Abstract
Research question
What is the incidence, origin and clinical significance of blastomere movement after
the first cell division in the human embryo?
Design
A total of 1096 embryos, cultured in the EmbryoScope+ ® time-lapse system and subjected
to a single fresh cleaved embryo transfer, were retrospectively analysed. Type and
duration of blastomere movement (dBMov) between the first (t2) and second cell division
(t3) was monitored, and the ratio of dBMov during the 2-cell stage [dBMov/(t3–t2)]
was calculated. Morphological evaluation of embryos was performed by referring to
the size of the blastomere and fragmentation after first division in addition to Veeck's
criteria on Day 2. The correlation between dBMov and ongoing pregnancy was evaluated
and the association of dBMov with patient and embryonic characteristics was determined.
Results
Both movement type and the value of dBMov/(t3–t2) were significantly associated with
asymmetrical first division, fragment formation and morphological grade on Day 2.
Multivariate logistic regression analysis revealed that a higher value of dBMov/(t3–t2)
significantly correlated with a decreased ongoing pregnancy rate, even after adjustment
for co-founders (odds ratio 0.399, P = 0.0419). The time intervals of pronuclear (PN) alignment and PN fading were significantly
correlated with the dBMov/(t3–t2) value.
Conclusions
Embryos with extended blastomere movement after the first cell division, which is
associated with the delay of PN fading and first cell division, have a lower competence
to initiate an ongoing pregnancy after fresh embryo transfer on Day 2. Thus, blastomere
movement could be a useful predictive parameter for selecting embryos at the early
cleavage stage.
Keywords
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Biography
Kenji Ezoe is a scientist at the R & D laboratory at Kato Ladies Clinic, Tokyo, Japan. He obtained his PhD degree in 2016 in Agriculture from Tokyo University of Agriculture and Technology. His research interests include embryology and endometrial receptivity during the implantation process.Key message
The chances of clinical and ongoing pregnancy after a single fresh cleaved embryo transfer is adversely affected by prolonged blastomere movement, which is associated with a delay in pronuclear fading and first cell division. Our results support the idea that blastomere movement can be used as a predictive parameter for pregnancy outcomes.
Article info
Publication history
Published online: December 22, 2018
Accepted:
December 11,
2018
Received in revised form:
November 9,
2018
Received:
August 29,
2018
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2018 Published by Elsevier Ltd on behalf of Reproductive Healthcare Ltd.
