Laboratoire de Biologie de la Reproduction, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
Centre d'Investigations Cliniques- Plurithématique Institut National de la Santé et de la Recherche Médicale 1432, Hôpital François Mitterrand, Université de Bourgogne, Dijon, France.
Fertil Steril. 2017 Jan;107(1):97-103.e4. doi: 10.1016/j.fertnstert.2016.09.022. Epub 2016 Oct 26.
To determine the prognostic impact of the nuclear status at the two-cell stage on intracytoplasmic sperm injection (ICSI) outcomes.
Retrospective study.
Hospital.
PATIENT(S): 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.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Implantation rate (IR) and live birth rate (LBR) according to the number of multinucleated blastomeres at the two-cell stage: none (Without-MNB), one (MNB), and two (MNB); morphokinetics of MNB embryos.
RESULT(S): Embryos with MNB led to lower IR (27.7%) and LBR (22.7%) than embryos Without-MNB (33.4% and 29.8%, respectively). The MNB embryos led to significantly lower IR (18.3%) and LBR (13.4%) than embryos Without-MNB. 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 MNB, if cleavage into four cells occurred later than 37 hours after insemination, embryos were significantly more likely to lead to birth.
CONCLUSION(S): 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.
确定两细胞期核状态对卵胞浆内单精子注射（ICSI）结局的预后影响。
回顾性研究。
医院。
仅纳入 2012 年 11 月至 2014 年 12 月具有已知种植/分娩数据的经延时监控的胚胎的 ICSI 周期。对两细胞期和四细胞期多核化率进行了 2449 个胚胎的评估，对 608 个移植胚胎进行了 ICSI 结局研究。
无。
根据两细胞期多核化胚的数量评估种植率（IR）和活产率（LBR）：无（无 MNB）、1 个（MNB）和 2 个（MNB）；MNB 胚胎的形态动力学。
MNB 胚胎的 IR（27.7%）和 LBR（22.7%）明显低于无 MNB 胚胎（分别为 33.4%和 29.8%）。MNB 胚胎的 IR（18.3%）和 LBR（13.4%）明显低于无 MNB 胚胎。多变量分析显示，MNB 对种植（优势比 0.57；95%置信区间 0.34-0.94）和分娩（优势比 0.46；95%置信区间 0.26-0.80）有显著影响，独立于其他重要参数（妇女年龄、两细胞形成时间和四细胞期多核化）。在植入的 MNB 中，如果在授精后 37 小时后分裂成四细胞，胚胎更有可能导致分娩。
两细胞期存在多核化，特别是在两个胚胎中存在多核化，对生育潜能有显著的负面影响。因此，两细胞期胚胎多核化应作为胚胎选择的额外非侵入性标准。
