Nucleation status of Day 2 pre-implantation embryos, acquired by time-lapse imaging during IVF, is associated with live birth

PLoS One. 2022 Sep 22;17(9):e0274502. doi: 10.1371/journal.pone.0274502. eCollection 2022.

Abstract

The primary purpose of this time-lapse data analysis was to identify the association between the nucleation status of a Day 2 preimplantation embryo and live births following in vitro fertilization (IVF). The retrospective data analysis was based on 2769 transferred embryos from 1966 treatment cycles and utilised only Known Implantation Data (KID) for live births. Nucleation errors (NE) such as micronucleation, binucleation, multinucleation and minor error groups, were annotated in the time-lapse images which were taken every 15 minutes for a minimum of 44 hours post insemination. Further, factors that may impact NE and the relationship of early morphological attributes and morphokinetic variables with NE occurrence were explored. The frequency of NE among the transferred embryos was 23.8%. The reversibility of NE evidenced by their presence at the two-cell stage, but absence at the four-cell stage was 89.6%. Embryos exhibiting nucleation errors at the two-cell stage had significantly lower live birth rates compared to embryos with no nucleation errors, constituting a significant predictor. A Generalized Additive Mixed Model was used to control for confounders and for controlling clustering effects from dual embryo transfers. Increased incidences of NE were observed with increasing age, with delayed occurrence of cell divisions and in oocytes inseminated with surgically retrieved spermatozoa. NE assessment and their impact on live birth provides valuable markers for early preimplantation embryo selection. In addition, the high incidence of reversibility of NE and their possible impact on live birth suggest that incorporating two-cell nuclear status annotations in embryo selection, alongside morphology and morphokinetics, is of value.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blastocyst
  • Embryo Culture Techniques*
  • Embryo Implantation
  • Female
  • Fertilization in Vitro / methods
  • Humans
  • Live Birth*
  • Pregnancy
  • Retrospective Studies
  • Time-Lapse Imaging / methods

Grants and funding

Klinikk Hausken provided support in the form of salaries for authors [S.S, J.W.H and A.S] as well as funding for data analysis assistance to B.M.P. The Norwegian Research Centre on Women’s Health, Oslo University Hospital provided support in the form of salaries for R.S and M.M.R. The specific roles of these authors are articulated in the ‘author contributions’ section. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.