Embriyonun Morfolojik Sınıflaması
Özet
Referanslar
Balaban, B., Yakin, K. & Urman, B. Randomized comparison of two different blastocyst grading systems. Fertil. Steril. 85, 559–563 (2006).
Veeck, L. L. & Zaninovic, N. An atlas of human blastocysts. An Atlas Hum. Blastocysts (2003) doi:10.3109/9780203008935.
Dokras, A., Sargent, I. L. & Barlow, D. H. Human blastocyst grading: an indicator of developmental potential? Hum. Reprod. 8, 2119–2127 (1993).
Consensus, T. W. G. on the update of the E. I. et al. The Istanbul consensus update: a revised ESHRE/ALPHA consensus on oocyte and embryo static and dynamic morphological assessment,. Hum. Reprod. (2025) doi:10.1093/HUMREP/DEAF021.
Gardner, D. K. & Schoolcraft, W. B. Culture and transfer of human blastocysts. Curr. Opin. Obstet. Gynecol. 11, 307–311 (1999).
Gardner, D. K. & Schoolcraft, W. B. In vitro culture of human blastocysts. in Towards Reproductive Certainty: Fertility and Genetics Beyond. (eds. Jansen, R. & Mortimer, D.) 378–388 (Parthenon Publishing, 1999).
Racowsky, C. et al. Standardization of grading embryo morphology. J. Assist. Reprod. Genet. 27, 437 (2010).
Racowsky, C. et al. Standardization of grading embryo morphology. Fertil. Steril. 94, 1152–1153 (2010).
Grading Scales | American Society for Reproductive Medicine | ASRM. https://www.asrm.org/asrm-academy/asrm-academy-on-the-go/embryo-data-grading--evaluation/grading-scales/.
Hossain, A., Phelps, J., Agarwal, A., Sanz, E. & Mahadevan, M. A Review of The Society for Assisted Reproductive Technology Embryo Grading System and Proposed Modification. Int. J. Fertil. Steril. 10, 141 (2016).
Cuevas Saiz, I. et al. The Embryology Interest Group: updating ASEBIR’s morphological scoring system for early embryos, morulae and blastocysts. Med. Reprod. y Embriol. Clínica 5, 42–54 (2018).
Ciray, H. N. et al. Proposed guidelines on the nomenclature and annotation of dynamic human embryo monitoring by a time-lapse user group. Hum. Reprod. 29, 2650–2660 (2014).
Balaban, B. et al. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum. Reprod. 26, 1270–1283 (2011).
Liu, Y., Chapple, V., Roberts, P., Ali, J. & Matson, P. Time-lapse videography of human oocytes following intracytoplasmic sperm injection: Events up to the first cleavage division. Reprod. Biol. 14, 249–256 (2014).
Barberet, J. et al. Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth? Hum. Reprod. 34, 1439–1449 (2019).
Kljajic, M. et al. Zygote Diameter and Total Cytoplasmic Volume as Useful Predictive Tools of Blastocyst Quality. Geburtshilfe Frauenheilkd. 83, 97–105 (2023).
Braude, P., Bolton, V. & Moore, S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development. Nature 332, 459–461 (1988).
Orevich, L. S. et al. Morphometric and morphokinetic differences in the sperm- and oocyte-originated pronuclei of male and female human zygotes: a time-lapse study. J. Assist. Reprod. Genet. 39, 97–106 (2022).
Otsuki, J. et al. Noninvasive embryo selection: kinetic analysis of female and male pronuclear development to predict embryo quality and potential to produce live birth. Fertil. Steril. 112, 874–881 (2019).
Ezoe, K. et al. Spatiotemporal perturbations of pronuclear breakdown preceding syngamy affect early human embryo development: a retrospective observational study. J. Assist. Reprod. Genet. 39, 75–84 (2022).
Cavazza, T. et al. Parental genome unification is highly error-prone in mammalian embryos. Cell 184, 2860-2877.e22 (2021).
Scott, L., Alvero, R., Leondires, M. & Miller, B. The morphology of human pronuclear embryos is positively related to blastocyst development and implantation. Hum. Reprod. 15, 2394–2403 (2000).
Tesarik, J. & Greco, E. The probability of abnormal preimplantation development can be predicted by a single static observation on pronuclear stage morphology. Hum. Reprod. 14, 1318–1323 (1999).
Coticchio, G. et al. Focused time-lapse analysis reveals novel aspects of human fertilization and suggests new parameters of embryo viability. Hum. Reprod. 33, 23–31 (2018).
Mio, Y. & Maeda, K. Time-lapse cinematography of dynamic changes occurring during in vitro development of human embryos. Am. J. Obstet. Gynecol. 199, 660.e1-660.e5 (2008).
Garello, C. et al. Pronuclear orientation, polar body placement, and embryo quality after intracytoplasmic sperm injection and in-vitro fertilization: further evidence for polarity in human oocytes? Hum. Reprod. 14, 2588–2595 (1999).
Ebner, T. et al. Presence, but not type or degree of extension, of a cytoplasmic halo has a significant influence on preimplantation development and implantation behaviour. Hum. Reprod. 18, 2406–2412 (2003).
Ezoe, K. et al. Cytoplasmic halo characteristics during fertilization and their implications for human preimplantation embryo development and pregnancy outcome. Reprod. Biomed. Online 41, 191–202 (2020).
Barberet, J. et al. Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth? Hum. Reprod. 34, 1439–1449 (2019).
Kemper, J. M., Liu, Y., Afnan, M., Mol, B. W. J. & Morbeck, D. E. What happens to abnormally fertilized embryos? A scoping review. Reprod. Biomed. Online 46, 802–807 (2023).
Barrie, A., Smith, R., Campbell, A. & Fishel, S. Optimisation of the timing of fertilisation assessment for oocytes cultured in standard incubation: lessons learnt from time-lapse imaging of 78 348 embryos. Hum. Reprod. 36, 2840–2847 (2021).
Araki, E. et al. Correlation between the pronucleus size and the potential for human single pronucleus zygotes to develop into blastocysts: 1pn zygotes with large pronuclei can expect an embryo development to the blastocyst stage that is similar to the development of 2pn zygotes. J. Assist. Reprod. Genet. 35, 817–823 (2018).
Kai, Y., Moriwaki, H., Yumoto, K., Iwata, K. & Mio, Y. Assessment of developmental potential of human single pronucleated zygotes derived from conventional in vitro fertilization. J. Assist. Reprod. Genet. 35, 1377–1384 (2018).
Kai, Y., Iwata, K., Iba, Y. & Mio, Y. Diagnosis of abnormal human fertilization status based on pronuclear origin and/or centrosome number. J. Assist. Reprod. Genet. 32, 1589–1595 (2015).
Wei, X. et al. Developmental trajectory of monopronucleated zygotes after in vitro fertilization when they include both male and female genomes. Fertil. Steril. 117, 213–220 (2022).
Itoi, F., Asano, Y., Shimizu, M., Honnma, H. & Murata, Y. Birth of nine normal healthy babies following transfer of blastocysts derived from human single-pronucleate zygotes. J. Assist. Reprod. Genet. 32, 1401–1407 (2015).
Hondo, S. et al. Clinical outcomes of transfer of frozen and thawed single blastocysts derived from nonpronuclear and monopronuclear zygotes. Reprod. Med. Biol. 18, 278–283 (2019).
Li, M. et al. Obstetric and neonatal outcomes after the transfer of vitrified-warmed blastocysts developing from nonpronuclear and monopronuclear zygotes: a retrospective cohort study. Fertil. Steril. 115, 110–117 (2021).
Currie, C. E. et al. The first mitotic division of human embryos is highly error prone. Nat. Commun. 2022 131 13, 1–13 (2022).
Capalbo, A. et al. Abnormally fertilized oocytes can result in healthy live births: improved genetic technologies for preimplantation genetic testing can be used to rescue viable embryos in in vitro fertilization cycles. Fertil. Steril. 108, 1007-1015.e3 (2017).
Canon, C. et al. Assessing the clinical viability of micro 3 pronuclei zygotes. J. Assist. Reprod. Genet. 40, 1765–1772 (2023).
Embryology, E. S. I. G. of & Medicine, A. S. in R. The Vienna consensus: report of an expert meeting on the development of art laboratory performance indicators. Hum. Reprod. Open 2017, 1–17 (2017).
Mutia, K. et al. The Frequency of Chromosomal Euploidy Among 3PN Embryos. J. Reprod. Infertil. 20, 127 (2019).
Yalçınkaya, E., Özay, A., Ergin, E. G., Öztel, Z. & Özörnek, H. Live birth after transfer of a tripronuclear embryo: An intracytoplasmic sperm injection as a combination of microarray and time-lapse technology. Turkish J. Obstet. Gynecol. 13, 95 (2016).
Bredbacka, P., Capalbo, A., Kananen, K., Picchetta, L. & Tomás, C. Healthy live birth following embryo transfer of a blastocyst of tetrapronuclear (4PN) origin: a case report. Hum. Reprod. 38, 1700–1704 (2023).
Lundin, K. & Ahlström, A. Quality control and standardization of embryo morphology scoring and viability markers. Reprod. Biomed. Online 31, 459–471 (2015).
Montag, M., Liebenthron, J. & Köster, M. Which morphological scoring system is relevant in human embryo development? Placenta 32, S252–S256 (2011).
Hardarson, T., Hanson, C., Sjögren, A. & Lundin, K. Human embryos with unevenly sized blastomeres have lower pregnancy and implantation rates: indications for aneuploidy and multinucleation. Hum. Reprod. 16, 313–318 (2001).
Shebl, O. et al. The hare and the tortoise: extreme mitotic rates and how these affect live birth. Reprod. Biomed. Online 42, 332–339 (2021).
Kong, X. et al. The Relationship between Cell Number, Division Behavior and Developmental Potential of Cleavage Stage Human Embryos: A Time-Lapse Study. PLoS One 11, e0153697 (2016).
Pons, M. C. et al. Deconstructing the myth of poor prognosis for fast-cleaving embryos on day 3. Is it time to change the consensus? J. Assist. Reprod. Genet. 36, 2299–2305 (2019).
Milewski, R. et al. A predictive model for blastocyst formation based on morphokinetic parameters in time-lapse monitoring of embryo development. J. Assist. Reprod. Genet. 32, 571–579 (2015).
Cecchele, A., Cermisoni, G. C., Giacomini, E., Pinna, M. & Vigano, P. Cellular and Molecular Nature of Fragmentation of Human Embryos. Int. J. Mol. Sci. 2022, Vol. 23, Page 1349 23, 1349 (2022).
Johansson, M., Hardarson, T. & Lundin, K. There is a cutoff limit in diameter between a blastomere and a small anucleate fragment. J. Assist. Reprod. Genet. 20, 309–313 (2003).
Ahlstrom, A., Park, H., Bergh, C., Selleskog, U. & Lundin, K. Conventional morphology performs better than morphokinetics for prediction of live birth after day 2 transfer. Reprod. Biomed. Online 33, 61–70 (2016).
Holte, J. et al. Construction of an evidence-based integrated morphology cleavage embryo score for implantation potential of embryos scored and transferred on day 2 after oocyte retrieval. Hum. Reprod. 22, 548–557 (2007).
Racowsky, C. et al. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil. Steril. 95, 1985–1989 (2011).
Puissant, F., Van Rysselberge, M., Barlow, P., Deweze, J. & Leroy, F. Embryo scoring as a prognostic tool in IVF treatment. Hum. Reprod. 2, 705–708 (1987).
Meseguer, M. et al. The use of morphokinetics as a predictor of embryo implantation. Hum. Reprod. 26, 2658–2671 (2011).
Ziebe, S. Morphometric analysis of human embryos to predict developmental competence. Reprod. Fertil. Dev. 26, 55–64 (2013).
Antczak, M. & Van Blerkom, J. Temporal and spatial aspects of fragmentation in early human embryos: possible effects on developmental competence and association with the differential elimination of regulatory proteins from polarized domains. Hum. Reprod. 14, 429–447 (1999).
Shenoy, C. C., Khan, Z., Coddington, C. C., Stewart, E. A. & Morbeck, D. E. Symmetry at the 4-Cell Stage Is Associated with Embryo Aneuploidy. Reprod. Sci. 28, 3473–3479 (2021).
Balakier, H. & Cadesky, K. The frequency and developmental capability of human embryos containing multinucleated blastomeres. Hum. Reprod. 12, 800–804 (1997).
Ergin, E. G. et al. Frequency of embryo multinucleation detected by time-lapse system and its impact on pregnancy outcome. Fertil. Steril. 102, 1029-1033.e1 (2014).
Talbot, A. L. et al. Binucleated embryos at the two-cell stage show higher blastocyst formation rates and higher pregnancy and live birth rates compared to non-multinucleated embryos. Hum. Reprod. Open 2022, 1–11 (2022).
Desai, N., Goldberg, J. M., Austin, C. & Falcone, T. Are cleavage anomalies, multinucleation, or specific cell cycle kinetics observed with time-lapse imaging predictive of embryo developmental capacity or ploidy? Fertil. Steril. 109, 665–674 (2018).
Iwata, K. et al. Analysis of compaction initiation in human embryos by using time-lapse cinematography. J. Assist. Reprod. Genet. 31, 421–426 (2014).
Gardner, D. K., Weissman, A., Howles, C. M. & Shoham, Z. Textbook of Assisted Reproductive Techniques: Volume 1: Laboratory Perspectives, Sixth Edition. Textb. Assist. Reprod. Tech. Vol. 1 Lab. Perspect. Sixth Ed. 1, 1–350 (2023).
Hung, T. Y. et al. Early blastulation of day 4 embryo correlates with the increased euploid rate of preimplantation genetic screening cycles. Taiwan. J. Obstet. Gynecol. 57, 858–861 (2018).
Desai, N. et al. Analysis of embryo morphokinetics, multinucleation and cleavage anomalies using continuous time-lapse monitoring in blastocyst transfer cycles. Reprod. Biol. Endocrinol. 12, 1–10 (2014).
Fishel, S. et al. Time-lapse imaging algorithms rank human preimplantation embryos according to the probability of live birth. Reprod. Biomed. Online 37, 304–313 (2018).
Coticchio, G. et al. Perturbations of morphogenesis at the compaction stage affect blastocyst implantation and live birth rates. Hum. Reprod. 36, 918–928 (2021).
Rienzi, L. et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum. Reprod. Update 23, 139–155 (2017).
Capalbo, A. et al. Sequential comprehensive chromosome analysis on polar bodies, blastomeres and trophoblast: insights into female meiotic errors and chromosomal segregation in the preimplantation window of embryo development. Hum. Reprod. 28, 509–518 (2013).
Roque, M. et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil. Steril. 99, 156–162 (2013).
Schoolcraft, W. B. et al. Blastocyst culture and transfer: Analysis of results and parameters affecting outcome in two in vitro fertilization programs. Fertil. Steril. 72, 604–609 (1999).
Gardner, D. & Schoolcraft, W. B. In vitro culture of human blastocysts. in TOWARDS REPRODUCTIVE CERTAINTY (eds. Jansen, R. & Mortimer, D.) 378–388 (PARTHENON PUBLISHING GROUP LTD, 1999).
Pierson, H. E., Invik, J., Meriano, J. & Pierson, R. A. A novel system for rapid conversion of Gardner embryo grades to linear scale numeric variables. Reprod. Biomed. Online 46, 808–818 (2023).
Hammond, E. R., Foong, A. K. M., Rosli, N. & Morbeck, D. E. Should we freeze it? Agreement on fate of borderline blastocysts is poor and does not improve with a modified blastocyst grading system. Hum. Reprod. 35, 1045–1053 (2020).
Saiz, I., Gatell, M., Vargas, M., … A. M.-M. R. y & 2018, undefined. The Embryology Interest Group: updating ASEBIR’s morphological scoring system for early embryos, morulae and blastocysts. Elsevier.
Macklon, N. S., Stouffer, R. L., Giudice, L. C. & Fauser, B. C. J. M. The Science behind 25 Years of Ovarian Stimulation for in Vitro Fertilization. Endocr. Rev. 27, 170–207 (2006).
Bourdon, M., … K. P.-C.-H. & 2019, undefined. Day 5 versus Day 6 blastocyst transfers: a systematic review and meta-analysis of clinical outcomes. Acad. Bourdon, K Pocate-Cheriet, A Finet Bantel, V Grzegorczyk-Martin, A Amar HoffetHuman Reprod. 2019•academic.oup.com.
Murata, Y. et al. Freeze–thaw programmes rescue the implantation of day 6 blastocysts. Reprod. Biomed. Online 11, 428–433 (2005).
Coticchio, G., Ezoe, K., Lagalla, C., … C. Z.-H. & 2023, undefined. The destinies of human embryos reaching blastocyst stage between Day 4 and Day 7 diverge as early as fertilization. Acad. Coticchio, K Ezoe, C Lagalla, C Zacà, A Borini, K Katoh. Reprod. 2023•academic.oup.com.
Tiegs, A., Sun, L., … G. P.-H. & 2019, undefined. Worth the wait? Day 7 blastocysts have lower euploidy rates but similar sustained implantation rates as Day 5 and Day 6 blastocysts. Acad. Tiegs, L Sun, G Patounakis, RT Scott JrHuman Reprod. 2019•academic.oup.com.
Lane, S., Reed, L., … W. S.-R. B. & 2022, undefined. Euploid day 7 blastocysts of infertility patients with only slow embryo development have reduced implantation potential. Elsevier.
Du, T. et al. Fertility and neonatal outcomes of embryos achieving blastulation on Day 7: are they of clinical value? Acad. Du, Y Wang, Y Fan, S Zhang, Z Yan, W Yu, Q Xi, Q Chen, BW Mol, Q Lyu, Y KuangHuman Reprod. 2018•academic.oup.com 33, 1038–1051 (2018).
Bakkensen, J. B. et al. Association between blastocyst morphology and pregnancy and perinatal outcomes following fresh and cryopreserved embryo transfer. J. Assist. Reprod. Genet. 36, 2315–2324 (2019).
Subira, J. et al. Grade of the inner cell mass, but not trophectoderm, predicts live birth in fresh blastocyst single transfers. Hum. Fertil. 19, 254–261 (2016).
Zou, H. et al. Blastocyst quality and reproductive and perinatal outcomes: a multinational multicentre observational study. Acad. Zou, JM Kemper, ER Hammond, F Xu, G Liu, L Xue, X Bai, H Liao, S Xue, S Zhao, L XiaHuman Reprod. 2023•academic.oup.com 38, 2391–2399 (2023).
Storr, A., Bilir, E., Cooke, S., … D. G.-R. B. & 2019, undefined. Fine-tuning blastocyst selection based on morphology: a multicentre analysis of 2461 single blastocyst transfers. Elsevier.
Abbeel, E. Van den, Balaban, B., … S. Z.-R. & 2013, undefined. Association between blastocyst morphology and outcome of single-blastocyst transfer. Elsevier.
Licciardi, F., McCaffrey, C., Oh, C., sterility, C. S.-S.-F. and & 2015, undefined. Birth weight is associated with inner cell mass grade of blastocysts. Elsevier.
Open, D. M.-H. R. & 2017, undefined. Blastocyst culture in the Era of PGS and FreezeAlls: Is a ’C’a failing grade? Acad. MorbeckHuman Reprod. Open, 2017•academic.oup.com 1–6 (2017) doi:10.1093/hropen/hox017.
Kemper, J. M. et al. Should we look for a low-grade threshold for blastocyst transfer? A scoping review. Reprod. Biomed. Online 42, 709–716 (2021).
Forman, E. et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection: a prospective study of 100 consecutive cycles of planned fresh. Elsevier.
Capalbo, A. et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Acad. Capalbo, L Rienzi, D Cimadomo, R Maggiulli, T Elliott, G Wright, ZP Nagy, FM UbaldiHuman Reprod. 2014•academic.oup.com 29, 1173–1181 (2014).
Minasi, M. G. et al. Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study. Hum. Reprod. 31, 2245–2254 (2016).
Kato, K. et al. Does embryo categorization by existing artificial intelligence, morphokinetic or morphological embryo selection models correlate with blastocyst euploidy rates? Reprod. Biomed. Online 46, 274–281 (2023).
Bamford, T., Easter, C., Montgomery, S., … R. S.-H. & 2023, undefined. A comparison of 12 machine learning models developed to predict ploidy, using a morphokinetic meta-dataset of 8147 embryos. Acad. Bamford, C Easter, S Montgomery, R Smith, RK Dhillon-Smith, A Barrie, A CampbellHuman Reprod. 2023•academic.oup.com.
Ma, B. X., Yang, L., Tian, Y., Jin, L. & Huang, B. Cytoplasmic strings between ICM and mTE are a positive predictor of clinical pregnancy and live birth outcomes: A time-lapse study. Front. Med. 9, (2022).
Eastick, J., Venetis, C., Cooke, S. & Chapman, M. The presence of cytoplasmic strings in human blastocysts is associated with the probability of clinical pregnancy with fetal heart. J. Assist. Reprod. Genet. 38, 2139–2149 (2021).
Busnelli, A., Dallagiovanna, C., Reschini, M., sterility, A. P.-F. and & 2019, undefined. Risk factors for monozygotic twinning after in vitro fertilization: a systematic review and meta-analysis. Elsevier.
Kadam, N., Woodhead, G., Kellam, L., … A. C.-J. of clinical & 2023, undefined. Odds and predictors of monozygotic twinning in a multicentre cohort of 25,794 IVF cycles. mdpi.comN Kadam, G Woodhead, L Kellam, A Campbell, K JayaprakasanJournal Clin. Med. 2023•mdpi.com 12, 2593 (2023).
Yin, H. et al. The effects of blastocyst morphological score and blastocoele re-expansion speed after warming on pregnancy outcomes. Clin. Exp. Reprod. Med. 43, 31 (2016).
Shu, Y. et al. The value of fast blastocoele re-expansion in the selection of a viable thawed blastocyst for transfer. Fertil. Steril. 91, 401–406.
Loutradi, K. E. et al. Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis. Fertil. Steril. 90, 186–193 (2008).
Coutinho, A. R. S. et al. Morphological changes in mouse embryos cryopreserved by different techniques. Microsc. Res. Tech. 70, 296–301 (2007).
Homayoun, H., Zahiri, S., Jahromi, H., Dehnavi, H. & Student, P. D. Morphological and morphometric study of early-cleavage mice embryos resulting from in vitro fertilization at different cleavage stages after vitrification. Iran. J. Vet. Res. (2016) doi:10.22099/IJVR.2016.3605.
Alteri, A. et al. Revisiting embryo assisted hatching approaches: a systematic review of the current protocols. J. Assist. Reprod. Genet. 35, 367 (2018).
Coello, A. et al. Analysis of the morphological dynamics of blastocysts after vitrification/warming: defining new predictive variables of implantation. Fertil. Steril. 108, 659-666.e4 (2017).
Yoneyama, M. et al. Blastocyst re-expansion rate immediately after warming is a strong dynamic indicator of embryo quality. Reprod. Biomed. Online 0, 104989 (2025).
Liehman, P. & Fulka, J. [Relation between the quality of cattle embryos after thawing and the pregnancy rate after their transfer]. Vet. Med. (Praha). (1986).
Guerif, F. et al. Parameters guiding selection of best embryos for transfer after cryopreservation: A reappraisal. Hum. Reprod. 17, 1321–1326 (2002).
Zheng, X. et al. Viability of frozen-thawed human embryos with one-two blastomeres lysis. doi:10.1007/s10815-008-9224-3.
Cimadomo, D. et al. How should the best human embryo in vitro be? Current and future challenges for embryo selection. Minerva Obstet. Gynecol. 76, 159–173 (2023).
Ziebe, S. et al. Embryo quality and developmental potential is compromised by age. Acta Obstet. Gynecol. Scand. 80, 169–174 (2001).
Kuznyetsova, I., Kuznyetsov, V., Bałakier, H. & Librach, C. Selecting Developmentally Competent Human Blastocysts: From Basic Morphological Assessment to Morphokinetics and Preimplantation Genetic Testing for Aneuploidy Iryna Scienti fi c Journal of Biology. (2020).
Referanslar
Balaban, B., Yakin, K. & Urman, B. Randomized comparison of two different blastocyst grading systems. Fertil. Steril. 85, 559–563 (2006).
Veeck, L. L. & Zaninovic, N. An atlas of human blastocysts. An Atlas Hum. Blastocysts (2003) doi:10.3109/9780203008935.
Dokras, A., Sargent, I. L. & Barlow, D. H. Human blastocyst grading: an indicator of developmental potential? Hum. Reprod. 8, 2119–2127 (1993).
Consensus, T. W. G. on the update of the E. I. et al. The Istanbul consensus update: a revised ESHRE/ALPHA consensus on oocyte and embryo static and dynamic morphological assessment,. Hum. Reprod. (2025) doi:10.1093/HUMREP/DEAF021.
Gardner, D. K. & Schoolcraft, W. B. Culture and transfer of human blastocysts. Curr. Opin. Obstet. Gynecol. 11, 307–311 (1999).
Gardner, D. K. & Schoolcraft, W. B. In vitro culture of human blastocysts. in Towards Reproductive Certainty: Fertility and Genetics Beyond. (eds. Jansen, R. & Mortimer, D.) 378–388 (Parthenon Publishing, 1999).
Racowsky, C. et al. Standardization of grading embryo morphology. J. Assist. Reprod. Genet. 27, 437 (2010).
Racowsky, C. et al. Standardization of grading embryo morphology. Fertil. Steril. 94, 1152–1153 (2010).
Grading Scales | American Society for Reproductive Medicine | ASRM. https://www.asrm.org/asrm-academy/asrm-academy-on-the-go/embryo-data-grading--evaluation/grading-scales/.
Hossain, A., Phelps, J., Agarwal, A., Sanz, E. & Mahadevan, M. A Review of The Society for Assisted Reproductive Technology Embryo Grading System and Proposed Modification. Int. J. Fertil. Steril. 10, 141 (2016).
Cuevas Saiz, I. et al. The Embryology Interest Group: updating ASEBIR’s morphological scoring system for early embryos, morulae and blastocysts. Med. Reprod. y Embriol. Clínica 5, 42–54 (2018).
Ciray, H. N. et al. Proposed guidelines on the nomenclature and annotation of dynamic human embryo monitoring by a time-lapse user group. Hum. Reprod. 29, 2650–2660 (2014).
Balaban, B. et al. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum. Reprod. 26, 1270–1283 (2011).
Liu, Y., Chapple, V., Roberts, P., Ali, J. & Matson, P. Time-lapse videography of human oocytes following intracytoplasmic sperm injection: Events up to the first cleavage division. Reprod. Biol. 14, 249–256 (2014).
Barberet, J. et al. Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth? Hum. Reprod. 34, 1439–1449 (2019).
Kljajic, M. et al. Zygote Diameter and Total Cytoplasmic Volume as Useful Predictive Tools of Blastocyst Quality. Geburtshilfe Frauenheilkd. 83, 97–105 (2023).
Braude, P., Bolton, V. & Moore, S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development. Nature 332, 459–461 (1988).
Orevich, L. S. et al. Morphometric and morphokinetic differences in the sperm- and oocyte-originated pronuclei of male and female human zygotes: a time-lapse study. J. Assist. Reprod. Genet. 39, 97–106 (2022).
Otsuki, J. et al. Noninvasive embryo selection: kinetic analysis of female and male pronuclear development to predict embryo quality and potential to produce live birth. Fertil. Steril. 112, 874–881 (2019).
Ezoe, K. et al. Spatiotemporal perturbations of pronuclear breakdown preceding syngamy affect early human embryo development: a retrospective observational study. J. Assist. Reprod. Genet. 39, 75–84 (2022).
Cavazza, T. et al. Parental genome unification is highly error-prone in mammalian embryos. Cell 184, 2860-2877.e22 (2021).
Scott, L., Alvero, R., Leondires, M. & Miller, B. The morphology of human pronuclear embryos is positively related to blastocyst development and implantation. Hum. Reprod. 15, 2394–2403 (2000).
Tesarik, J. & Greco, E. The probability of abnormal preimplantation development can be predicted by a single static observation on pronuclear stage morphology. Hum. Reprod. 14, 1318–1323 (1999).
Coticchio, G. et al. Focused time-lapse analysis reveals novel aspects of human fertilization and suggests new parameters of embryo viability. Hum. Reprod. 33, 23–31 (2018).
Mio, Y. & Maeda, K. Time-lapse cinematography of dynamic changes occurring during in vitro development of human embryos. Am. J. Obstet. Gynecol. 199, 660.e1-660.e5 (2008).
Garello, C. et al. Pronuclear orientation, polar body placement, and embryo quality after intracytoplasmic sperm injection and in-vitro fertilization: further evidence for polarity in human oocytes? Hum. Reprod. 14, 2588–2595 (1999).
Ebner, T. et al. Presence, but not type or degree of extension, of a cytoplasmic halo has a significant influence on preimplantation development and implantation behaviour. Hum. Reprod. 18, 2406–2412 (2003).
Ezoe, K. et al. Cytoplasmic halo characteristics during fertilization and their implications for human preimplantation embryo development and pregnancy outcome. Reprod. Biomed. Online 41, 191–202 (2020).
Barberet, J. et al. Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth? Hum. Reprod. 34, 1439–1449 (2019).
Kemper, J. M., Liu, Y., Afnan, M., Mol, B. W. J. & Morbeck, D. E. What happens to abnormally fertilized embryos? A scoping review. Reprod. Biomed. Online 46, 802–807 (2023).
Barrie, A., Smith, R., Campbell, A. & Fishel, S. Optimisation of the timing of fertilisation assessment for oocytes cultured in standard incubation: lessons learnt from time-lapse imaging of 78 348 embryos. Hum. Reprod. 36, 2840–2847 (2021).
Araki, E. et al. Correlation between the pronucleus size and the potential for human single pronucleus zygotes to develop into blastocysts: 1pn zygotes with large pronuclei can expect an embryo development to the blastocyst stage that is similar to the development of 2pn zygotes. J. Assist. Reprod. Genet. 35, 817–823 (2018).
Kai, Y., Moriwaki, H., Yumoto, K., Iwata, K. & Mio, Y. Assessment of developmental potential of human single pronucleated zygotes derived from conventional in vitro fertilization. J. Assist. Reprod. Genet. 35, 1377–1384 (2018).
Kai, Y., Iwata, K., Iba, Y. & Mio, Y. Diagnosis of abnormal human fertilization status based on pronuclear origin and/or centrosome number. J. Assist. Reprod. Genet. 32, 1589–1595 (2015).
Wei, X. et al. Developmental trajectory of monopronucleated zygotes after in vitro fertilization when they include both male and female genomes. Fertil. Steril. 117, 213–220 (2022).
Itoi, F., Asano, Y., Shimizu, M., Honnma, H. & Murata, Y. Birth of nine normal healthy babies following transfer of blastocysts derived from human single-pronucleate zygotes. J. Assist. Reprod. Genet. 32, 1401–1407 (2015).
Hondo, S. et al. Clinical outcomes of transfer of frozen and thawed single blastocysts derived from nonpronuclear and monopronuclear zygotes. Reprod. Med. Biol. 18, 278–283 (2019).
Li, M. et al. Obstetric and neonatal outcomes after the transfer of vitrified-warmed blastocysts developing from nonpronuclear and monopronuclear zygotes: a retrospective cohort study. Fertil. Steril. 115, 110–117 (2021).
Currie, C. E. et al. The first mitotic division of human embryos is highly error prone. Nat. Commun. 2022 131 13, 1–13 (2022).
Capalbo, A. et al. Abnormally fertilized oocytes can result in healthy live births: improved genetic technologies for preimplantation genetic testing can be used to rescue viable embryos in in vitro fertilization cycles. Fertil. Steril. 108, 1007-1015.e3 (2017).
Canon, C. et al. Assessing the clinical viability of micro 3 pronuclei zygotes. J. Assist. Reprod. Genet. 40, 1765–1772 (2023).
Embryology, E. S. I. G. of & Medicine, A. S. in R. The Vienna consensus: report of an expert meeting on the development of art laboratory performance indicators. Hum. Reprod. Open 2017, 1–17 (2017).
Mutia, K. et al. The Frequency of Chromosomal Euploidy Among 3PN Embryos. J. Reprod. Infertil. 20, 127 (2019).
Yalçınkaya, E., Özay, A., Ergin, E. G., Öztel, Z. & Özörnek, H. Live birth after transfer of a tripronuclear embryo: An intracytoplasmic sperm injection as a combination of microarray and time-lapse technology. Turkish J. Obstet. Gynecol. 13, 95 (2016).
Bredbacka, P., Capalbo, A., Kananen, K., Picchetta, L. & Tomás, C. Healthy live birth following embryo transfer of a blastocyst of tetrapronuclear (4PN) origin: a case report. Hum. Reprod. 38, 1700–1704 (2023).
Lundin, K. & Ahlström, A. Quality control and standardization of embryo morphology scoring and viability markers. Reprod. Biomed. Online 31, 459–471 (2015).
Montag, M., Liebenthron, J. & Köster, M. Which morphological scoring system is relevant in human embryo development? Placenta 32, S252–S256 (2011).
Hardarson, T., Hanson, C., Sjögren, A. & Lundin, K. Human embryos with unevenly sized blastomeres have lower pregnancy and implantation rates: indications for aneuploidy and multinucleation. Hum. Reprod. 16, 313–318 (2001).
Shebl, O. et al. The hare and the tortoise: extreme mitotic rates and how these affect live birth. Reprod. Biomed. Online 42, 332–339 (2021).
Kong, X. et al. The Relationship between Cell Number, Division Behavior and Developmental Potential of Cleavage Stage Human Embryos: A Time-Lapse Study. PLoS One 11, e0153697 (2016).
Pons, M. C. et al. Deconstructing the myth of poor prognosis for fast-cleaving embryos on day 3. Is it time to change the consensus? J. Assist. Reprod. Genet. 36, 2299–2305 (2019).
Milewski, R. et al. A predictive model for blastocyst formation based on morphokinetic parameters in time-lapse monitoring of embryo development. J. Assist. Reprod. Genet. 32, 571–579 (2015).
Cecchele, A., Cermisoni, G. C., Giacomini, E., Pinna, M. & Vigano, P. Cellular and Molecular Nature of Fragmentation of Human Embryos. Int. J. Mol. Sci. 2022, Vol. 23, Page 1349 23, 1349 (2022).
Johansson, M., Hardarson, T. & Lundin, K. There is a cutoff limit in diameter between a blastomere and a small anucleate fragment. J. Assist. Reprod. Genet. 20, 309–313 (2003).
Ahlstrom, A., Park, H., Bergh, C., Selleskog, U. & Lundin, K. Conventional morphology performs better than morphokinetics for prediction of live birth after day 2 transfer. Reprod. Biomed. Online 33, 61–70 (2016).
Holte, J. et al. Construction of an evidence-based integrated morphology cleavage embryo score for implantation potential of embryos scored and transferred on day 2 after oocyte retrieval. Hum. Reprod. 22, 548–557 (2007).
Racowsky, C. et al. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil. Steril. 95, 1985–1989 (2011).
Puissant, F., Van Rysselberge, M., Barlow, P., Deweze, J. & Leroy, F. Embryo scoring as a prognostic tool in IVF treatment. Hum. Reprod. 2, 705–708 (1987).
Meseguer, M. et al. The use of morphokinetics as a predictor of embryo implantation. Hum. Reprod. 26, 2658–2671 (2011).
Ziebe, S. Morphometric analysis of human embryos to predict developmental competence. Reprod. Fertil. Dev. 26, 55–64 (2013).
Antczak, M. & Van Blerkom, J. Temporal and spatial aspects of fragmentation in early human embryos: possible effects on developmental competence and association with the differential elimination of regulatory proteins from polarized domains. Hum. Reprod. 14, 429–447 (1999).
Shenoy, C. C., Khan, Z., Coddington, C. C., Stewart, E. A. & Morbeck, D. E. Symmetry at the 4-Cell Stage Is Associated with Embryo Aneuploidy. Reprod. Sci. 28, 3473–3479 (2021).
Balakier, H. & Cadesky, K. The frequency and developmental capability of human embryos containing multinucleated blastomeres. Hum. Reprod. 12, 800–804 (1997).
Ergin, E. G. et al. Frequency of embryo multinucleation detected by time-lapse system and its impact on pregnancy outcome. Fertil. Steril. 102, 1029-1033.e1 (2014).
Talbot, A. L. et al. Binucleated embryos at the two-cell stage show higher blastocyst formation rates and higher pregnancy and live birth rates compared to non-multinucleated embryos. Hum. Reprod. Open 2022, 1–11 (2022).
Desai, N., Goldberg, J. M., Austin, C. & Falcone, T. Are cleavage anomalies, multinucleation, or specific cell cycle kinetics observed with time-lapse imaging predictive of embryo developmental capacity or ploidy? Fertil. Steril. 109, 665–674 (2018).
Iwata, K. et al. Analysis of compaction initiation in human embryos by using time-lapse cinematography. J. Assist. Reprod. Genet. 31, 421–426 (2014).
Gardner, D. K., Weissman, A., Howles, C. M. & Shoham, Z. Textbook of Assisted Reproductive Techniques: Volume 1: Laboratory Perspectives, Sixth Edition. Textb. Assist. Reprod. Tech. Vol. 1 Lab. Perspect. Sixth Ed. 1, 1–350 (2023).
Hung, T. Y. et al. Early blastulation of day 4 embryo correlates with the increased euploid rate of preimplantation genetic screening cycles. Taiwan. J. Obstet. Gynecol. 57, 858–861 (2018).
Desai, N. et al. Analysis of embryo morphokinetics, multinucleation and cleavage anomalies using continuous time-lapse monitoring in blastocyst transfer cycles. Reprod. Biol. Endocrinol. 12, 1–10 (2014).
Fishel, S. et al. Time-lapse imaging algorithms rank human preimplantation embryos according to the probability of live birth. Reprod. Biomed. Online 37, 304–313 (2018).
Coticchio, G. et al. Perturbations of morphogenesis at the compaction stage affect blastocyst implantation and live birth rates. Hum. Reprod. 36, 918–928 (2021).
Rienzi, L. et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum. Reprod. Update 23, 139–155 (2017).
Capalbo, A. et al. Sequential comprehensive chromosome analysis on polar bodies, blastomeres and trophoblast: insights into female meiotic errors and chromosomal segregation in the preimplantation window of embryo development. Hum. Reprod. 28, 509–518 (2013).
Roque, M. et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis. Fertil. Steril. 99, 156–162 (2013).
Schoolcraft, W. B. et al. Blastocyst culture and transfer: Analysis of results and parameters affecting outcome in two in vitro fertilization programs. Fertil. Steril. 72, 604–609 (1999).
Gardner, D. & Schoolcraft, W. B. In vitro culture of human blastocysts. in TOWARDS REPRODUCTIVE CERTAINTY (eds. Jansen, R. & Mortimer, D.) 378–388 (PARTHENON PUBLISHING GROUP LTD, 1999).
Pierson, H. E., Invik, J., Meriano, J. & Pierson, R. A. A novel system for rapid conversion of Gardner embryo grades to linear scale numeric variables. Reprod. Biomed. Online 46, 808–818 (2023).
Hammond, E. R., Foong, A. K. M., Rosli, N. & Morbeck, D. E. Should we freeze it? Agreement on fate of borderline blastocysts is poor and does not improve with a modified blastocyst grading system. Hum. Reprod. 35, 1045–1053 (2020).
Saiz, I., Gatell, M., Vargas, M., … A. M.-M. R. y & 2018, undefined. The Embryology Interest Group: updating ASEBIR’s morphological scoring system for early embryos, morulae and blastocysts. Elsevier.
Macklon, N. S., Stouffer, R. L., Giudice, L. C. & Fauser, B. C. J. M. The Science behind 25 Years of Ovarian Stimulation for in Vitro Fertilization. Endocr. Rev. 27, 170–207 (2006).
Bourdon, M., … K. P.-C.-H. & 2019, undefined. Day 5 versus Day 6 blastocyst transfers: a systematic review and meta-analysis of clinical outcomes. Acad. Bourdon, K Pocate-Cheriet, A Finet Bantel, V Grzegorczyk-Martin, A Amar HoffetHuman Reprod. 2019•academic.oup.com.
Murata, Y. et al. Freeze–thaw programmes rescue the implantation of day 6 blastocysts. Reprod. Biomed. Online 11, 428–433 (2005).
Coticchio, G., Ezoe, K., Lagalla, C., … C. Z.-H. & 2023, undefined. The destinies of human embryos reaching blastocyst stage between Day 4 and Day 7 diverge as early as fertilization. Acad. Coticchio, K Ezoe, C Lagalla, C Zacà, A Borini, K Katoh. Reprod. 2023•academic.oup.com.
Tiegs, A., Sun, L., … G. P.-H. & 2019, undefined. Worth the wait? Day 7 blastocysts have lower euploidy rates but similar sustained implantation rates as Day 5 and Day 6 blastocysts. Acad. Tiegs, L Sun, G Patounakis, RT Scott JrHuman Reprod. 2019•academic.oup.com.
Lane, S., Reed, L., … W. S.-R. B. & 2022, undefined. Euploid day 7 blastocysts of infertility patients with only slow embryo development have reduced implantation potential. Elsevier.
Du, T. et al. Fertility and neonatal outcomes of embryos achieving blastulation on Day 7: are they of clinical value? Acad. Du, Y Wang, Y Fan, S Zhang, Z Yan, W Yu, Q Xi, Q Chen, BW Mol, Q Lyu, Y KuangHuman Reprod. 2018•academic.oup.com 33, 1038–1051 (2018).
Bakkensen, J. B. et al. Association between blastocyst morphology and pregnancy and perinatal outcomes following fresh and cryopreserved embryo transfer. J. Assist. Reprod. Genet. 36, 2315–2324 (2019).
Subira, J. et al. Grade of the inner cell mass, but not trophectoderm, predicts live birth in fresh blastocyst single transfers. Hum. Fertil. 19, 254–261 (2016).
Zou, H. et al. Blastocyst quality and reproductive and perinatal outcomes: a multinational multicentre observational study. Acad. Zou, JM Kemper, ER Hammond, F Xu, G Liu, L Xue, X Bai, H Liao, S Xue, S Zhao, L XiaHuman Reprod. 2023•academic.oup.com 38, 2391–2399 (2023).
Storr, A., Bilir, E., Cooke, S., … D. G.-R. B. & 2019, undefined. Fine-tuning blastocyst selection based on morphology: a multicentre analysis of 2461 single blastocyst transfers. Elsevier.
Abbeel, E. Van den, Balaban, B., … S. Z.-R. & 2013, undefined. Association between blastocyst morphology and outcome of single-blastocyst transfer. Elsevier.
Licciardi, F., McCaffrey, C., Oh, C., sterility, C. S.-S.-F. and & 2015, undefined. Birth weight is associated with inner cell mass grade of blastocysts. Elsevier.
Open, D. M.-H. R. & 2017, undefined. Blastocyst culture in the Era of PGS and FreezeAlls: Is a ’C’a failing grade? Acad. MorbeckHuman Reprod. Open, 2017•academic.oup.com 1–6 (2017) doi:10.1093/hropen/hox017.
Kemper, J. M. et al. Should we look for a low-grade threshold for blastocyst transfer? A scoping review. Reprod. Biomed. Online 42, 709–716 (2021).
Forman, E. et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection: a prospective study of 100 consecutive cycles of planned fresh. Elsevier.
Capalbo, A. et al. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Acad. Capalbo, L Rienzi, D Cimadomo, R Maggiulli, T Elliott, G Wright, ZP Nagy, FM UbaldiHuman Reprod. 2014•academic.oup.com 29, 1173–1181 (2014).
Minasi, M. G. et al. Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study. Hum. Reprod. 31, 2245–2254 (2016).
Kato, K. et al. Does embryo categorization by existing artificial intelligence, morphokinetic or morphological embryo selection models correlate with blastocyst euploidy rates? Reprod. Biomed. Online 46, 274–281 (2023).
Bamford, T., Easter, C., Montgomery, S., … R. S.-H. & 2023, undefined. A comparison of 12 machine learning models developed to predict ploidy, using a morphokinetic meta-dataset of 8147 embryos. Acad. Bamford, C Easter, S Montgomery, R Smith, RK Dhillon-Smith, A Barrie, A CampbellHuman Reprod. 2023•academic.oup.com.
Ma, B. X., Yang, L., Tian, Y., Jin, L. & Huang, B. Cytoplasmic strings between ICM and mTE are a positive predictor of clinical pregnancy and live birth outcomes: A time-lapse study. Front. Med. 9, (2022).
Eastick, J., Venetis, C., Cooke, S. & Chapman, M. The presence of cytoplasmic strings in human blastocysts is associated with the probability of clinical pregnancy with fetal heart. J. Assist. Reprod. Genet. 38, 2139–2149 (2021).
Busnelli, A., Dallagiovanna, C., Reschini, M., sterility, A. P.-F. and & 2019, undefined. Risk factors for monozygotic twinning after in vitro fertilization: a systematic review and meta-analysis. Elsevier.
Kadam, N., Woodhead, G., Kellam, L., … A. C.-J. of clinical & 2023, undefined. Odds and predictors of monozygotic twinning in a multicentre cohort of 25,794 IVF cycles. mdpi.comN Kadam, G Woodhead, L Kellam, A Campbell, K JayaprakasanJournal Clin. Med. 2023•mdpi.com 12, 2593 (2023).
Yin, H. et al. The effects of blastocyst morphological score and blastocoele re-expansion speed after warming on pregnancy outcomes. Clin. Exp. Reprod. Med. 43, 31 (2016).
Shu, Y. et al. The value of fast blastocoele re-expansion in the selection of a viable thawed blastocyst for transfer. Fertil. Steril. 91, 401–406.
Loutradi, K. E. et al. Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis. Fertil. Steril. 90, 186–193 (2008).
Coutinho, A. R. S. et al. Morphological changes in mouse embryos cryopreserved by different techniques. Microsc. Res. Tech. 70, 296–301 (2007).
Homayoun, H., Zahiri, S., Jahromi, H., Dehnavi, H. & Student, P. D. Morphological and morphometric study of early-cleavage mice embryos resulting from in vitro fertilization at different cleavage stages after vitrification. Iran. J. Vet. Res. (2016) doi:10.22099/IJVR.2016.3605.
Alteri, A. et al. Revisiting embryo assisted hatching approaches: a systematic review of the current protocols. J. Assist. Reprod. Genet. 35, 367 (2018).
Coello, A. et al. Analysis of the morphological dynamics of blastocysts after vitrification/warming: defining new predictive variables of implantation. Fertil. Steril. 108, 659-666.e4 (2017).
Yoneyama, M. et al. Blastocyst re-expansion rate immediately after warming is a strong dynamic indicator of embryo quality. Reprod. Biomed. Online 0, 104989 (2025).
Liehman, P. & Fulka, J. [Relation between the quality of cattle embryos after thawing and the pregnancy rate after their transfer]. Vet. Med. (Praha). (1986).
Guerif, F. et al. Parameters guiding selection of best embryos for transfer after cryopreservation: A reappraisal. Hum. Reprod. 17, 1321–1326 (2002).
Zheng, X. et al. Viability of frozen-thawed human embryos with one-two blastomeres lysis. doi:10.1007/s10815-008-9224-3.
Cimadomo, D. et al. How should the best human embryo in vitro be? Current and future challenges for embryo selection. Minerva Obstet. Gynecol. 76, 159–173 (2023).
Ziebe, S. et al. Embryo quality and developmental potential is compromised by age. Acta Obstet. Gynecol. Scand. 80, 169–174 (2001).
Kuznyetsova, I., Kuznyetsov, V., Bałakier, H. & Librach, C. Selecting Developmentally Competent Human Blastocysts: From Basic Morphological Assessment to Morphokinetics and Preimplantation Genetic Testing for Aneuploidy Iryna Scienti fi c Journal of Biology. (2020).