Human Reproduction, Vol 12, 800-804, Copyright © 1997 by Oxford University Press
H Balakier and K Cadesky
The frequency of multinucleated blastomeres (MNB) in 2- and 4-cell stage
human embryos was recorded immediately before embryo transfer using a
high-power inverted microscope. About 44% of patients (150/338) possessed
embryos exhibiting MNB. The appearance of this nuclear abnormality was not
correlated with maternal age. Overall, 15% of the otherwise good quality
embryos (274/1885) that developed after monospermic fertilization contained
several multinuclei (from two to seven) in at least one cell. Quite often
MNB were found within all cells of the embryo (50% in 2-cell embryos).
Blastomere multinucleation was significantly higher in 2-cell than 4-cell
embryos (P <0.0001). This suggests that a considerable number of human
embryos become abnormal during the first embryonic division. The embryos
containing MNB were usually excluded for uterine transfers, with the
exception of 19 cases when only such embryos could be replaced (6%; 19/338
patients). The results demonstrated that embryos with MNB may implant (4/19
cases; 21%) and they can lead to both spontaneous abortions and the
successful birth of healthy infants (two cases). The fact that in the
successful cases, 2-cell stage embryos with a mononucleated and a
binucleated blastomere were transferred also suggests that due to the cell
totipotency, development of a healthy baby is possible from one normal
blastomere. Since multinucleation in early embryos may reflect gross
chromosomal abnormalities or development of mosaic embryos, it is advisable
not to replace embryos with MNB. Occasional transfers, however, can be
considered because defective embryos may sometimes develop normally.
ARTICLES
The frequency and developmental capability of human embryos containing multinucleated blastomeres
S.T.A.R.T. Inc., In Vitro Fertilization Clinic, Toronto, Ontario, Canada.
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