Evaluation of fragmented embryos implantation potential using time-lapse technology.

Area of Science:

• Reproductive Medicine and Embryology
• Assisted Reproductive Technology (ART)
• In Vitro Fertilization (IVF)

Background:

• Embryo fragmentation is a common concern in IVF, often leading to embryo discard.
• Traditional embryo assessment may overlook the viability of fragmented embryos.
• Time-lapse imaging (TLI) offers advanced morphokinetic evaluation of embryo development.

Purpose of the Study:

• To evaluate the implantation potential and live birth rates of fragmented embryos.
• To assess the role of morphokinetics and fragmentation worsening in predicting embryo viability.
• To inform clinical decision-making regarding the transfer of fragmented embryos.

Main Methods:

• Retrospective analysis of 4210 Day 5 embryos from 2013-2019 using TLI.
• Inclusion of 379 embryos with >5% fragmentation, evaluated by general and in-house models.
• Documentation of fragmentation progression (start, final, worsening ratio) and correlation with outcomes.

Main Results:

• Embryo fragmentation and morphokinetics were independent predictors of clinical pregnancy.
• Higher fragmentation worsening was significantly associated with discarded embryos (p<0.0001).
• Live birth rates were comparable for fragmented embryos selected via morphokinetics.

Conclusions:

• Fragmented embryos possess significant implantation potential and should be considered for transfer.
• Laboratories without TLI should consider transferring fragmented embryos due to acceptable live birth chances.
• Quantifying fragmentation worsening may improve prediction of embryo development and selection.