UNASSIGNED: This study used a retrospective dataset from a single IVF Unit. A total of 3,060 embryos from 1,811 fresh IVF cycles were analyzed. The cleavage pattern, morphokinetics, and outcome were recorded. Only 2pn embryos, fertilized by ejaculated sperm, and cultured in a time-lapse system for at least 5 days were included. We generated three study groups according to the embryo\'s cleavage pattern: (I) Control, normal cleavage (n = 551); (II) fast cleavage, zygote to three cells within 5 h (n = 1,587); and (III) instant direct tripolar cleavage (IDC) from zygote to three cells (n = 922).
UNASSIGNED: The rate of usable fast cleavage blastocysts was 108/1,587 (6.81%) and usable control blastocysts was 180/551 (32.67%). The time of PN fading and from fading to first cleavage differed significantly between the three groups. Although the pregnancy rate of control and fast cleavage blastocysts were comparable (40.35% and 42.55%, respectively), the amount of instant direct cleavage embryos that reached blastocyst stage was neglectable (only four embryos out of 922 analyzed IDC embryos) and unsuitable for statistical comparison of pregnancy rates.
UNASSIGNED: Our results indicate the need to culture instant direct cleavage embryos for 5 days, up to the blastocyst stage, and avoid transfer of embryos that are fated to arrest even when their morphological grade on day 3 is acceptable, whereas fast cleavage embryos could be transferred on day 3 when there is no alternative.
■本研究使用了来自单个IVF单元的回顾性数据集。分析了来自1,811个新鲜IVF周期的总共3,060个胚胎。卵裂模式,形态动力学,并记录结果。只有2pn的胚胎,被射精的精子受精,并在延时系统中培养至少5天。我们根据胚胎的卵裂模式建立了三个研究组:(I)对照,正常卵裂(n=551);(II)快速卵裂,受精卵在5小时内到达三个细胞(n=1,587);和(III)从受精卵到三个细胞的即时直接三极裂解(IDC)(n=922)。
■可用的快速卵裂囊胚率为108/1,587(6.81%),可用的对照囊胚率为180/551(32.67%)。三组之间的PN衰落和从衰落到第一次分裂的时间显着不同。尽管对照和快速卵裂囊胚的妊娠率相当(40.35%和42.55%,分别),达到胚泡期的即时直接卵裂胚胎的数量是可以忽略的(922个分析的IDC胚胎中只有4个胚胎),并且不适合用于妊娠率的统计比较.
■我们的结果表明需要培养即时直接卵裂胚胎5天,直到胚泡阶段,并避免转移注定要被捕的胚胎,即使它们在第3天的形态等级是可以接受的,而快速卵裂胚胎可以在没有其他选择的第3天转移。