Embryo multinucleation at the two-cell stage is an independent predictor of intracytoplasmic sperm injection outcomes

Laurent Desch; Céline Bruno; Maxime Luu; Julie Barberet; Cécile Choux; Marjorie Lamotte; Emeline Schmutz; Paul Sagot; Patricia Fauque

doi:10.1016/j.fertnstert.2016.09.022

Embryo multinucleation at the two-cell stage is an independent predictor of intracytoplasmic sperm injection outcomes

Fertil Steril. 2017 Jan;107(1):97-103.e4. doi: 10.1016/j.fertnstert.2016.09.022. Epub 2016 Oct 26.

Authors

Laurent Desch¹, Céline Bruno¹, Maxime Luu², Julie Barberet¹, Cécile Choux³, Marjorie Lamotte³, Emeline Schmutz³, Paul Sagot³, Patricia Fauque⁴

Affiliations

¹ Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
² Centre d'Investigations Cliniques- Plurithématique Institut National de la Santé et de la Recherche Médicale 1432, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
³ Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
⁴ Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France. Electronic address: patricia.fauque@chu-dijon.fr.

PMID: 28228320
DOI: 10.1016/j.fertnstert.2016.09.022

Abstract

Objective: To determine the prognostic impact of the nuclear status at the two-cell stage on intracytoplasmic sperm injection (ICSI) outcomes.

Design: Retrospective study.

Setting: Hospital.

Patient(s): Only ICSI cycles with time-lapse monitoring of transferred embryos with known implantation/delivery data from November 2012 to December 2014 were included. A total of 2,449 embryos were assessed for multinucleation rates at the two- and four-cell stage, and 608 transferred embryos were studied for ICSI outcomes.

Intervention(s): None.

Main outcome measure(s): Implantation rate (IR) and live birth rate (LBR) according to the number of multinucleated blastomeres at the two-cell stage: none (Without-MNB^2cell), one (MNB^1/2cell), and two (MNB^2/2cell); morphokinetics of MNB^2cell embryos.

Result(s): Embryos with MNB^1/2cell led to lower IR (27.7%) and LBR (22.7%) than embryos Without-MNB^2cell (33.4% and 29.8%, respectively). The MNB^2/2cell embryos led to significantly lower IR (18.3%) and LBR (13.4%) than embryos Without-MNB^2cell. This difference remained significant in multivariate analysis for implantation (odds ratio 0.57; 95% confidence interval 0.34-0.94) and birth (odds ratio 0.46; 95% confidence interval 0.26-0.80), independently of the other significant parameters (women's age, time of two-cell formation, and multinucleation at the four-cell stage). Among implanted MNB^2cell, if cleavage into four cells occurred later than 37 hours after insemination, embryos were significantly more likely to lead to birth.

Conclusion(s): The presence of multinucleation at the two-cell stage and more specifically in both blastomeres had a significant negative impact on birth potential. Thus, embryo multinucleation at the two-cell stage should be used as an additional noninvasive criterion for embryo selection.

Keywords: Birth rate; ICSI outcomes; embryo multinucleation; implantation; time-lapse system.

MeSH terms

Blastomeres / cytology*
Cell Nucleus*
Chi-Square Distribution
Cleavage Stage, Ovum
Embryo Implantation
Embryo Transfer / adverse effects
Embryo, Mammalian / cytology*
Female
Fertility
Humans
Infertility / diagnosis
Infertility / physiopathology
Infertility / therapy*
Live Birth
Logistic Models
Microscopy, Video
Multivariate Analysis
Odds Ratio
Pregnancy
Pregnancy Rate
Retrospective Studies
Risk Factors
Sperm Injections, Intracytoplasmic / adverse effects*
Time-Lapse Imaging / methods
Treatment Outcome