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This study examines how different abnormal cleavage patterns influence embryonic development potential and clinical outcomes.

June 21, 2026European journal of medical research0 citationsOpen Access

The effects of different types of abnormal cleavage and their occurrence periods on the developmental potential of early embryos

SWShikai WangThe People's Hospital of Guangxi Zhuang Autonomous Region LLL T LiuJiangxi University of Traditional Chinese Medicine XMXianbao MaoThe People's Hospital of Guangxi Zhuang Autonomous Region

Key Points

This study examines how different abnormal cleavage patterns influence embryonic development potential and clinical outcomes.
Retrospective analysis of 10,144 fertilized embryos from 1321 IVF/ICSI cycles.
Embryos cultured in a time-lapse incubator and assessed for abnormal cleavage events.
Embryo quality and clinical pregnancy rates analyzed based on cleavage patterns and timing.
33.68% incidence of abnormal cleavage; direct cleavage was most frequent at 13.23%.
Abnormal cleavage types significantly reduced rates of high-quality D3 embryos and blastocyst formation.
No clinical pregnancies were achieved with embryos exhibiting direct cleavage in the first division cycle.

Abstract

This study aims to investigate the effects of abnormal cleavage patterns, with a specific focus on the cell cycle in which they occur, on embryonic developmental potential and clinical outcomes using time lapse. This retrospective study analyzed 10,144 fertilized (2PN) embryos from 1321 IVF/ICSI cycles. Embryos were cultured in a time-lapse incubator (Primo Vision) and assessed for abnormal cleavage events: direct cleavage (DC), reverse cleavage (RC), chaotic cleavage (CC), multinucleation (Mn), and mixed patterns. These events were further categorized based on their occurrence in the first (S1), second (S2), or third (S3) division cycle. Embryo quality was assessed on days 3 and 5/6. Clinical pregnancy and implantation rates were analyzed for the transferred embryos. The overall incidence of abnormal cleavage was 33.68%, with DC being the most frequent (13.23%), followed by Mn (7.68%), mixed (6.39%), RC (3.90%), and CC (2.47%). The subgroup analysis revealed different distribution patterns across division cycles (e.g., DC-1, 6.15%; DC-2, 6.71%; and DC-3, 0.36%). Compared with normal cleavage, all abnormal cleavage types were associated with significantly lower rates of high-quality D3 embryos, blastocyst formation, and high-quality blastocysts. Critically, abnormalities occurring in the first division cycle (S1) had a more profound negative effect on the development potential (e.g., D3 high-quality embryo rate and blastocyst formation rate) than those in S2 or S3 did. Clinically, no pregnancies resulted from embryos with DC in the first cycle (DC-1), a rate that was significantly lower than that of the normal cleavage group. Clinical outcomes tended to decrease in the other abnormal cleavage subgroups, although the difference was not always statistically significant. The timing of abnormal cleavage is a critical determinant of embryonic potential. Abnormalities occurring in the first cell cycle, particularly direct cleavage (DC-1), are most detrimental, leading to poor development and a high likelihood of implantation failure. These findings emphasize the importance of incorporating the specific type and timing of cleavage anomalies into time-lapse-based embryo selection models to improve clinical pregnancy success. Clinical trial registration https://www.medicalresearch.org.cn/ , identifier MR-45-23-039336. Registered 1 July 2022.

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