How to manage an accelerated embryo cohort in IVF

The case of a successful pregnancy is reported here, following intracytoplasmic sperm injection which resulted in a cohort of embryos showing accelerated cleavage kinetics. Pregnancy was not achieved with fresh embryos transferred at the 4-cell stage but was achieved with cryopreserved accelerated embryos. After an ovarian stimulation cycle, 20 mature oocytes were observed. Early cleavage was observed in 19 of these, 26 h post-injection, and 17 were beyond the 4-cell stage 42 h after injection. No pregnancy was obtained after the transfer of two fresh embryos at the 4-cell stage without fragments. Following the transfer of two frozen accelerated embryos, a twin pregnancy was obtained, which resulted in the delivery of two healthy babies. This case report demonstrates that classical scoring systems may need to be adapted to reflect the cleavage kinetics of the whole embryo cohort.