An embryo cleavage pattern based on the relative blastomere size as a function of cell number for predicting implantation outcome

Capsule:
The embryo’s cleavage pattern provides valuable supplementary information to the standard evaluation for selecting embryos by cleavage rate and fragmentation, enhancing the likelihood for successful implantation.

Authors:
Roee Sela, D.V.M., Liat Samuelov, M.D., Benny Almog, M.D., Tamar Schwartz, B.Sc., Tania Cohen, M.Sc., Ami Amit, M.D., Foad Azem, M.D., Dalit Ben-Yosef, Ph.D.

Volume 98, Issue 3, Pages 650-656.e4, September 2012

Abstract:

Objective:
To analyze whether the cleavage pattern redefined for all cleavage stages according to the relative blastomere size as a function of cell number has an additive value in predicting implantation potential of day 2-3 embryos.

Design:
Retrospective analysis of standard embryo morphological parameters (cleavage rate and degree of fragmentation) supplemented by cleavage pattern findings of 347 implanted embryos compared to those of a matched control group of 307 embryos that failed to implant.

Setting:
University-based tertiary medical center.

Patient(s):
Two hundred and nine women with successful implantation and 181 controls matched for age and demographic parameters with failed implantation.

Interventions:
In vitro fertilization (IVF), embryo assessment, and embryo transfer

Main Outcome Measures:
Determination of cleavage patterns in synchronized and unsynchronized cleaving embryos and correlations to implantation outcomes.

Results:
Significantly more embryos of the implanted group were of good cleavage pattern compared to the non-implanted group (88% vs. 70%; P70%) when the cleavage pattern was assessed on both days 2 & 3.

Conclusions:
When combined with measurements of the cleavage rate and degree of fragmentation, the cleavage pattern refines our ability to predict the likelihood of implantation, representing a definitive tool in the selection of top-quality embryos.

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