Prognostic value of first polar body morphology on fertilization rate and embryo quality in intracytoplasmic sperm injection.

The association between oocyte morphology and subsequent fertilization rate and embryo quality in intracytoplasmic sperm injection (ICSI) is subject to considerable controversy. This retrospective study was carried out to investigate a possible prognostic value of first polar body morphology with regard to fertilization rate and embryo quality. A total of 70 consecutive ICSI cases was included in this study. The results showed that classification based on first polar body morphology revealed a significant correlation with fertilization rate (P < 0.025) and embryo quality (P < 0.001). Cytoplasmic criteria showed no correlation in this respect. Present data indicate that ICSI of oocytes with intact well-shaped first polar bodies yields higher fertilization rates and higher quality embryos.

Elective transfer of embryos selected on the basis of first polar body morphology is associated with increased rates of implantation and pregnancy.

OBJECTIVE: To determine the relationship between first polar body morphology and implantation rate and pregnancy rate (PR), to facilitate decision making concerning elective ET. DESIGN: Prospective, randomized study. SETTING: Fertility center. PATIENT(S): One hundred fifty-eight consecutive patients (173 intracytoplasmic sperm injection cycles) resulting in embryo transfers. INTERVENTION(S): In our study group, priority in ET was given to embryos derived from well-shaped first polar bodies, whereas selection of embryos for transfer in the control group was based exclusively on the degree of embryo fragmentation. MAIN OUTCOME MEASURE(S): Total numbers of implantations and pregnancies, PR and implantation rate, and rates of multiple pregnancy and miscarriage. RESULT(S): In the study cohort, 212 embryos were transferred. In the control group, 313 embryos were transferred. The implantation rate and PR were significantly lower in the control group than in the study cohort. In addition, the rate of multiple pregnancy was significantly higher in the study group. CONCLUSION(S): Elective transfer of embryos selected on the basis of first polar body morphology results in higher implantation and pregnancy rates. Multiple pregnancy can be avoided by transferring a reduced number of embryos selected on the basis of first polar body morphology.