ArticleJournal of assisted reproduction and genetics2026
Not all abnormal fertilization is equal: occurrence, developmental competence, and ploidy outcomes of 1PN, 3PN, and 2.1PN zygotes in ICSI/PGT-A cycles.
Article in Journal of assisted reproduction and genetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo characterize the occurrence, developmental competence, and ploidy outcomes of abnormally fertilized oocyte (AFO) subtypes in ICSI/PGT-A cycles, and to assess whether maternal age independently predicts abnormal fertilization.
methodsProspective observational study including 1033 ICSI/PGT-A cycles (6373 inseminated oocytes). AFO occurrence was analyzed by binomial logistic regression and multivariable analysis. In 664 time-lapse cycles, pronuclear status was reassessed at 22-24 hpi (Check II) after routine evaluation at 16-18 hpi (Check I). Ploidy analysis was performed on 78 AFO-derived blastocysts by SNP genotyping using NGS technology.
resultsAFOs accounted for 6.8% of inseminated oocytes (1PN 3.1%, 3PN 2.1%, 2.1PN 1.2%, > 3PN 0.4%). Maternal age was the only independent predictor (OR 1.04/year; p < 0.05), mainly for 3PN and 2.1PN. Blastocyst development differed across categories (1PN 11.1%, 3PN 25.7%, 2.1PN 40.5% vs. 2PN 54.4% p < 0.05), and 1PN and 2.1PN were mainly diploid (71.4% and 88.9% respectively), though both were lower than 2PN (99.9%; p < 0.001), while 3PN were mostly triploid (73.3%). The rate of blastocysts suitable for transfer calculated per zygote was 1PN 2.0%, 3PN 0.8%, and 2.1PN 8.1%, markedly lower than 2PN (22.5%; p < 0.001). Pronuclear status could change after the standard assessment window: 26% of 2.1PN-derived blastocysts were initially classified as 2PN, suggesting that single-timepoint assessment may misclassify fertilization.
conclusionsAFO subtypes differed in clinical potential according to their developmental competence and ploidy status. Time-lapse monitoring further indicated that some AFOs may be misclassified in a single static pronuclear assessment. Therefore, both ploidy assessment and PGT-A should be considered before the clinical use of AFO-derived embryos.
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