Background: The aim was to study zygote evaluation based on pronuclear morphology under the German embryo protection law, according to which only a maximum of three zygotes are allowed to be cultured for embryo transfer.
Methods: In this prospective multicentre study, a total of 512 treatment cycles was performed at 10 centres, between November 1999 and October 2000. Zygotes were classified into seven patterns (0A, 0B and 1-5). Pattern 0A and 0B zygotes were preferentially used for further culture and transfer.
Results: Cycles with transfer of at least one embryo derived from pattern 0B, but not pattern 0A, resulted in significantly higher pregnancy (37.9%) and implantation rates (20.5%) compared with non-pattern 0B cycles (26.4 and 15.7%; P < 0.05 and P < 0.01 respectively). In younger patients (aged < or =35 years), significantly more 0B zygotes were available for transfer than in older patients (34.2 versus 25.8%; P < 0.005).
Conclusions: From these data, it is concluded that evaluation of pronuclear morphology is beneficial, especially for countries with legal restrictions regarding embryo selection.