Day1,2,3之胚胎型態並無法有效預估囊胚之形成

Day1,2,3之胚胎型態並無法有效預估囊胚之形成

http://humrep.oxfordjournals.org/content/22/7/1973.full

Limited value of morphological assessment at days 1 and 2 to predict blastocyst development potential: A prospective study based on 4042 embryos

1. F. Guerif1, 
2. A. Le Gouge2, 
3. B. Giraudeau2, 
4. J. Poindron1, 
5. R. Bidault1,
6. O. Gasnier1 and 
7. D. Royere1,3

+Author Affiliations

1. ¹Service de Médecine et Biologie de la Reproduction, CHU Bretonneau, 2 Boulevard Tonnelle, 37000 Tours, France
2. ²INSERM CIC 202, Université François Rabelais de Tours, CHRU de Tours, France

1. 3Correspondence address. Tel: +33-247-474-746; Fax: +33-247-478-484; E-mail:royere@med.univ-tours.fr

• Received December 11, 2006.
• Revision received March 14, 2007.
• Accepted March 29, 2007.

 

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Abstract

BACKGROUND Non-invasive and routine developmental markers are available to select the most viable embryo; however their respective values in terms of blastocyst development potential remain difficult to distinguish.

METHODS During this prospective study, the sequential growth of 4042 embryos individually cultured from day 1 to day 5/6 was recorded. Pronuclear morphology on day 1, and early cleavage, cell number and fragmentation rate on day 2 were evaluated for each zygote. Additionally, blastocyst transfers were analysed with regard to their implantation ability and early embryo development parameters.

RESULTS Once adjusted to each other, each of the four parameters remained related to blastocyst development. Early cleavage and cell number on day 2 were the most powerful parameters to predict the development of a good morphology blastocyst at day 5. Moreover, whereas transfers of a good morphology blastocyst were associated with high implantation and live birth rates, parameters of early development were not helpful in predicting their implantation ability.

CONCLUSIONS The combination of all four parameters allowed the prediction of blastocyst development with an area under the receiver operating characteristics curve of 0.688, which represents a fairly low prediction of embryo viability. Such results indicate that it is necessary to search for additional criteria, including the ability of the blastocyst to develop.