title: Transfer of blastocysts with deviant morphological and morphokinetic parameters at early stages of in-vitro development: a case series.
abstract: Time-lapse imaging is increasingly applied as an adjunct to reproductive medicine. The gained information of the morphological and morphokinetic variables before the onset of transcription are supposed to be good predictors for the selection of the best embryo for transfer and are often seen in line with clinical outcomes. This retrospective case series investigated the outcome of transferred blastocysts that did not fulfil the proposed embryo scores at early cleavage or at later stages of development. The observations were made by time-lapse imaging. This study reports the birth of 16 healthy children after day-5 blastocyst transfer, of which at least one of the transferred embryos originated from deviant morphology and/or kinetic cleavage patterns. This case series suggests that some blastocysts derived from embryos with poor conventional morphological score and/or suboptimal morphokinetics can be successfully transferred and might result in live births. Such results might raise awareness that discarding embryos based only on early events is not a suitable approach to give patients the chance to conceive. In conclusion, to date only the transfer of viable embryos after culturing them until day 5 guarantees optimal embryo selection and helps to prevent embryo wastage.
authors.affiliation: IVF Centers Prof. Zech-Bregenz, Austria. Electronic address: a.stecher@ivf.at.
authors.forename: Astrid
authors.initials: A
authors.lastname: Stecher
authors.affiliation: IVF Centers Prof. Zech-Bregenz, Austria; Centre Hospitalier Inter Régional Edith Cavell (CHIREC), Braine-l'Alleud, Brussels, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vanderzwalmen
authors.affiliation: IVF Centers Prof. Zech-Bregenz, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Zintz
authors.affiliation: IVF Centers Prof. Zech-Bregenz, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Wirleitner
authors.affiliation: IVF Centers Prof. Zech-Bregenz, Austria.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schuff
authors.affiliation: IVF Centers Prof. Zech-Salzburg, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Spitzer
authors.affiliation: IVF Centers Prof. Zech-Bregenz, Austria.
authors.forename: Nicolas H
authors.initials: NH
authors.lastname: Zech
mesh_terms: D000328:Adult; D001755:Blastocyst; D046149:Embryo Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D018871:Endoplasmic Reticulum, Smooth; D005260:Female; D006801:Humans; D008297:Male; D009865:Oocytes / Q000166:cytology; D011247:Pregnancy; D012189:Retrospective Studies; D059008:Time-Lapse Imaging; D017388:Zygote Intrafallopian Transfer
keywords: blastocyst culture; case series; day-5 transfer; embryo scoring; morphokinetics; time-lapse imaging