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Human Reproduction, Vol. 17, No. 12, 3193-3200, December 2002
© 2002 European Society of Human Reproduction and Embryology

Pronuclear morphology scoring and chromosomal status of embryos in severe male infertility

S. Kahraman1,5, Y. Kumtepe2, S. Sertyel1, E. Dönmez1, M. Benkhalifa1,3, N. Findikli1 and P. Vanderzwalmen4

1 Istanbul Memorial Hospital, Reproductive Endocrinology and ART Unit, Istanbul, Turkey, 2 Ataturk University, School of Medicine, Department of Obstetrics and Gynaecology, Erzurum, Turkey, 3 Advanced Technologies Laboratory, Paris, France and 4 Von Helmont Hospital, IVF Center, Brussels, Belgium

BACKGROUND: The study aim was to evaluate the relationship between pronuclei morphology scoring (PNMS) and the chromosomal complement of embryos in couples with severe male infertility undergoing ICSI. A total of 3116 pre-embryos was scored according to PNMS in 452 cycles. METHODS: Pre-embryos were classified into eight categories based on the alignment, size, linear or irregular distribution of pronuclear bodies (PNB), position and clarity of cytoplasmic halo and abutting of the pronucleus. These categories were subdivided into groups I and II according to the similarity and distribution of PNB. RESULTS: In total, 2574 pre-embryos formed by using ejaculated sperm, while 542 pre-embryos developed by injection of testicular sperm or round spermatids. More group II pre-embryos with markedly different morphology from group I were formed after ICSI with testicular sperm than with fresh ejaculated sperm (32.1 versus 22.7%, P < 0.01). Of 490 pre-embryos in which pronuclear morphology was evaluated, 263 were biopsied for preimplantation genetic diagnosis. The rate of chromosomal abnormality was higher in embryos developed from group II pre-embryos (52.2%) than in embryos developed from group I prezygotes (37.6%, P < 0.05). CONCLUSIONS: Group II pre-embryos had markedly different morphology from group I, and had a low rate of blastocyst formation and high risk of chromosomally abnormal embryos. When testicular sperm and round spermatids were used for ICSI, more group II pre-embryos and chromosomally abnormal embryos were produced than with ejaculated sperm. Pronuclear morphology was correlated with chromosomal complement, and impacted upon by the sperm source.

Key words: chromosomal complement/embryo development/preimplantation genetic diagnosis/pronuclei morphology/severe male infertility

5 To whom correspondence should be addressed at: Istanbul Memorial Hospital, Reproductive Endocrinology and ART Unit, Piyalepasa Bulvari, 80270, Okmeydani, Istanbul, Turkey. E-mail: skahraman{at}superonline.com


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