Article| Volume 43, ISSUE 4, P627-636, October 2021

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Early embryo development anomalies identified by time-lapse system: prevalence and impacting factors


      Research question

      What is the prevalence of embryo abnormal early cleavage (ACL) identified by time lapse and factors related to patients and treatment that explain ACL occurrence?


      A single-centre, retrospective cohort study. Data were collected on all IVF cycles for which embryos were observed in the EmbryoScope® between December 2015 and August 2017. Only diploid zygotes cleaved on day 2 were included. The study included 318 cycles (250 couples and 1343 embryos). Embryo videos were retrospectively analysed for ACL. The prevalence of each type of ACL was recorded. The influence of clinical factors (whether they were intrinsic to patients or specific to IVF treatment) on ACL occurrence was analysed in multivariate multilevel mixed-effect logistic regression analysis.


      A high prevalence of ACL was observed: 37.6% (505/1343) of embryos presented at least one ACL, 22.8% (306/1343) a trichotomous mitosis, 25.8% (347/1343) a rapid cleavage, 6.7% (90/1343) a cell fusion and two or more ACL (16.1%). Part of the variation (12–25%) in ACL occurrence could be explained by embryo origin. Trichotomous mitosis and two or more ACL phenotypes were less likely to occur in women with endometriosis or tubal pathology and tubal pathology alone, respectively. No factor related to IVF cycles was found to be statistically associated with ACL occurrence.


      Our findings emphasize the importance of considering embryo origin when interpreting studies focusing on embryo characteristics and factors that could affect their quality. The present study is limited by a small sample size of known embryo implantations and monocentric criterion.


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      Xavier Ferraretto, MD, PhD, is a medical doctor and senior embryologist at the Reproduction Biology Department of Bichat Hospital in Paris (Assistance Publique – Hôpitaux de Paris). His research interests are embryo morphokinetics, fertility preservation and assisted reproductive technology in a viral context (hepatitis B, hepatitis C and human immunodeficiency virus).
      Key message
      Abnormal early cleavages can be partially explained by embryo origin, with only a few patient-related factors exerting an influence. It is important when analysing embryonic parameters, therefore, not to consider the embryos individually but to take into account whether or not they are from the same couple.