Pronuclear score improves prediction of embryo implantation success in ICSI cycles
Abstract Background In assisted reproduction technology embryo competence is routinely evaluated on morphological criteria but efficacy remains relatively low. Additional information could be obtained by evaluating pronuclear (PN) morphology. Up to now controversial results have been reported about...
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doaj-cb09a0d425434018967f5997e32142842021-05-09T11:17:37ZengBMCBMC Pregnancy and Childbirth1471-23932021-05-012111910.1186/s12884-021-03820-7Pronuclear score improves prediction of embryo implantation success in ICSI cyclesSara Stigliani0Claudia Massarotti1Francesca Bovis2Ida Casciano3Fausta Sozzi4Valentino Remorgida5Angelo Cagnacci6Paola Anserini7Paola Scaruffi8UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San MartinoDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Academic Unit of Obstetrics and Gynecology, University of GenovaDepartment of Health Sciences (DISSAL), University of GenovaUOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San MartinoUOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San MartinoDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Academic Unit of Obstetrics and Gynecology, University of GenovaDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Academic Unit of Obstetrics and Gynecology, University of GenovaUOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San MartinoUOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San MartinoAbstract Background In assisted reproduction technology embryo competence is routinely evaluated on morphological criteria but efficacy remains relatively low. Additional information could be obtained by evaluating pronuclear (PN) morphology. Up to now controversial results have been reported about the prognostic value of PN score. One of the main limitations of literature data is the use of different PN classification methods. In this regard, in 2011 the ESHRE and Alpha Scientists in Reproductive Medicine defined three PN categories to standardize zygote assessment. In this study we evaluated whether the consensus ESHRE-Alpha system for the pronuclear scoring could be an useful additional criterion to improve prediction of embryo implantation potential. Methods This is a retrospective, longitudinal, observational, cohort study. We included 3004 zygotes from 555 women who underwent ICSI treatment at our Center between January 2014 and June 2019. The PN were categorized as score 1: symmetrical, 2: non-symmetrical, 3: abnormal. A subset of 110 zygotes did not cleaved. On day 2–3 1163 embryos were transferred, 232 arrested, and 9 were cryopreserved. Among the 1490 embryos cultured up to day 5–7, 516 became blastocysts: 123 were transferred on day 5 and 393 were cryopreserved. Comparisons of age, cleavage and blastocyst rate, quality of embryos, implantation success among PN score groups were evaluated by chi-square test or Kruskal-Wallis test as appropriate. Potential predictors of embryo implantation were first tested in univariable analysis using generalized estimating equations taking into account correlation between embryos originated from the same patient. Then, variables potentially associated with implantation success (P<0.05) were included in a multivariable analysis for calculating the adjusted odds ratio (OR) and 95% confidence interval (CI). Results There was no significant difference in patients’age, cleavage and blastulation rates, and embryo morphology among the three PNscore groups. The PN score 1-embryos had a greater implantation success respect to score 2-3-ones (OR 1.83; 95% CI 1.34-2.50, P=0.0001). Consistently, the pronuclear score remained predictive of implantation in top quality embryos (OR 1.68; 95%CI 1.17-2.42, P= 0.005). Conclusions The consensus pronuclear score may be routinely included among criteria for embryo evaluation to increase patients’ chance of becoming pregnant.https://doi.org/10.1186/s12884-021-03820-7Pronuclear morphologyZygoteBlastocyst developmentImplantationPreimplantation embryo |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sara Stigliani Claudia Massarotti Francesca Bovis Ida Casciano Fausta Sozzi Valentino Remorgida Angelo Cagnacci Paola Anserini Paola Scaruffi |
spellingShingle |
Sara Stigliani Claudia Massarotti Francesca Bovis Ida Casciano Fausta Sozzi Valentino Remorgida Angelo Cagnacci Paola Anserini Paola Scaruffi Pronuclear score improves prediction of embryo implantation success in ICSI cycles BMC Pregnancy and Childbirth Pronuclear morphology Zygote Blastocyst development Implantation Preimplantation embryo |
author_facet |
Sara Stigliani Claudia Massarotti Francesca Bovis Ida Casciano Fausta Sozzi Valentino Remorgida Angelo Cagnacci Paola Anserini Paola Scaruffi |
author_sort |
Sara Stigliani |
title |
Pronuclear score improves prediction of embryo implantation success in ICSI cycles |
title_short |
Pronuclear score improves prediction of embryo implantation success in ICSI cycles |
title_full |
Pronuclear score improves prediction of embryo implantation success in ICSI cycles |
title_fullStr |
Pronuclear score improves prediction of embryo implantation success in ICSI cycles |
title_full_unstemmed |
Pronuclear score improves prediction of embryo implantation success in ICSI cycles |
title_sort |
pronuclear score improves prediction of embryo implantation success in icsi cycles |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-05-01 |
description |
Abstract Background In assisted reproduction technology embryo competence is routinely evaluated on morphological criteria but efficacy remains relatively low. Additional information could be obtained by evaluating pronuclear (PN) morphology. Up to now controversial results have been reported about the prognostic value of PN score. One of the main limitations of literature data is the use of different PN classification methods. In this regard, in 2011 the ESHRE and Alpha Scientists in Reproductive Medicine defined three PN categories to standardize zygote assessment. In this study we evaluated whether the consensus ESHRE-Alpha system for the pronuclear scoring could be an useful additional criterion to improve prediction of embryo implantation potential. Methods This is a retrospective, longitudinal, observational, cohort study. We included 3004 zygotes from 555 women who underwent ICSI treatment at our Center between January 2014 and June 2019. The PN were categorized as score 1: symmetrical, 2: non-symmetrical, 3: abnormal. A subset of 110 zygotes did not cleaved. On day 2–3 1163 embryos were transferred, 232 arrested, and 9 were cryopreserved. Among the 1490 embryos cultured up to day 5–7, 516 became blastocysts: 123 were transferred on day 5 and 393 were cryopreserved. Comparisons of age, cleavage and blastocyst rate, quality of embryos, implantation success among PN score groups were evaluated by chi-square test or Kruskal-Wallis test as appropriate. Potential predictors of embryo implantation were first tested in univariable analysis using generalized estimating equations taking into account correlation between embryos originated from the same patient. Then, variables potentially associated with implantation success (P<0.05) were included in a multivariable analysis for calculating the adjusted odds ratio (OR) and 95% confidence interval (CI). Results There was no significant difference in patients’age, cleavage and blastulation rates, and embryo morphology among the three PNscore groups. The PN score 1-embryos had a greater implantation success respect to score 2-3-ones (OR 1.83; 95% CI 1.34-2.50, P=0.0001). Consistently, the pronuclear score remained predictive of implantation in top quality embryos (OR 1.68; 95%CI 1.17-2.42, P= 0.005). Conclusions The consensus pronuclear score may be routinely included among criteria for embryo evaluation to increase patients’ chance of becoming pregnant. |
topic |
Pronuclear morphology Zygote Blastocyst development Implantation Preimplantation embryo |
url |
https://doi.org/10.1186/s12884-021-03820-7 |
work_keys_str_mv |
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