title: Prediction of embryo developmental potential and pregnancy based on early stage morphological characteristics.
abstract: OBJECTIVE
  To analyze the association between morphological details at different stages of culture with blastocyst development, with an aim to improve selection for transfer.
  
  
  METHODS
  Retrospective audit of data.
  
  
  METHODS
  Tertiary referral center and university hospital.
  
  
  METHODS
  Two hundred sixty-eight couples underwent 357 treatment cycles.
  
  
  METHODS
  Oocyte pickups for IVF or intracytoplasmic sperm injection (ICSI) after ovarian stimulation. Embryos were individually cultured and examined on days 0-2 for morphological details and developmental characteristics, and selected for transfer, freezing, or further culture.
  
  
  METHODS
  The association of blastocyst development and pregnancy with morphological characteristics.
  
  
  RESULTS
  Five morphological characteristics (appearance of the cytoplasm, pronuclei and nucleoli, cytoplasmic deficit, and developmental rate) showed the strongest association with blastocyst development. By combining information from all days of culture into a cumulative score, prediction was greatly improved, compared to only using day 2 morphology. Cytoplasmic dysmorphisms of the oocyte, including accumulation of smooth endoplasmic reticulum, were associated with poor developmental performance. Differential weighting of these characteristics was included in a new embryo scoring system, which showed a strong correlation with implantation.
  
  
  CONCLUSIONS
  Weighting individual morphological characteristics of zygotes and embryos and combining them into a cumulative embryo score can improve selection of embryos for transfer.
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Australia. peter.sjoblom@fcivf.com
authors.forename: Peter
authors.initials: P
authors.lastname: Sjöblom
authors.forename: Judith
authors.initials: J
authors.lastname: Menezes
authors.forename: Lisa
authors.initials: L
authors.lastname: Cummins
authors.forename: Bagyalakshmi
authors.initials: B
authors.lastname: Mathiyalagan
authors.forename: Michael F
authors.initials: MF
authors.lastname: Costello
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000166:cytology*; D047108:Embryonic Development; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*