title: The predictive value of pronuclear morphology of zygotes in the assessment of human embryo quality.
abstract: BACKGROUND
  Recent studies have shown that zygote morphology could be used for the assessment of human embryo quality. Pronuclear (PN) morphology is based on certain distinct features seen in zygotes 16-18 h after fertilization. In the present study PN stage morphology was assessed and combined with a single embryo transfer in order to investigate whether currently used zygote classifications are able to predict embryo quality and implantation rates.
  
  
  RESULTS
  Zygotes were analysed according to two different classification systems. In the first, a total of 764 zygotes was analysed according to the degree of polarization of nucleolar precursor bodies (NPB). Zygotes with unpolarized PN (i.e. scattered localization of NPB) showed significantly slower (P < 0.005) cleavage rates (38.9%) than zygotes having at least one pronucleus polarized (57.3% and 54%). However, there was no difference in the pregnancy rate in 105 single embryo transfers between the groups. The appearance of a cytoplasmic halo was related to embryo morphology. Embryos derived from halo-positive zygotes had significantly better (P < 0.05) morphology (60.9%) compared to halo-negative derived embryos (52.2%), but in terms of pregnancy rates no difference was found. A total of 1520 zygotes was analysed according to a second classification system, which was based on the number and distribution of NPB. In the comparative analysis, none of the six different classes produced superior quality embryos or higher pregnancy rates in 144 single embryo transfers.
  
  
  CONCLUSIONS
  Our results indicate that there are no significant differences in embryo quality or implantation/pregnancy rates between proposed zygote classes.
authors.affiliation: Infertility Clinic, The Family Federation of Finland, Kalevankatu 16, FIN-00100 Helsinki, Finland. andres.salumets@vaestoliitto.fi
authors.forename: A
authors.initials: A
authors.lastname: Salumets
authors.forename: C
authors.initials: C
authors.lastname: Hydén-Granskog
authors.forename: A M
authors.initials: AM
authors.lastname: Suikkari
authors.forename: A
authors.initials: A
authors.lastname: Tiitinen
authors.forename: T
authors.initials: T
authors.lastname: Tuuri
mesh_terms: D002466:Cell Nucleolus / Q000648:ultrastructure; D016764:Cell Polarity; D002970:Cleavage Stage, Ovum; D003593:Cytoplasm / Q000648:ultrastructure; D010064:Embryo Implantation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D009865:Oocytes / Q000145:classification / Q000502:physiology / Q000648:ultrastructure*; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate