Clinical outcomes and euploidy rates of embryos derived from zygotes with nonpronuclear (0PN) and monopronuclear (1PN) in IVF or ICSI cycles: a systematic review and meta-analysis.
Hoi Wing Chan, Chi Chiu Wang, David Yiu Leung Chan
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In 30 seconds
This systematic review and meta-analysis compared euploidy and clinical outcomes for embryos derived from 0PN or 1PN zygotes with those from normally fertilized 2PN zygotes in IVF/ICSI cycles. Eleven studies contributed 37 240 single-embryo transfer cycles and 27 195 biopsied blastocysts. For 0PN-derived embryos, live birth rates did not differ significantly from 2PN embryos (OR = 0.94, 95% CI = 0.83-1.06, P = 0.33). For 1PN-derived embryos, live birth and clinical pregnancy rates were significantly lower, while euploidy rates were similar for both groups.
Key findings
- 0PN-derived embryos had a lower blastulation rate than 2PN embryos (OR = 0.34, 95% CI = 0.17-0.68, P = 0.002).
- For 1PN-derived embryos, live birth rate was lower than for 2PN embryos (OR = 0.83, 95% CI = 0.70-0.98, P = 0.03).
- Clinical pregnancy rate was lower for 1PN-derived than 2PN-derived embryos (OR = 0.81, 95% CI = 0.68-0.96, P = 0.01).
- Euploidy rates did not differ significantly for 0PN- or 1PN-derived embryos compared with 2PN embryos.
Why it matters
The findings distinguish outcomes by pronuclear status: 0PN-derived embryos had no significant differences in reported transfer outcomes, whereas 1PN-derived embryos had lower clinical pregnancy and live birth rates. Similar euploidy rates do not eliminate these differences in clinical outcomes. This evidence can inform discussion of the potential role of these embryos when normally fertilized embryos are limited, while recognising uncertainty across studies.
What to keep in mind
The review reports substantial heterogeneity for blastulation and euploidy outcomes, including I2 = 99% for 0PN blastulation and I2 = 66% for 1PN euploidy.