title: Detection of early cleavage embryos improves pregnancy and delivery rates of Day 3 embryo transfer during in vitro fertilization.
abstract: OBJECTIVE
  This study established a simple criterion for improving the pregnancy and delivery rates of Day 3 embryo transfer for in vitro fertilization (IVF) by assessing the early cleavage of two-cell stage embryos.
  
  
  METHODS
  In total, 258 cycle patients undergoing an IVF and Day 3 embryo transfer program were recruited. All cycles were divided into four groups containing viable Day 3 embryos and those (A) with distinct early cleavage (equal-sized blastomeres and ≤10% fragmentation: ECA grade); (B) with indistinct early cleavage (equal sized blastomeres, >2 blastomeres, or >10% fragmentation: ECB grade); (C) without early cleavage [no early cleavage (NEC grade)]; or (D) without early cleavage being assessed (control) at 25-27 after insemination.
  
  
  RESULTS
  The percentage of viable Day 3 embryos from ECA grade (75.1%, 507/675) was significantly higher than that from ECB grade (19.2%, 151/403) or NEC grade (27.1%, 127/469) embryos (p < 0.01). The pregnancy and delivery rates in the ECA group [65.7% (65/990) and 48.5% (48/990), respectively] were significantly higher than those in the ECB group [30.8% (4/13) and 7.7% (1/13), respectively] or NEC group [36.8% (14/38) and 23.7% (9/38), respectively; all p < 0.01]. The implantation rate in the ECA group (32.3%, 129/400) was higher than those in the ECB (6.8%, 4/59) and NEC (13.0%, 18/136) groups (p < 0.01).
  
  
  CONCLUSIONS
  Simple selection using the early cleavage morphology may improve the pregnancy and delivery rates of Day 3 embryo transfer programs.
authors: Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
authors: Chun-I
authors: CI
authors: Lee
authors: Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors: Tsung-Hsien
authors: TH
authors: Lee
authors: Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan; Department of Biotechnology, Chungtai Medicine University, Taichung, Taiwan.
authors: Chun-Chia
authors: CC
authors: Huang
authors: Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan; Department of Life Sciences, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan.
authors: Hsiu-Hui
authors: HH
authors: Chen
authors: Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors: Chung-Hsien
authors: CH
authors: Liu
authors: Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan. Electronic address: msleephd@gmail.com.
authors: Maw-Sheng
authors: MS
authors: Lee
mesh_terms: D000328:Adult; D002970:Cleavage Stage, Ovum; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D013997:Time Factors
keywords: Day 3 embryo; delivery rate; early cleavage; pregnancy rate