Predictive Factors For Three Pronuclear Zygote In Ivf Cycle


Introduction: Preimplantation Genetic Testing is one of the methods to screen genetic defects in embryos created through In Vitro Fertilization. In developing country this technique is still new and expensive method. Thus, knowing several factors in predicting the occurrence of three-pronuclear zygote can help much.

Method: 472 cycles in 449 subjects who underwent controlled ovarian hyperstimulation in IVF cycles between January 2013 and August 2014 were included in the study. Categorical variables were compared using Chi Square test and continuous variables were analyzed using Independent t-test, and statistically significant was considered when p < 0.05. Multivariate logistic regression analysis was performed in order to correlate clinical variables and the occurrence of three-pronuclear zygote (3pn). 

Results: There were 38 3pn was identified in this study (8.05%). No correlation was found between age of the women, number of mature follicles, which are less than six with the incidence of 3pn. However, level of Anti Mullerian Hormones (AMH) found to be the strongest predictor with the incidence of 3PN (p < 0,01, RR 2.5, CI95% 1,55; 4.16).

Conclusion: level of AMH is known to be strong predictor of thee pronuclear zygote after IVF cycle.

[1] A. E. Puscheck, Infertility [article on internet] 2015 [cited 3 March 2016]. Available from:

[2] S. O. Rutstein, O. R. Marco, and I. H. Shah, Infenduncity, infertility, and childlessness in developing countries, World Health Organization: Calverton, 2004.

[3] A. Nicoli, F. Capodanno, L. Moscato, I. Rondini, M. T. Villani, A. Tuzio, and G. B. La Sala, Analysis of pronuclear zygote configurations in 459 clinical pregnancies obtained with assisted reproductive technique procedures, Reproductive Biology and Endocrinology, 8, article no. 77, (2010).

[4] C. Staessen and A. C. Van Steirteghem, The chromosomal constitution of embryos developing from abnormally fertilized oocytes after intracytoplasmic sperm injection and conventional in-vitro fertilization, Human Reproduction, 12, no. 2, 321– 327, (1997).

[5] M. Li, W. Zhao, X. Xue, S. Zhang, W. Shi, and J. Shi, Three pro-nuclei (3PN) incidence factors and clinical outcomes: A retrospective study from the fresh embryo transfer of in vitro fertilization with donor sperm (IVF-D), International Journal of Clinical and Experimental Medicine, 8, no. 8, 13997–14003, (2015).

[6] B. E. Rosenbusch, Mechanisms giving rise to triploid zygotes during assisted reproduction, Fertility and Sterility, 90, no. 1, 49–55, (2008).

[7] D. E. McFadden and W. P. Robinson, Phenotype of triploid embryos, Journal of Medical Genetics, 43, no. 7, 609–612, (2006).

[8] M. J. G. Gruijters, J. A. Visser, A. L. L. Durlinger, and A. P. N. Themmen, Anti-Müllerian hormone and its role in ovarian function, Molecular and Cellular Endocrinology, 211, no. 1-2, 85–90, (2003).

[9] A. L. L. Durlinger, J. A. Visser, and A. P. N. Themmen, Regulation of ovarian function: The role of anti-Müllerian hormone, Reproduction, 124, no. 5, 601–609, (2002).

[10] B. N. Mehta, M. N. Chimote, N. N. Chimote, N. M. Nath, and N. M. Chimote, Follicular-fluid anti-Mullerian hormone (FF AMH) is a plausible biochemical indicator of functional viability of oocyte in conventional in vitro fertilization (IVF) cycles, Journal of Human Reproductive Sciences, 6, no. 2, 99–105, (2013).

[11] AP. Melnick, EM. Murphy, H. Liu, OK. Davis, and Z. Rosenwaks, Low AMH is associated with increased aneuploidy in women 40 and younger. Fertil steril, in Rosenwaks Z. Low AMH is associated with increased aneuploidy in women 40 and younger. Fertil steril, 104–248, 104, 248-249, 2015.