Transfer of blastocysts with deviant morphological and morphokinetic parameters at early stages of in-vitro development: a case series  Astrid Stecher,

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Transfer of blastocysts with deviant morphological and morphokinetic parameters at early stages of in-vitro development: a case series  Astrid Stecher, Pierre Vanderzwalmen, Martin Zintz, Barbara Wirleitner, Maximilian Schuff, Dietmar Spitzer, Nicolas H. Zech  Reproductive BioMedicine Online  Volume 28, Issue 4, Pages 424-435 (April 2014) DOI: 10.1016/j.rbmo.2013.12.008 Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 1 Case 1. (A, B) First embryo: multinucleation in one blastomere at the 2-cell stage after 58.4h (A) and development at 115.3h (B). (C, D) Second embryo: t5=58.4h (C); after 115.3h trophectoderm consisting of a few cells (D). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 2 Case 2. Both embryos reveal uneven blastomeres on day 2 (A, D); assisted zona hatching was performed on day 4 (B, E); outcome on day 5 (C, F). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 3 Case 3. (A–D) First embryo: SER cluster before 2 pronuclei Formation (A–C); quality of transferred blastocyst (D). (E–J) Second embryo: two blastomeres were not incorporated in the blastocyst. Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 4 Case 4. (A–D) First embryo: z-score of z3–4 (A, B), multinucleation at the 2-cell stage in one blastomere (C) and development to the blastocyst stage (D). (E–H) Second embryo: z-score of z3–4 (E–F), 2-cell-stage embryo (G) and development to the blastocyst stage (H). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 5 Case 5. Large area of granularity (A–C). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 6 Case 6. (A–C) First embryo: different size and number of nucleolar precursor bodies at 17h (A) and 22.9h (B) and blastocyst showing an inner cell mass forming a bridge (C). (D–H) Second embryo: unequal size and number of nucleolar precursor bodies (z-score of z3–3) (D–F), multinucleation in one blastomere at 2-cell stage (G) and development to the blastocyst stage (H). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 7 Case 7. (A–D) First embryo: 2 pronuclei stage with separated pronuclei at 17.0h (A), embryo at 21.4h (B), one blastomere showing a micronucleus at 34.5h (C) and outcome after 115h (D). (E–H) Second embryo: 2 pronuclei stage embryo at 17.1h (E), 4-cell-stage embryo at 35.5h (F), embryo at 102.7h, one blastomere not incorporated within the blastocyst (G) and 115.0h (H). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 8 Case 8. Direct cleavage from 1 to 3 cells (A–C), high degree of fragmentation on day 3 (D) and outcome on day 5 (E). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions

Figure 9 Case 9. Day-2 embryo cleaving forward and backward between 26.6 and 36.5h (A–D), on early day 5, two blastomeres are not included in the blastocyst formation (E) and outcome at 115.9h (F). Bar=50μm. Reproductive BioMedicine Online 2014 28, 424-435DOI: (10.1016/j.rbmo.2013.12.008) Copyright © 2014 Reproductive Healthcare Ltd. Terms and Conditions