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Early embryo morphokinetics is a better predictor of post-ICSI live birth than embryo morphology: speed is more important than beauty at the cleavage stage

Published online by Cambridge University Press:  29 April 2021

Alessandro Bartolacci Open the ORCID record for Alessandro Bartolacci [Opens in a new window] ,
Mariabeatrice Dal Canto ,
Maria Cristina Guglielmo ,
Laura Mura ,
Claudio Brigante ,
Mario Mignini Renzini  and
Jose Buratini
Alessandro Bartolacci
Affiliation:
Biogenesi, Reproductive Medicine Centre, Istituti Clinici Zucchi, Monza, Italy
Mariabeatrice Dal Canto
Affiliation:
Biogenesi, Reproductive Medicine Centre, Istituti Clinici Zucchi, Monza, Italy
Maria Cristina Guglielmo
Affiliation:
Biogenesi, Reproductive Medicine Centre, Istituti Clinici Zucchi, Monza, Italy
Laura Mura
Affiliation:
Biogenesi, Reproductive Medicine Centre, Istituti Clinici Zucchi, Monza, Italy
Claudio Brigante
Affiliation:
Biogenesi, Reproductive Medicine Centre, Istituti Clinici Zucchi, Monza, Italy
Mario Mignini Renzini
Affiliation:
Biogenesi, Reproductive Medicine Centre, Istituti Clinici Zucchi, Monza, Italy
Jose Buratini*
Affiliation:
Biogenesi, Reproductive Medicine Centre, Istituti Clinici Zucchi, Monza, Italy Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University, Botucatu, Brazil
*
Author for correspondence: Jose Buratini. Biogenesi Reproductive Medicine Centre, Istituti Clinici Zucchi, Via Zucchi, 24 Monza, Italy. Tel: + 39 039 8383314. E-mail: jburatini@eugin.it
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Abstract

Given the importance of embryo developmental competence assessment in reproductive medicine and biology, the aim of this study was to compare the performance of fertilization and cleavage morphokinetics with embryo morphology to predict post-ICSI live birth. Data from embryos cultured in a time-lapse microscopy (TLM) incubator and with known live birth outcomes (LB: embryos achieving live birth, n = 168; NLB: embryos not achieving live birth, n = 1633) were used to generate receiver operating characteristic (ROC) curves based on morphokinetic or morphological scores, and the respective areas under the curve (AUC) were compared. The association between live birth and 12 combinations of four morphokinetic quality degrees (A–D) with three morphological quality degrees (A–C) was assessed using multivariate analysis. Morphokinetic parameters from tPNa to t8 were reached earlier in LB compared with NLB embryos. The ROC curve analysis indicated that morphokinetic information is more accurate than conventional morphology to predict live birth [AUC = 0.64 (95% CI 0.58–0.70) versus AUC = 0.58 (95% CI 0.51–0.65)]. The multivariate analysis was in line with AUCs, revealing that embryos with poor morphokinetics, independently of their morphology, provide lower live birth rates (P < 0.001). A considerable percentage of embryos with top morphology presented poor morphokinetics (20.10%), accompanied by a severely reduced live birth rate in comparison with embryos with top morphology and morphokinetics (P < 0.001). In conclusion, TLM-derived early morphokinetic parameters were more predictive of live-birth achievement following ICSI than conventional morphology.

Keywords

ICSILive birthMorphokineticsMorphologyTime-lapse microscopy
Type
Research Article
Information
Zygote , Volume 29 , Issue 6 , December 2021 , pp. 495 - 502
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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