title: Embryo quality but not pronuclear score is associated with clinical pregnancy following IVF.
abstract: OBJECTIVE
  The association between pronuclear (PN) scoring of embryos from assisted reproductive technology (ART) and clinical pregnancy remains controversial. We hypothesized that embryos with PNs scored on the day of fertilization check offer better embryo selection on day 3 and higher CPR compared to non-PN scored embryos.
  
  
  METHODS
  Patients (19-46 years) undergoing IVF/ICSI cycles at Montefiore's Institute for Reproductive Medicine and Health between January 2006 and December 2009 were included in our study. We analyzed fresh day 3 cycles only with autologous oocytes and partner's fresh sperm (n = 344). A total of 1,899 embryos were included. We compared CPR from non-PN scored embryos (Group 1, n = 835) with PN scored embryos (Group 2, n = 1,064). Composite scores by patient were developed based on embryo disposition. We also assessed traditional embryo grading derived from cell number, fragmentation and cell symmetry. Data analysis included chi square and t test to determine if PN scoring was associated with improved CPR, and to compare the additional variables.
  
  
  RESULTS
  CPR between Group 1 and Group 2 were not different (p = 0.91). CPR was significantly associated with female age, number of mature oocytes retrieved, number of day 3 embryos and grade of embryos transferred on day 3 (p < 0.05).
  
  
  CONCLUSIONS
  PN scoring was not associated with improved CPR in day 3 embryo transfers. Mean grade of transferred embryos continues to be a well-established, independent predictor of CPR. We conclude that further refinement of embryo grading by PN scoring is not beneficial.
authors.affiliation: Montefiore's Institute for Reproductive Medicine and Health, 141 South Central Ave, Suite 201, Hartsdale, NY, 10530, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Berger
authors.forename: A
authors.initials: A
authors.lastname: Zapantis
authors.forename: Z
authors.initials: Z
authors.lastname: Merhi
authors.forename: J
authors.initials: J
authors.lastname: Younger
authors.forename: A J
authors.initials: AJ
authors.lastname: Polotsky
authors.forename: S K
authors.initials: SK
authors.lastname: Jindal
mesh_terms: D000328:Adult; D002970:Cleavage Stage, Ovum; D019924:Embryo Disposition; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D020554:Sperm Injections, Intracytoplasmic; D017388:Zygote Intrafallopian Transfer