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Hum. Reprod. Advance Access originally published online on January 29, 2004
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Human Reproduction, Vol. 19, No. 3, 645-648, March 2004
© 2004 European Society of Human Reproduction and Embryology

Zygote transfer on day 1 versus cleavage stage embryo transfer on day 3: a prospective randomized trial

Kamal Jaroudi1, Saad Al-Hassan1, Ulla Sieck1, Hamad Al-Sufyan1, Maya Al-Kabra2 and Serdar Coskun2,3

King Faisal Specialist Hospital and Research Center, Departments of 1 Obstetrics and Gynecology and 2 Pathology and Laboratory Medicine, P.O.Box 3354, Riyadh, 11211, Saudi Arabia

3 To whom correspondence should be addressed. e-mail: serdar{at}kfshrc.edu.sa

BACKGROUND: It has been reported that pronuclear morphology is related to embryo quality and viability, and that zygote stage embryos might establish pregnancies after being transferred to the uterus. The objective of this study was to investigate whether transferring zygotes on day 1 would result in similar pregnancy rates compared to transferring cleavage stage embryos on day 3 in a prospective randomized trial. METHODS: Patients undergoing IVF/ICSI treatments were randomized to either day 1 or day 3 transfers by envelope withdrawal technique. Zygotes were classified as ‘pattern 0’ and ‘non-pattern 0’ according to the size and alignment of pronuclei, the number and distribution of nucleoli. The two best zygotes or embryos were transferred on day 1 or day 3 respectively. The primary outcome measure was pregnancy rate. RESULTS: Pregnancy rates were higher in day 3 group (55/131, 42%) when compared to day 1 (34/123, 28%, P = 0.024). Similarly, implantation rates were higher in day 3 group (P = 0.03). There were more cycles with cryopreservation in the day 1 group (P < 0.001). Embryo quality on day 3 was similar between pattern 0 and non-pattern 0 zygotes. CONCLUSIONS: Day 3 embryo transfers result in better pregnancy and implantation rates compared to day 1 zygote transfers. The present pronuclei scoring cannot reliably select zygotes for transfer on day 1.

Key words: embryo transfer/pronuclear scoring/zygote


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A. N. James, S. Hennessy, B. Reggio, K. Wiemer, F. Larsen, and J. Cohen
The limited importance of pronuclear scoring of human zygotes
Hum. Reprod., June 1, 2006; 21(6): 1599 - 1604.
[Abstract] [Full Text] [PDF]


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