Does Severe Endometriosis have an Effect on Embryo Morphokinetic Parameters?

Endometriosis is one of the leading causes of infertility, affecting approximately one-third of women undergoing in vitro fertilization (IVF) treatment. Despite extensive research, the impact of endometriosis on embryo development remains controversial, particularly regarding its influence on both morphological and dynamic parameters. This retrospective comparative study analyzed 1,280 embryos cultured in a time-lapse incubator derived from 241 women under 38 years of age with a body mass index (BMI) below 30, whose partners did not present with severe male factor infertility. Of these, 729 embryos were obtained from patients with severe endometriosis (SE) and 551 from patients with tubal factor infertility (control group). All oocytes underwent intracytoplasmic morphologically selected sperm injection (IMSI). The abnormal fertilization rate was significantly higher in the SE group compared to the control group (4.9% vs. 2.7%, p = 0.022). No significant differences were observed in the time to pronuclear fading (tPNf), start of compaction (tSC), and expanded blastocyst formation (tEB) (p > 0.05). However, the durations of the first, second, and third embryonic cell cycles (ECC1, ECC2, and ECC3), as well as the synchronization of cell divisions (S2: t4–t3) and cleavage patterns (S3: t8–t5), were significantly different between the study groups (p < 0.05). Although most morphokinetic parameters were delayed in the SE group, the frequency of good-quality embryos on Days 3 and 5 and overall clinical outcomes were not significantly affected (p < 0.05). In conclusion, although embryos from patients with severe endometriosis exhibit significant delays in morphokinetic parameters, implantation and live birth outcomes remain comparable to those of controls when high-quality embryos are transferred. Similar content being viewed by others Data Availability Data is available at a reasonable request to the corresponding author.

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Corresponding author Ethics declarations Conflict of interest The authors declare no competing interests. Ethical Approval The study was approved by the Non-Invasive Research Ethics Committee of Bezmialem Vakıf University (Approval No: 122607; Date: 15/09/2023). Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Sezer, F., Yazici, M.G.K., Ozer, G. et al. Does Severe Endometriosis have an Effect on Embryo Morphokinetic Parameters?. Bratisl. Med. J. 127, 544–552 (2026). https://doi.org/10.1007/s44411-025-00397-x Received: Revised: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s44411-025-00397-x