2006년 미국불임학회(ASRM) P-258 The embryo selection based on morphology of zygote combined with day3 embryo had increased pregnancy rates compared with those of day3 embryos only. (3일 배양 후 배아 이식할 때 수정란의 형태를 확인 후 이식하는 것이 임신율의 향상에 도움이 된다.)

S.G. Kim, J.Y. Kim, B.R. Do, J.H. Song, K.H. Lee
Mamapapa & baby obstetrics and Gynecology, Ulsan, Republic of Korea.c

OBJECTIVE

To determine and verify the better prediction system for pregnancy outcomes in IVF/ICSI program, the present study was compared the embryo selection methods based on the morphology of zygote and embryo and the pregnancy rates.

DESIGN

Retrospective study.

MATERIALS AND METHODS

Total 3,809 zygotes from 460 treatment cycles (347 couples) were analyzed. The embryos from 248 of 460 cycles were selected by day3 morphology only. The remaining embryos from 212 cycles were selected and transferred to patients by the morphology of zygote and day3 embryos from April 2003 to December 2005. Embryo quality was assessed a zygote morphology scoring method (z-scoring method) 18h after fertilization and day2 and 3 standard embryo morphology grading method (Embryo grading) 44h or 68h after fertilization by ICSI.

RESULTS

Polarization of the nucleoli in both pronuclei had a statistically significant correlation with faster cleavage and lower fragmentation rates of embryos at day2 and 3. The embryo selection based on morphology of zygote combined with day3 embryo had increased a clinical pregnancy rate compared with those selected by day3 embryo morphology only (50.5% and 42.3% respectively; P<0.01). Moreover, the pregnancy rates were significantly differed between the group of women <36 years old and ≥36 years (62.2% and 32.9% respectively; P<0.01).

CONCLUSION

These results suggested that the method of zygote morphology combined with day3 embryo is highly predictive one of pregnancy outcome after IVF/ICSI program. Especially, the evaluation of morphology of embryos subsequent with zygote was significantly increased the pregnancy rates.