Objective: To analyze whether a change in three-dimensional structure of the zona pellucida could indicate suboptimal gamete quality. Design: Prospective study. Setting: Women's general hospital. Patient(s): A total of 72 patients who gave informed consent. Intervention(s): The birefringence of all oocytes was prospectively analyzed with an automatic user-independent polarization microscopy imaging system. Main Outcome Measure(s): Birefringence of the inner zona layer, preimplantation development, implantation, and pregnancy. Result(s): In approximately one third of all gametes (244/712), the system's automatic detection of the inner zona layer did not succeed. This phenomenon was a negative predictor of compaction (P < 0.01), blastulation (P < 0.001), and pregnancy (P < 0.001). In cases of successful zona imaging, the score based on the birefringence of the inner zona layer was a strong predictor of blastocyst formation but not of embryo quality or pregnancy (P > 0.05). Interestingly, antagonist protocol resulted in lower zona scores as compared with the long protocol (P < 0.05). Conclusion(s): Combining the information from both undetected and detected oocytes, zona imaging was a helpful tool in oocyte selection. This knowledge might further help to reduce both the time in culture and the number of concepti considered for transfer. © 2010 by American Society for Reproductive Medicine.
Ebner, T., Balaban, B., Moser, M., Shebl, O., Urman, B., Ata, B., & Tews, G. (2010). Automatic user-independent zona pellucida imaging at the oocyte stage allows for the prediction of preimplantation development. Fertility and Sterility, 94(3), 913–920. https://doi.org/10.1016/j.fertnstert.2009.03.106