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Human Reproduction, Vol. 17, No. 9, 2402-2409, September 2002
© 2002 European Society of Human Reproduction and Embryology

High outcome predictability after IVF using a combined score for zygote and embryo morphology and growth rate

Giuseppe De Placido1, Martin Wilding1,2,3, Ida Strina1, Erminia Alviggi1, Carlo Alviggi1, Antonio Mollo1, Maria Teresa Varicchio1, Achille Tolino1, Cristina Schiattarella1 and Brian Dale2

1 Area Funzionale di Medicina della Riproduzione, Università degli Studi `Federico II', Naples and 2 Centre for Reproductive Biology, Clinica Villa del Sole, Naples, Italy

BACKGROUND: A scoring system has been developed to determine preimplantation embryo quality, and used to select embryos for transfer into the uterus of patients. METHODS AND RESULTS: The system was used to study early embryo development and to test whether these scores alone can accurately predict IVF outcome. Following zygote and embryo scores through early development, the data showed that a top quality zygote does not necessarily indicate that the resulting embryo will be top quality after in-vitro culture. The embryo quality score can change dramatically when embryos are cultured to day 2 or 3 post-fertilization. Pregnancy rates and implantation rates were compared with the cumulative and separated zygote and embryo scores. Analysis of the predictability of scoring systems suggested that morphological scores alone are relatively unpredictive of IVF outcome. When weighted for in-vitro growth rate, scores were highly predictive, more so than the rate of development alone. CONCLUSIONS: These data suggested that a combination of in-vitro growth rate and morphological analysis both of zygotes and embryos was highly indicative of outcome after IVF. The results can be adopted to the single embryo transfer approach to IVF.

Key words: assisted reproduction/embryo score/human embryo/IVF/single embryo transfer

3 To whom correspondence should be addressed at: Area Funzionale di Medicina della Riproduzione, Università degli Studi `Federico II', Via S. Pansini, 5, 80131 Naples, Italy. E-mail: martinwilding{at}katamail.com


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