The probability of abnormal preimplantation development can be predicted by a single static observation on pronuclear stage morphology

TLDR

The study aims to determine whether the developmental fate of two‑pronucleated zygotes can be predicted from a single, non‑invasive pronuclear morphology assessment based on nucleolar precursor body distribution, and calls for prospective validation of these criteria. By retrospectively classifying pronuclear patterns 0–5 from 2PN zygotes—where pattern 0 reflects normal nucleolar precursor body distribution associated with 100 % implantation cycles—the authors examined how these patterns relate to blastomere multinucleation and early embryo morphology. Pattern 0 zygotes had only an 8.5 % arrest rate and yielded a 50 % clinical pregnancy rate when transferred, whereas patterns 1–5 had arrest rates of 20–32 % and a 9 % pregnancy rate, demonstrating that early pronuclear morphology can predict developmental outcome.

Abstract

This retrospective study was undertaken to determine whether further developmental progression of twopronucleated (2PN) zygotes can be predicted by a single, non-invasive examination of pronuclei, with the use of criteria based on the number and distribution of nucleolar precursor bodies in each pronucleus. The normal range of pronuclear variability was defined by analysis of zygotes giving rise to embryos transferred in 100%-implantation cycles (pattern 0). Morphological patterns differing from pattern 0 were classified as patterns 1–5. The frequency of developmental arrest of pattern 0 zygotes was only 8.5% as compared with 31.6, 21.9, 30.0, 20.5 and 24.1% for patterns 1–5 respectively. Relationships of pronuclear patterns with blastomere multinucleation and cleaving embryo morphology were also noted. Clinical pregnancy was achieved in 22 of 44 (50%) treatment cycles in which at least one pattern 0 embryo was transferred, but only in two of 23 (9%) cycles in which only pattern 1–5 embryos were transferred. These data present new evaluation criteria which can be used to predict the developmental fate of human embryos as early as the pronuclear stage, without requiring repeated observations or an exact timing of pronuclear zygote inspection. Further prospective study is needed for clinical validation of these criteria.