title: Atypical embryo phenotypes identified by time-lapse microscopy: high prevalence and association with embryo development.
abstract: OBJECTIVE
  To characterize atypical dynamic embryo phenotypes identified by time-lapse microscopy, evaluate their prevalence, and determine their association with embryo development.
  
  
  METHODS
  Retrospective multicenter cohort study.
  
  
  METHODS
  Five IVF clinics in the United States.
  
  
  METHODS
  Sixty-seven women undergoing IVF treatment with 651 embryos.
  
  
  METHODS
  Embryo videos were retrospectively analyzed for atypical phenotypes.
  
  
  METHODS
  Identification of four groups of atypical embryo phenotypes: abnormal syngamy (AS), abnormal first cytokinesis (A1(cyt)), abnormal cleavage (AC), and chaotic cleavage (CC). Prevalence and association with embryo morphology and development potential were evaluated.
  
  
  RESULTS
  A high prevalence of atypical phenotypes was observed among embryos: AS 25.1% (163/649), A1(cyt) 31.0% (195/639), AC 18% (115/639) and CC 15% (96/639). A high percentage of embryos with atypical phenotype(s) had good quality on day 3 (overall grade good or fair): AS 78.6% (70/89); A1(cyt) 79.7% (94/119), AC 86.4% (70/81), and CC 35.2% (19/54), but the blastocyst formation rates for these embryos were significantly lower compared with their respective control groups: AS 21.5% vs. 44.9%, A1(cyt) 21.7% vs. 44.6%, AC 11.7% vs. 43.1%, and CC 14.0% vs. 42.3%.
  
  
  CONCLUSIONS
  Embryos exhibiting atypical phenotypes are highly prevalent in human embryos and show significantly lower developmental potential than control embryos.
  
  
  BACKGROUND
  NCT01369446.
authors.affiliation: Auxogyn, Menlo Park, California.
authors.forename: Kelly
authors.initials: K
authors.lastname: Athayde Wirka
authors.affiliation: Auxogyn, Menlo Park, California.
authors.forename: Alice A
authors.initials: AA
authors.lastname: Chen
authors.affiliation: Pacific Fertility Center, San Francisco, California.
authors.forename: Joe
authors.initials: J
authors.lastname: Conaghan
authors.affiliation: Reproductive Science Center of the Bay Area, San Ramon, California.
authors.forename: Kristen
authors.initials: K
authors.lastname: Ivani
authors.affiliation: Fertility Physicians of Northern California, Palo Alto Medical Foundation, San Jose, California.
authors.forename: Marina
authors.initials: M
authors.lastname: Gvakharia
authors.affiliation: Stanford Fertility and Reproductive Medicine Center, Palo Alto, California.
authors.forename: Barry
authors.initials: B
authors.lastname: Behr
authors.affiliation: Auxogyn, Menlo Park, California.
authors.forename: Vaishali
authors.initials: V
authors.lastname: Suraj
authors.affiliation: Auxogyn, Menlo Park, California.
authors.forename: Lei
authors.initials: L
authors.lastname: Tan
authors.affiliation: Auxogyn, Menlo Park, California. Electronic address: sshen@auxogyn.com.
authors.forename: Shehua
authors.initials: S
authors.lastname: Shen
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000473:pathology; D002140:California; D002970:Cleavage Stage, Ovum; D048749:Cytokinesis; D046149:Embryo Culture Techniques; D004622:Embryo, Mammalian / Q000473:pathology*; D047108:Embryonic Development; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D018715:Microscopy, Video; D010641:Phenotype; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D059008:Time-Lapse Imaging
keywords: Atypical phenotype; abnormal embryo development; embryo selection; embryo viability assessment; time-lapse microscopy