Day1&2胚胎細胞核狀況無法有效預測胚胎懷孕率

Day1胚胎原核PN狀況(Z score) & Day2胚胎細胞核狀況無法有效預測胚胎品質與懷孕率

http://www.ncbi.nlm.nih.gov/pubmed/21316045?dopt=Abstract&holding=f1000,f1000m,isrctn

Fertil Steril. 2011 Apr;95(5):1624-8.e1-2. doi: 10.1016/j.fertnstert.2011.01.034.

Morphological embryo assessment: reevaluation.

Bar-Yoseph H1, Levy A, Sonin Y, Alboteanu S, Levitas E, Lunenfeld E, Har-Vardi I.

Author information

• 1Fertility and IVF Unit, Department of Obstetrics/Gynecology, Soroka University Medical Center, Beer Sheva, Israel.

Abstract

OBJECTIVE:

To assess whether the pronuclear score and embryo nuclear scoring have an additive value to day 2 morphology criteria in the prediction of the implantation rate (IR).

DESIGN:

Retrospective clinical study.

SETTING:

IVF Unit, Soroka University Medical Center.

PATIENT(S):

Analysis of all homogenous IVF fresh embryo transfers from 2008-2010.

INTERVENTION(S):

Morphological evaluation of pronuclear scoring, embryo nuclear scoring, and day 2 embryo morphology scoring on embryos obtained from IVF or intracytoplasmic sperm injection (ICSI) cycles.

MAIN OUTCOME MEASURE(S):

Implantation rate of homogeneous transfers.

RESULT(S):

No statistical association was found between the pronuclear scoring system (Z) and IR. The pronuclear score Z3 had a significantly better performance than Z1, Z2, and Z4 (IR = 25.2%, 22%, 21.4%, and 11.8%, respectively). Assessment of the second day embryo morphology scoring (index [IDX]) was found to associate with IR. IDX1, IDX2, IDX3, IDX4, and IDX5 had an IR of 36.1%, 28%, 21.9%, 14.2%, and 0, respectively. The nuclear scoring including: 1 nucleus in all blastomeres, 1 nucleus in part of the blastomeres, no visualization, and multinucleation showed high association with IR = 32.7%, 22.9%, 14.8%, and 9.1%, respectively. The effect of the nuclear scoring on IR was lost in a multivariable analysis that included day 2 embryo morphology scoring.

CONCLUSION(S):

Our results suggest that there is no additive value in grading the zygote on day 1 or embryo nuclear scoring on day 2 to day 2 embryo morphology for the prediction of IR.