2 cell 胚胎胚葉細胞呈現多核現象活產率明顯下降
(MNB2/2cell  vs MNB1/2cell vs Without-MNB2cell ----->18 vs 22 vs 29%)

Fertil Steril. 2017 Jan;107(1):97-103.e4. doi: 10.1016/j.fertnstert.2016.09.022. Epub 2016 Oct 26.

Embryo multinucleation at the two-cell stage is an independent predictor of intracytoplasmic sperm injection outcomes.

Desch L1, Bruno C1, Luu M2, Barberet J1, Choux C3, Lamotte M3, Schmutz E3, Sagot P3, Fauque P4.

Author information

Abstract

OBJECTIVE:

To determine the prognostic impact of the nuclear status at the two-cell stage on intracytoplasmic sperm injection (ICSI) outcomes.

DESIGN:

Retrospective study.

SETTING:

Hospital.

PATIENT(S):

Only ICSI cycles with time-lapse monitoring of transferred embryos with known implantation/delivery data from November 2012 to December 2014 were included. A total of 2,449 embryos were assessed for multinucleation rates at the two- and four-cell stage, and 608 transferred embryos were studied for ICSI outcomes.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Implantation rate (IR) and live birth rate (LBR) according to the number of multinucleated blastomeres at the two-cell stage: none (Without-MNB2cell), one (MNB1/2cell), and two (MNB2/2cell); morphokinetics of MNB2cell embryos.

RESULT(S):

Embryos with MNB1/2cell led to lower IR (27.7%) and LBR (22.7%) than embryos Without-MNB2cell (33.4% and 29.8%, respectively). The MNB2/2cell embryos led to significantly lower IR (18.3%) and LBR (13.4%) than embryos Without-MNB2cell. This difference remained significant in multivariate analysis for implantation (odds ratio 0.57; 95% confidence interval 0.34-0.94) and birth (odds ratio 0.46; 95% confidence interval 0.26-0.80), independently of the other significant parameters (women's age, time of two-cell formation, and multinucleation at the four-cell stage). Among implanted MNB2cell, if cleavage into four cells occurred later than 37 hours after insemination, embryos were significantly more likely to lead to birth.

CONCLUSION(S):

The presence of multinucleation at the two-cell stage and more specifically in both blastomeres had a significant negative impact on birth potential. Thus, embryo multinucleation at the two-cell stage should be used as an additional noninvasive criterion for embryo selection.