blank C, DeCroo I, Weyers B, van Avermaet L, Tilleman K, van Rumste M, et al. Improvement instead of stability in embryo quality between day 3-5: A possible extra predictor for blastocyst selection. Eur J Obstet Gynecol Reprod Biol. 2020;253:198-205.
Lahav-Baratz S, Blais I, Koifman M, Ishai D, Wiener-Megnazi Z, Peer G, et al. Live birth from the transfer of a severely fragmented embryo observed by morphokinetics. Case Rep Obstet Gynecol. 2018;2018:1-3. https://doi.org/10.1155/2018/2152918.eCollection
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.
Stensen MH, Tanbo T, Storeng R, Byholm T, Fèdorcsak P. Routine morphological scoring systems in assisted reproduction treatment fail to reflect age-related impairment of oocyte and embryo quality. Reprod Biomed Online. 2010;21:118-25.
Liao Q-Y, Huang B, Zhang S-J, Chen J, Chen G, Li K-Z, et al. Influence of different quality sperm on early embryo morphokinetic parameters and cleavage patterns: A retrospective time-lapse study. Curr Med Sci. 2020;40:960-7.
Ebner T, Moser M, Sommergruber M, Yaman C, Pfleger U, Tews G. First polar body morphology and blastocyst formation rate in ICSI patients. Hum Reprod. 2002;17:2415-8.
Kirillova A, Lysenkov S, Farmakovskaya M, Kiseleva Y, Martazanova B, Mishieva N, et al. Should we transfer poor quality embryos? Fertil Res Pract. 2020;19(6):2.
Oron G, Son W-Y, Buckett W, Tulandi T, Holzer H. The association between embryo quality and perinatal outcome of singletons born after single embryo transfers: a pilot study. Hum Reprod. 2014;29:1444-51.