傳統觀念認為Day3 (HCG後70-78h)胚胎分裂速度過達12胚葉細胞通常預後不佳
本篇反駁此觀點
事實上胚胎分裂ㄉ速度  型態  在Day3 通常可說大勢底定 
Day 3 通常分裂為8-10 cell   速度略快是可被接受
速度慢於6 cell 的胚胎幾乎無法著床

J Assist Reprod Genet. 2019 Sep 2. doi: 10.1007/s10815-019-01574-y. [Epub ahead of print]

Deconstructing the myth of poor prognosis for fast-cleaving embryos on day 3. Is it time to change the consensus?

Pons MC1, Carrasco B2, Parriego M2, Boada M2, González-Foruria I2, Garcia S2, Coroleu B2, Barri PN2, Veiga A2,3.

Author information

1

Reproductive Medicine Service, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, 08028, Barcelona, Spain. carpon@dexeus.com.

2

Reproductive Medicine Service, Dexeus Mujer, Hospital Universitari Dexeus, Gran Via Carles III, 71-75, 08028, Barcelona, Spain.

3

Barcelona Stem Cell Bank, Centre of Regenerative Medicine in Barcelona, Hospital Duran i Reynals, Gran Via de l' Hospitalet 199, 08908, Hospitalet de Llobregat, Spain.

Abstract

PURPOSE:

To determine the developmental competence of fast-cleaving D3 embryos.

METHODS:

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.

RESULTS:

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)).

CONCLUSIONS:

Embryos with more than 11 cells exhibit similar developmental competence to 8-cell embryos. Their poor prognosis should be reconsidered.