title: Embryo multinucleation at the two-cell stage is an independent predictor of intracytoplasmic sperm injection outcomes.
abstract: To determine the prognostic impact of the nuclear status at the two-cell stage on intracytoplasmic sperm injection (ICSI) outcomes.
  
  
  
  Retrospective study.
  
  
  
  Hospital.
  
  
  
  Only ICSI cycles with time-lapse monitoring of transferred embryos with known implantation/delivery data from November 2012 to December 2014 were included. A total of 2,449 embryos were assessed for multinucleation rates at the two- and four-cell stage, and 608 transferred embryos were studied for ICSI outcomes.
  
  
  
  None.
  
  
  
  Implantation rate (IR) and live birth rate (LBR) according to the number of multinucleated blastomeres at the two-cell stage: none (Without-MNB2cell), one (MNB1/2cell), and two (MNB2/2cell); morphokinetics of MNB2cellembryos.
  
  
  
  Embryos with MNB1/2cellled to lower IR (27.7%) and LBR (22.7%) than embryos Without-MNB2cell(33.4% and 29.8%, respectively). The MNB2/2cellembryos led to significantly lower IR (18.3%) and LBR (13.4%) than embryos Without-MNB2cell. This difference remained significant in multivariate analysis for implantation (odds ratio 0.57; 95% confidence interval 0.34-0.94) and birth (odds ratio 0.46; 95% confidence interval 0.26-0.80), independently of the other significant parameters (women's age, time of two-cell formation, and multinucleation at the four-cell stage). Among implanted MNB2cell, if cleavage into four cells occurred later than 37 hours after insemination, embryos were significantly more likely to lead to birth.
  
  
  
  The presence of multinucleation at the two-cell stage and more specifically in both blastomeres had a significant negative impact on birth potential. Thus, embryo multinucleation at the two-cell stage should be used as an additional noninvasive criterion for embryo selection.
authors.affiliation: Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Desch
authors.affiliation: Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Bruno
authors.affiliation: Centre d'Investigations Cliniques- Plurithématique Institut National de la Santé et de la Recherche Médicale 1432, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Luu
authors.affiliation: Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Barberet
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Choux
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Lamotte
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Emeline
authors.initials: E
authors.lastname: Schmutz
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Sagot
authors.affiliation: Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France. Electronic address: patricia.fauque@chu-dijon.fr.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fauque
mesh_terms: D001757:Blastomeres / Q000166:cytology*; D002467:Cell Nucleus; D016009:Chi-Square Distribution; D002970:Cleavage Stage, Ovum; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000009:adverse effects; D004622:Embryo, Mammalian / Q000166:cytology*; D005260:Female; D005298:Fertility; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D016015:Logistic Models; D018715:Microscopy, Video; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects*; D059008:Time-Lapse Imaging / Q000379:methods; D016896:Treatment Outcome
keywords: Birth rate; ICSI outcomes; embryo multinucleation; implantation; time-lapse system