A retrospective investigation of the effects of chromosome aneuploidy on preimplantation embryos’ development: base on time-lapse

A retrospective investigation of the effects of chromosome aneuploidy on preimplantation embryos’ development: base on time-lapse | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A retrospective investigation of the effects of chromosome aneuploidy on preimplantation embryos’ development: base on time-lapse Zhihui Chen, Yufei Yao, Yanlin Ma, Qingfei Zhong, Yu Zhang, Yuanhua Huang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4349351/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose To investigate the effects of chromosomal aneuploidy on preimplantation embryos’ development by analyzing the morphological and morphokinetic parameters between euploid embryos and aneuploid embryos. Methods Conducted a retrospective analysis of the morphological and morphokinetic parameters of embryos cultured in the Embryo Scope Plus time-lapse incubator and underwent trophectoderm cell sampling for preimplantation genetic testing (PGT) at the Reproductive Center of the First Affiliated Hospital of Hainan Medical University from June 2019 to September 2022. Statistical methods, including the Mann-Whitney U test and Chi-Square test, were used to analyze the data. Results 1. A total of 1888 embryos from 487 cycles were included, with 724 being euploid embryos (38.30%) and 1164 being aneuploid embryos (61.70%). 2.In embryos that has become blastocysts, aneuploidy of embryonic genome had no effect on morphology of D1 and D2 embryos, had moderate effect on D3 embryos but significantly affects blastocysts, the worse the Gardner score, the higher the aneuploidy rate. 3. The influence of aneuploidy on the morphokinetic of the embryo becomes apparent at t5, with euploid embryos exhibiting faster development compared to aneuploid embryos. 4.There is no evidence to suggest that single chromosome aneuploidies, such as chr-3, chr-7, chr-8, chr-10, chr-11, chr-12, chr-13, chr-15, chr-18, chr-20, and chr-21, has any influence on the morphokinetic of embryos. Conclusion Genomic aneuploidy has an impact on embryo development, but not every stage is affected. Additionally, certain specific single chromosome aneuploidies does not influence embryo development during the preimplantation stage. Time-lapse Chromosome aneuploidy Preimplantation genetic testing Morphokinetic Morphology Figures Figure 1 Figure 2 Figure 3 Figure 4 INTRODUCTION Embryonic development is a manifestation of genome functionality following a programmed sequence. In other words, the genome controls the developmental process of an embryo. Consequently, embryos with normal genomes may exhibit developmental differences compared to those with abnormal genomes at specific stages. Previous research has suggested that the activation of the embryonic genome occurs during the 4-cell to 8-cell stage [ 1 ] . Prior to embryonic genome activation, maternally inherited genetic material carried by the oocyte controls embryo development. However, recent research suggests that genome activation takes place between the 2-cell and 4-cell stage, with the gradual clearance of maternal mRNA during the blastocyst stage [ 2 ] . Abnormal genome activation or excessive methylation can result in the developmental arrest of the embryo [ 3 ] . In recent years, time-lapse incubator has gained extensive usage in the field of assisted reproduction. It combines an optical microscopy system with an embryo incubator to automatically capture images of embryos at defined intervals, accurately documenting the complete process from fertilization to blastocyst formation, and even hatching [ 4 ] . Consequently, it enables the observation of continuous morphological changes throughout embryo development and the precise timing of reaching distinct stages. Based on time-lapse, previous studies have established correlations between embryo morphology, development speed, and embryo chromosomal ploidy [ 5 – 7 ] . For example, Y. Kumtep et al. discovered that the development speed of euploid embryos (at time points t2, t8, and tB) was faster than that of aneuploid embryos [ 8 ] . BRAGA D et al. discovered that aneuploid embryos showed significantly longer tPNf, t2, t3, t4, t6, t7, t8, tM, tsB, and tB compared with euploidy embryos [ 9 ] .Using time-lapse, it was observed that euploid embryos had a faster development speed, higher scores for the quality of the trophectoderm and inner cell mass [ 10 ] . However, various studies have reported statistically significant parameters that differ from one another. In conclusion, the utilization of time-lapse incubator allows the observation of chromosomal aneuploidy's impact on early embryo development. Nevertheless, not all genes participate in early embryo development. This study aims to retrospectively analyze the developmental parameters of embryos that underwent chromosomal aneuploidy screening using a time-lapse incubator. By analyzing the morphological and morphokinetic between euploid and aneuploid embryos, and combining the results of preimplantation genetic testing, our aim is to investigate the effects of specific chromosomal aneuploidy on preimplantation embryos. MATERIALS AND METHODS Patients and Study Design Patients who underwent preimplantation genetic testing (PGT) at the Reproductive Center of the First Affiliated Hospital of Hainan Medical University were enrolled in this study between June 2019 and September 2022. Inclusion criteria: All embryos cultured in the time-lapse incubator Embryo Scope Plus (Vitrolife; Sweden) until the 5th or 6th day followed by laser drilling for trophectoderm biopsy for genetic testing, Exclusion criteria: (1) Embryos with mostly missing images; (2) Embryos with ≥2 morphokinetic parameters that cannot be annotated; (3) Embryos that form blastocysts on the 7th day. Ovarian stimulation, oocyte retrieval, fertilization procedures, embryo culture and biopsy The ovarian stimulation protocol is selected based on the specific condition of the patient, and can include long protocol, short protocol, antagonist protocol, mild stimulation protocol. Gonadotropin included rFSH(Merck-Serono; Switzerland or GeneScience; China),FSH(Livzon; China),HMG(Livzon; China). Antagonist was Cetrorelix(Baxter Oncology GmbH; Germany).The dosages were adjusted according to a variety of clinical factors, including sex hormone levels, follicle count and follicle size. Oocytes were collected 32 to 36 h after triggering using hCG(Livzon; China). All oocytes were inseminated using intracytoplasmic sperm injection (ICSI) after the removal of cumulus cells, and all embryos were cultured until day 5 or 6 using time-lapse incubator (6% CO2,6% O2,37°C). Three to five trophectoderm cells located farthest from the inner cell mass were gently aspirated and separated from the blastocyst through a zona pellucida opening created using a laser system. Genetic testing The biopsied cells were subjected to whole-genome amplification using the SurePlex or MDA. High-throughput sequencing was performed using the Ion Torrent sequencing system and Ion 318 Chip v2 (Thermo Fisher, USA) with a detection resolution of 4 Mb. The data was further analyzed using the PGXCloud bioinformatics platform (Jabrehoo; China). Morphological and morphokinetic parameters Table.1 Definition of morphological parameters Morphological parameters Description Pronuclei Evaluation Z1: The number and size of the nucleoli equal, and arranged in parallel at the junction of the two pronuclei; Z2: The number and size of the nucleoli are equal, and scattered in the two pronuclei; Z3: The number and size of the nucleoli are different, and arranged in parallel or scattered in the two pronuclei; Z4: Abnormal pronuclei morphology, two pronuclei scattered in the zygote, or different sizes (small pronuclear volume less than 1/2 of the volume of large pronuclear volume). As shown in Fig.1 Cell Fragment Fragment in the embryo, which is cytoplasm wrapped by cell membrane without nucleus, divided into four grades: 0% ~ 5%, 6% ~ 20%, 21% ~ 50% and > 50%. As shown in Fig.2 Heterogeneity of Blastomere Divided into A, B and C grades (A: the two cells were round and similar in size; C: The volume of one blastomere is less than half that of the other or the blastomere is irregular; B is somewhere in between), as shown in Fig. 3 Gardner Criteria Rank according to the arrangement and the number of cells in the inner cell mass and trophoblast cells (A: more cells, closely arranged; B: Slightly fewer cells, loose connections; C: Very few cells).As shown in Fig.4 Table.2 Definition of morphokinetic parameters Morphokinetic parameters Description tPB2（h） Appearance of second polar body tPNa（h） Appearance of the first pronuclei tPNf（h） Time when both pronuclei had faded t2～t8（h） Time to 2-cell～8-cell blastomere CC2（h） Time of second cell cycle(t4-t3), from 2 to 4 cells S2（h） Time of synchrony of the second cycle (t4-t3), from 3 to 4 cells CC3（h） Time of third cell cycle (t8-t4), from 4 to 8 cells S3（h） Time of synchrony of the third cycle (t8-t5), from 5 to 8 cells tSB（h） Time from insemination to start blastulation tB（h） Time form insemination to formation of a full blastocyst tB-t8(h) Time from 8-cell blastomere to full blastocyst tB-tSB(h) Time from start blastulation to full blastocyst t0: Time of insemination, when ICSI started ICSI: Intracytoplasmic sperm injection Captions of Fig.1to Fig.4 are described in Table.1 “Definition of morphological parameters” Statistical analysis SPSS (version 25.0; IBM, USA) was used for statistical analysis. Statistical methods included the Mann-Whitney U test (Since the quantitative data did not follow a normal distribution) and Chi-Square test. RESULTS Morphological parameters and euploidy rates Pronuclei evaluation : The embryos were classified into four groups (Z1 to Z4) based on the D1 pronuclei evaluation. A comparison was made between the inter-group euploidy rates to investigate potential differences in the D1 pronuclei evaluation between euploid and aneuploid embryos. To account for the influence of maternal age on embryo euploidy [11, 12] , we conducted separate Chi-Square tests for the age groups 0.05, signifying that the variations in euploidy rate across the Z1 to Z4 groups were not statistically significant. Thus, there was no observed distinction in the D1 pronuclei evaluation between euploid and aneuploid embryos. Table.3 Pronuclei Evaluation and Euploidy Rate Female Age Pronuclei Evaluation Euploidy Rate Chi-Square test Z1 36.76% (25/68) c 2 =5.001 P =0.172 <35y Z2 44.12% (105/238) Z3 47.89% (193/403) Z4 32.00% (8/25) Z1 30.19% (16/53) c 2 =0.210 P =0.976 ≥35y Z2 30.93% (60/194) Z3 31.09% (74/238) Z4 25.00% (3/12) Cell Fragment: The embryos were divided into three groups based on the degree of cell fragmentation on D2 and D3 (0% to 5%, 6% to 20%, 21% to 50%), and no embryos with cell fragmentation greater than 50% were collected. As shown in Table.4, all P-values were >0.05, demonstrating that the differences in euploidy rates among the three groups of embryos were not statistically significant. Therefore, the degree of cell fragmentation on D2 and D3 does not reflect the euploidy of embryos. Table.4 Cell Fragment and Euploidy Rate Female Age Cell Fragment D2 Euploidy Rate Chi-Square test D3 Euploidy Rate Chi-Square test 0%-5% 44.14% (241/546) c 2 =0.983 P =0.612 43.68% (197/451) c 2 =1.641 P =0.440 <35y 6%-20% 47.40% (82/172) 48.41% (122/252) 21%-50% 53.33% (8/15) 41.38% (12/29) 0%-5% 32.19% (122/379) c 2 =1.212 # P =0.538 32.72% (107/327) c 2 =2.964 P =0.227 ≥35y 6%-20% 26.79% (30/112) 26.14% (40/153) 21%-50% 28.57% (2/7) 41.18% (7/17) # For 33.33% of theoretical frequency <5, Pearson Chi-square test is not applicable, so Monte Carlo approximation is used to calculate Chi-square value and asymptotic significance D2: The second day after ICSI, D3: The third day after ICSI Heterogeneity of Blastomere: The embryos were classified into three groups (A, B, C; description shown in Table.1) based on the heterogeneity of blastomere on D2 and D3. The results, as shown in Table.5, indicated that the P-values for the Chi-Square tests for the euploidy rates among the three groups of D2 embryos were all >0.05, demonstrating that the differences were not statistically significant. For the D3 embryos, when the woman's age was ≥35y, the P-values were all >0.05, showing no statistically significant difference. However, for embryos of women aged <35y, the P-value was <0.05, indicating a significant difference in the euploidy rates among the three groups. Comparing the three groups pairwise, the difference in euploidy rate was statistically significant between groups A and B, while the differences between groups A and C, and B and C, were not statistically significant. Table.5 Heterogeneity of Blastomere and Euploidy Rate Female Age Heterogeneity of Blastomere D2 Euploidy Rate Chi-Square test D3 Euploidy Rate Chi-Square test A 50.00% (40/80) c 2 =2.679 P =0.250 62.71% (37/59) a c 2 =8.202 P =0.017 * <35y B 43.55% (253/581) 43.24%(243/562) b C 52.05% (38/73) 45.95%(51/111) a,b A 34.29% (24/70) c 2 =0.886 P =0.642 40.48% (17/42) c 2 =4.349 P =0.114 ≥35y B 29.87% (115/385) 31.28% (127/406) C 34.88% (15/43) 20.41% (10/49) * Significant differences by two-tailed Pearson chi-square test a,b Different superscript letters indicate significant differences among groups ( P < 0.05) D2: The second day after ICSI, D3: The third day after ICSI Gardner Criteria: Blastocysts were categorized into four groups based on Gardner Criteria of inner cell mass (ICM) and trophectoderm (TE) for comparison of their euploidy rates. The groups included Top group = AA (n=595), Good group = AB, BA, BB (n=823), Fair group = AC, BC, CA, CB (n=465), and Poor group = CC (n=5). For the small number of embryos in the poor group (n=5), they were excluded from the analysis. As shown in Table.6, regardless of maternal age, the euploidy rate of embryos decreased with a decrease in Gardner grading levels, with all P-values < 0.001. There was a significant difference in euploidy rates among the three groups. Further pairwise comparisons revealed that when the woman was <35y, the differences between the Top and Good groups, as well as between the Good and Fair groups, were statistically significant, while the difference between the Top and Good groups was not statistically significant. When the woman was ≥35y, the differences between the Top and Fair groups, as well as between the Top and Good groups, were both statistically significant, while the difference between the Good and Fair groups was not statistically significant. In conclusion, the Gardner Criteria of blastocysts is associated with the euploidy of embryos, especially for older women. The euploidy rate for the Fair group (AC, BC, CA, CB) was 15.75%. When either the ICM or TE is graded as C, the euploidy rate significantly decreases. Table.6 Gardner Criteria and Euploidy Rate Female Age Gardner Criteria Euploidy Rate Chi-Square test Top 53.25% (131/246) a c 2 =17.410 P <0.001 * <35y Good 45.10% (152/337) a Fair 31.79% (48/151) b Top 55.78% (82/147) a c 2 =62.451 P <0.001 * ≥35y Good 23.21% (52/224) b Fair 15.75% (20/127) b * Significant differences by two-tailed Pearson chi-square test a,b Different superscript letters indicate significant differences among groups ( P < 0.05) Morphokinetic parameters and euploidy rates Female Age: The female age was grouped by whether it was advanced maternal age or not. The differences in 18 morphokinetic parameters and 2 AI scores between groups were compared. As shown in Table.7, the differences in parameters such as tPB2, tPNa, t3, t4, t5, t6, t7, t8, tSB, tB, tB-tSB, KIDScore, iDAScore, were statistically significant with P < 0.05. Combined with the median, it can be seen that embryos from females aged <35y develop faster at time points such as tPB2, tPNa, t3, t4, t5, t6, t7, t8, tSB, tB, with the time interval from blastocyst formation to blastocyst formation being shorter compared to embryos from females aged ≥35y, and both KIDScore and iDAScore scores are higher. Table.7 Female Age and Morphokinetic Parameters Morphokinetic Parameters <35y（n=1044） ≥35y（n=844） Mann-Whitney U test M（P25，P75） M（P25，P75） Z-value P- value tPB2(h) 3.54(2.97,4.40) 3.71(3.06,4.52) -2.685 0.007 * tPNa(h) 18.85(17.82,19.93) 19.33(18.20,20.44) -5.972 <0.001 * tPNf(h) 23.22(21.44,25.12) 23.44(21.79,25.11) -1.832 0.067 t2(h) 25.73(23.84,27.62) 25.83(24.11,27.59) -1.452 0.147 t3(h) 35.91(33.00,38.48) 36.41(33.99,38.69) -2.678 0.007 * t4(h) 37.25(33.00,38.48) 37.62(35.32,40.03) -2.074 0.038 * CC2(h) 11.57(10.69,12.49) 11.69(10.86,12.64) -1.774 0.076 S2(h) 0.42(0.21,1.26) 0.42(0.21,1.12) -0.444 0.657 t5(h) 48.72(43.80,53.00) 49.45(45.17,53.49) -2.785 0.005 * t6(h) 55.30(50.96,61.68) 55.96(51.62,63.05) -2.153 0.031 * t7(h) 55.57(51.20,61.91) 56.23(51.91,63.32) -2.148 0.032 * t8(h) 55.63(51.22,61.95) 56.28(51.94,63.32) -2.132 0.033 * CC3(h) 17.58(14.82,23.09) 17.77(15.36,23.87) -1.891 0.059 S3(h) 5.47(2.50,15.47) 5.18(2.52,14.79) -0.545 0.586 tSB(h) 97.20(91.80,103.45) 98.31(92.69,104.09) -2.212 0.027 * tB(h) 105.80(100.13,113.54) 107.74(102.09,114.63) -3.290 0.001 * tB-t8(h) 49.36(43.67.55.78) 50.27(444.36,57.03) -1.952 0.051 tB-tSB(h) 8.85(6.42,11.13) 9.40(6.50,11.95) -2.812 0.005 * KIDScore 6.20(4.60,8.00) 5.80(4.40,7.60) -2.741 0.006 * iDAScore 8.50(7.30,9.10) 8.30(7.00,9.10) -2.118 0.034 * * Significant differences by two-tailed Mann-Whitney U test M= Median, P25= Lower Quartile, P75= Upper Quartile Embryonic Euploidy ： As shown in Table.8, comparing the 18 parameters and 2 AI scores between euploidy embryos and aneuploidy embryos, the results indicate that the euploid develops faster at time points such as t5, t6, t7, t8, tSB, and tB compared to aneuploid, with a shorter time interval from the 8-cell stage to blastocyst formation, and from the initiation of blastocyst formation to formation. The third cleavage cycle (CC3) also takes less time, and the differences are statistically significant. The KIDScore and iDAScore scores are also significantly higher. Table.8 Embryonic Euploidy and Morphokinetic Parameters Morphokinetic Parameters Euploid（n=724） Aneuploid（n=1164） Mann-Whitney U test M（P25，P75） M（P25，P75） Z-value P- value tPB2(h) 3.63(3.07,4.45) 3.59(3.00,4.42) -0.934 0.35 tPNa(h) 19.03(17.99,20.02) 19.05(18.00,20.12) -0.927 0.354 tPNf(h) 23.30(21.58,25.05) 23.35(21.63,25.19) -1.074 0.283 t2(h) 25.77(23.94,27.50) 25.82(23.90,27.66) -0.643 0.52 t3(h) 35.93(33.18,38.44) 36.35(33.70,38.67) -1.790 0.073 t4(h) 37.19(35.06,39.77) 37.51(35.15,40.08） -1.519 0.129 CC2(h) 11.56(10.71,12.51) 11.66（10.82,12.60） -1.584 0.113 S2(h) 0.42(0.21,1.23) 0.42（0.21,1.18） -0.485 0.627 t5(h) 48.53(43.82,52.79) 49.42（44.85,53.44） -2.476 0.013 * t6(h) 54.94(50.96,60.49) 56.06（51.29,63.47） -3.107 0.002 * t7(h) 55.16(51.10,60.76) 56.37（51.62,63.80) -3.491 <0.001 * t8(h) 55.20(51.14,60.81) 56.40(51.66,63.85) -3.531 <0.001 * CC3(h) 17.15(14.84,21.63) 18.22(15.17,25.54) -3.568 <0.001 * S3(h) 5.04(2.46,14.75) 5.71(2.56,15.30) -1.479 0.139 tSB(h) 96.56(91.18,102.53) 98.36(92.70,104.62) -4.421 <0.001 * tB(h) 105.44(99.49,111.63) 107.86(101.72,115.42) -5.782 <0.001 * tB-t8(h) 48.65(43.75,54.86) 50.48(44.14,57.31) -3.131 0.002 * tB-tSB(h) 8.71(6.45,10.62) 9.41(6.45,12.10) -4.127 <0.001 * KIDScore 6.7(4.9,8.3) 5.6(4.3,7.3) -7.804 <0.001 * iDAScore 8.8(7.8,9.2) 8.2(6.7,9.) -7.887 <0.001 * * Significant differences by two-tailed Mann-Whitney U test M= Median, P25= Lower Quartile, P75= Upper Quartile Single Chromosome Abnormal: The development process of the embryo is controlled by the genome. As indicated in Table.8, it is known that the non-ploidy of embryonic chromosomes has an impact on the early development of the embryo. However, not all genes affect the early development of the embryo. We want to further explore the effects of specific chromosome aneuploidy on pre-implantation embryos. Therefore, the morphokinetic parameters of embryos with aneuploidy in single chromosomes were analyzed and compared with euploidy embryos. The morphokinetic parameters of embryos with aneuploidy in single chromosomes were separately compared with euploid using the Mann-Whitney U test. Due to the large number of original data tables, it is not possible to present them one by one, so the statistically significant differences in morphokinetic parameters are summarized in Table. 9. As shown in Table. 9, based on the data included in this study, there is no evidence to suggest that single chromosome aneuploidies, such as chr-3, chr-7, chr-8, chr-10, chr-11, chr-12, chr-13, chr-15, chr-18, chr-20, and chr-21, have any influence on the morphokinetic of embryos from fertilization to the preimplantation stage. Table.9 Morphokinetic Parameters between Euploid and Single Chromosome Abnormal Embryos Abnormal Chromosome Morphokinetic Parameters that Have Significant Differences by Mann-Whitney U test Between Groups Chromosome 1（n=18） t7、t8、CC3、S3、tSB、tB、 Chromosome 2（n=21） tPNf、t2、t4、tSB、tB Chromosome3（n=17） None Chromosome 4（n=22） t6、t7、t8、CC3、tB Chromosome 5（n=14） t5、t7、t8、CC3、 Chromosome 6（n=6） t6、tB-t8、KIDScore Chromosome 7（n=20） None Chromosome 8（n=12） None Chromosome 9（n=19） t6、t7、t8、CC3 Chromosome10（n=10） None Chromosome 11（n=21） None Chromosome 12（n=8） None Chromosome 13（n=25） None Chromosome 14（n=27） tSB、tB、tB-t8、tB-tSB Chromosome15（n=27） None Chromosome16（n=45） tB-tSB Chromosome17（n=9） tPNa、tB、tB-t8、tB-tSB Chromosome18（n=7） None Chromosome19（n=24） tB-tSB Chromosome20（n=7） None Chromosome21（n=27） None Chromosome22（n=49） tB-tSB Chromosome X（n=9） tPB2、t8、CC3 Chromosome Y（n=3） S3 DISCUSSION The development of the embryo is controlled by the genome. Before the activation of the embryonic genome, the development of the embryo is controlled by maternal genetic material. Research by Braude et al. in 1988 suggested that the human embryonic genome is activated during the 4-cell to 8-cell stage [1] . Subsequent studies have also confirmed that the activation of the embryonic genome mainly occurs during the 4-cell to 8-cell stage [13] . Some studies have indicated the activation of the embryonic genome before the 4-cell stage. For example, YAO Y et al. found that the transcription-related genes of zygote began to be expressed 24 hours after fertilization [14] , and Asami M et al. discovered the activation of the embryonic genome at the 1-cell stage [15] . In 2023, Hernandez JR et al.found through single-cell sequencing that the expression of the male sex-determining gene (SRY) peaks at the 2-cell stage, the eukaryotic transcription initiation factor (EIF1AY) gradually activates from the 2-cell stage to the blastocyst stage, and maternal mRNA in the oocyte is gradually cleared at the blastocyst stage, confirming the activation of the embryonic genome during the 2-cell to 4-cell stage [2] . However, the activation of the embryo's genome does not mean that the embryo’s development shifts from being controlled by maternal genetic material to being controlled by the embryo’s genome completely. From Table.4 to Table.6, it is evident that regardless of whether the woman is advanced maternal age or not, there is no statistically significant difference in the D1 pronuclei evaluation, D2 or D3 cell fragmentation, as well as the cell heterogeneity of D2 between euploid and aneuploid embryos. In the case of the heterogeneity of D3, when the maternal age is less than 35y, the rate of euploidy in embryos graded as A is higher than those graded as B or C, with the difference between A and B being statistically significant, while the difference between A and C is not statistically significant. The difference in the rate of euploidy between B and C embryos is also not statistically significant. At D3, embryos are generally at the 8-cell stage, with the embryonic genome already activated. Therefore, the difference in the rate of euploidy between embryos graded as A and B is statistically significant, while the differences between A and C, and B and C are not significant. This may be due to the fact that the sample size of A and C is less than B, and further research is needed to increase the data for verification. When the woman's age is 35y or older, there is also no statistically significant difference in the rate of euploidy among the three groups, perhaps because the increased rate of aneuploidy due to advanced maternal age has masked the differences among the groups. In the blastocyst stage, maternal mRNA gradually degrades, indicating a shift in embryonic development from maternal control to embryonic genome control, with morphological manifestations of aneuploidy. When the woman is under 35y, there is no significant statistical difference in euploidy rates between groups with ICM and TE graded as A or B; however, a significant decrease in euploidy rates is observed when either the ICM or TE is graded as C. In women aged 35y or older, there is no significant statistical difference in euploidy rates between groups with ICM and TE graded as B or C, but both are significantly lower than those graded as AA. As mentioned prior the grading of ICM and TE in blastocysts is closely associated with embryonic euploidy, with lower rates of euploidy linked to poorer grading. This is particularly noticeable in older women, where the influence of age on the embryonic euploidy rate is compounded. Notably, when either the ICM or the TE is assigned a C grade (i.e., AC, BC, CA, CB), there is a significant decrease in euploidy rates to 15.75%. This is consistent with many studies [16-19] . As shown in Table.7, the differences in the morphokinetic parameters between groups were compared according to whether the woman was of advanced maternal age. It was found that the woman's age has an impact on the embryonic dynamics from the appearance of the second polar body(tPB2) to the formation of the blastocyst(tB). Combining the median values, it was observed that the embryos of women aged <35y develop faster than those of women aged ≥35y, with higher AI model scores. This further confirms that the development before embryonic genome activation is controlled by maternal genetic material, and the maternal mRNA gradually clears until the blastocyst stage, indicating the maternal genetic material's influence on the embryo from fertilization until implantation. Shown in Table.8, it was found that the differences in t5, t6, t7, t8, CC3, tSB, tB, tB-t8, and tB-tSB between aneuploidy embryos and euploidy embryos were statistically significant，and euploidy embryos developed faster than aneuploidy embryos, requiring less time to transition from one cellular state to another. The results of the dynamic analysis suggest that the impact of embryo chromosomal aneuploidy on its development begins at the 5-cell stage and aligns with the theory of embryonic genome activation and the above morphological analysis results. From Table.8, it is evident that the aneuploidy of embryonic chromosomes affects the early development of embryos, but not all genes are involved in the early development of embryos. As shown in Table.9, based on the data included in this study, there is no evidence to suggest that single chromosome aneuploidies, such as chr-3, chr-7, chr-8, chr-10, chr-11, chr-12, chr-13, chr-15, chr-18, chr-20, and chr-21, have any influence on the morphokinetic of embryos from fertilization to the preimplantation stage. This suggests that for embryos that have developed to the blastocyst stage, the aforementioned chromosomal aneuploidies are not sufficient to impact the embryo from fertilization to the D5/D6 blastocyst stage; clinically, individuals with 8-trisomy [20] , 13-trisomy [21] , 18-trisomy [22] , 13-trisomy combined with 18-trisomy [23, 24] , and 21-trisomy can survive. It is necessary to further study whether other chromosomal abnormalities that do not affect early embryo development influence the embryo from implantation to birth. In comparison with euploidy embryos, most single chromosomal abnormal embryos that show statistically significant differences start to differ from t5 to t6. Among them, chr-16, chr-19, and chr-22 only affect the stage from blastocyst formation to the beginning of blastocyst formation. Numerous studies suggest that the most common chromosomal abnormalities leading to early miscarriage are 16-trisomy and 22-trisomy, which may have some connection and deserve our further exploration [25-28] . Chromosome 2 abnormality affects an even earlier stage of embryo development (tPNf, t2, t4). Therefore, if patients undergo PGT for chromosomal structural abnormalities, focusing on the statistically significant morphokinetic parameters corresponding to the abnormal chromosomes of both spouses when observing embryos would be more favorable for selecting embryos with a higher likelihood of being euploid. There are two limitations of this study, one is the embryos included in this study have all developed to the blastocyst stage. It was found that single aneuploidy in chr-3, chr-7, chr-8, chr-10, chr-11, chr-12, chr-13, chr-15, chr-18, chr-20 or chr-21 does not have an impact on the morphology or morphokinetic of embryos from fertilization to the blastocyst stage on the 5th or 6th day. However, for embryos that could not reached the blastocyst stage, further research is needed to determine the impact of the mentioned chromosomes on their development. And another is due to the limited sample size, this study only addresses single-chromosome abnormalities. The next step should involve enlarging the sample size to further investigate whether the impact of the absence or addition of a single chromosome on embryo development is consistent, and to identify specific chromosomal segments that effects embryos’ development in pre-implantation stage. Declarations Ethical Approval The study was approved by the Ethics Committee of the First Affiliated Hospital of Hainan Medical University (the PDF file is uploaded in the Related files ) Funding Funded by the Major Science and Technology Program of Hainan Province (ZDKJ2021037). Supported by the specific research fund of The Innovation Platform for Academicians of Hainan Province. Project supported by Hainan Province Clinical Medical Center. Availability of data and materials The datasets generated during the current study are available. Conflict of Interest The author declared that there is no conflict of interest that could be perceived as prejudicial to the impartiality of the reported research. Consent to publication All authors agreed to publish the manuscript. Acknowledgments The authors sincerely thank all participation in this study. Authors Contributions YH, YZ conceived and supervised the study, ZC, YY, and QZ collected datas, ZC worte the manuscript and YY, YM offered help. All authors read and approved the final version. References BRAUDE P, BOLTON V, MOORE S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development [J]. Nature, 1988, 332(6163): 459-61. HERNANDEZ MORA J R, BUHIGAS C, CLARK S, et al. Single-cell multi-omic analysis profiles defective genome activation and epigenetic reprogramming associated with human pre-implantation embryo arrest [J]. Cell reports, 2023, 42(2): 112100. YUAN P, GUO Q, GUO H, et al. The methylome of a human polar body reflects that of its sibling oocyte and its aberrance may indicate poor embryo development [J]. Human reproduction (Oxford, England), 2021, 36(2): 318-30. GIMéNEZ C, CONVERSA L, MURRIA L, et al. Time-lapse imaging: Morphokinetic analysis of in vitro fertilization outcomes [J]. Fertility and sterility, 2023, 120(2): 218-27. BAMFORD T, BARRIE A, MONTGOMERY S, et al. Morphological and morphokinetic associations with aneuploidy: a systematic review and meta-analysis [J]. Human reproduction update, 2022, 28(5): 656-86. DESAI N, GOLDBERG J M, AUSTIN C, et al. Are cleavage anomalies, multinucleation, or specific cell cycle kinetics observed with time-lapse imaging predictive of embryo developmental capacity or ploidy? [J]. Fertility and sterility, 2018, 109(4): 665-74. MINASI M G, COLASANTE A, RICCIO T, et al. Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study [J]. Human reproduction (Oxford, England), 2016, 31(10): 2245-54. KUMTEPE ÇOLAKOĞLU Y, TüFEKçI M, ÇıNAR YAPAN Ç, et al. Correlation Between Aneuploidy, Mosaicism and Morphokinetic Development in 1550 Biopsied Blastocysts [J]. Reproductive BioMedicine Online, 2019, 39. BRAGA D, SETTI A S, GUILHERME P, et al. Time-lapse monitoring: An adjunct tool to select embryos for preimplantation genetic testing [J]. Molecular reproduction and development, 2023, 90(6): 389-96. QING-YUN S, YUAN-JIE D, YUE W, et al. Correlation between blastocyst evaluation parameters and euploidy rate in PGT cycles of chromosomal structural abnormality[in chiese] [J]. Journal of Reproductive Medicine, 2021, 30(3): 304-12. FRANASIAK J M, FORMAN E J, HONG K H, et al. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening [J]. Fertility and sterility, 2014, 101(3): 656-63.e1. VERDYCK P, ALTARESCU G, SANTOS-RIBEIRO S, et al. Aneuploidy in oocytes from women of advanced maternal age: analysis of the causal meiotic errors and impact on embryo development [J]. Human reproduction (Oxford, England), 2023, 38(12): 2526-35. NOTHIAS J Y, MAJUMDER S, KANEKO K J, et al. Regulation of gene expression at the beginning of mammalian development [J]. The Journal of biological chemistry, 1995, 270(38): 22077-80. YAO Y Q, XU J S, LEE W M, et al. Identification of mRNAs that are up-regulated after fertilization in the murine zygote by suppression subtractive hybridization [J]. Biochemical and biophysical research communications, 2003, 304(1): 60-6. ASAMI M, LAM B Y H, MA M K, et al. Human embryonic genome activation initiates at the one-cell stage [J]. Cell stem cell, 2022, 29(2): 209-16.e4. YUAN Z, YUAN M, SONG X, et al. Development of an artificial intelligence based model for predicting the euploidy of blastocysts in PGT-A treatments [J]. Scientific reports, 2023, 13(1): 2322. BAMFORD T, EASTER C, MONTGOMERY S, et al. A comparison of 12 machine learning models developed to predict ploidy, using a morphokinetic meta-dataset of 8147 embryos [J]. Human reproduction (Oxford, England), 2023, 38(4): 569-81. MAJUMDAR G, MAJUMDAR A, VERMA I C, et al. Relationship Between Morphology, Euploidy and Implantation Potential of Cleavage and Blastocyst Stage Embryos [J]. Journal of human reproductive sciences, 2017, 10(1): 49-57. YOSHIDA I H, SANTOS M, BERTON C Z, et al. Can trophectoderm morphology act as a predictor for euploidy? [J]. JBRA assisted reproduction, 2018, 22(2): 113-5. GAGLIARDI A R, TAJARA E H, VARELLA-GARCIA M, et al. Trisomy 8 syndrome [J]. Journal of medical genetics, 1978, 15(1): 70-3. HU R S, HEFFERNAN J, SIMS J, et al. Trisomy 13: Survival beyond the NICU [J]. NeoReviews, 2023, 24(1): 51-6. SALDARRIAGA W, RENGIFO-MIRANDA H, RAMíREZ-CHEYNE J. [Trisomy 18 syndrome: A case report] [J]. Revista chilena de pediatria, 2016, 87(2): 129-36. CAREY J C. Survival Outcomes of Infants with the Trisomy 13 or Trisomy 18 Syndromes [J]. The Journal of pediatrics, 2022, 247: 11-3. WEAVER M S, ANDERSON V, BECK J, et al. Interdisciplinary care of children with trisomy 13 and 18 [J]. American journal of medical genetics Part A, 2021, 185(3): 966-77. JIA C W, WANG L, LAN Y L, et al. Aneuploidy in Early Miscarriage and its Related Factors [J]. Chinese medical journal, 2015, 128(20): 2772-6. YUAN S, LIAO C, LI D, et al. Chorionic villus cell culture and karyotype analysis in 1983 cases of spontaneous miscarriage[in Chinese] [J]. Chinese Journal of Obstetrics and Gynecology, 2017, 52(7): 461-6. QU S, WANG L, CAI A, et al. Exploring the cause of early miscarriage with SNP-array analysis and karyotyping [J]. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet, 2019, 32(1): 1-10. WANG Y, CHENG Q, MENG L, et al. Clinical application of SNP array analysis in first-trimester pregnancy loss: a prospective study [J]. Clinical genetics, 2017, 91(6): 849-58. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4349351","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":300090517,"identity":"41b0aea3-7b9e-4eb2-9e30-0405e72fb107","order_by":0,"name":"Zhihui Chen","email":"","orcid":"","institution":"The First Affiliated Hospital of Hainan Medical University, Hainan Medical University","correspondingAuthor":false,"prefix":"","firstName":"Zhihui","middleName":"","lastName":"Chen","suffix":""},{"id":300090519,"identity":"4209950c-7005-4914-9457-e85cfac04ded","order_by":1,"name":"Yufei Yao","email":"","orcid":"","institution":"The First Affiliated Hospital of Hainan Medical University, Hainan Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yufei","middleName":"","lastName":"Yao","suffix":""},{"id":300090521,"identity":"5c6f6750-ddb8-4449-9a3a-66d8071dd6fa","order_by":2,"name":"Yanlin Ma","email":"","orcid":"","institution":"The First Affiliated Hospital of Hainan Medical University, Hainan Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yanlin","middleName":"","lastName":"Ma","suffix":""},{"id":300090523,"identity":"df5787fe-37b0-4584-9beb-b2c6cdee012b","order_by":3,"name":"Qingfei Zhong","email":"","orcid":"","institution":"The First Affiliated Hospital of Hainan Medical University, Hainan Medical University","correspondingAuthor":false,"prefix":"","firstName":"Qingfei","middleName":"","lastName":"Zhong","suffix":""},{"id":300090525,"identity":"817c6d6e-6c2b-4e09-a8ea-dc095babfc78","order_by":4,"name":"Yu Zhang","email":"","orcid":"","institution":"The First 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University","correspondingAuthor":true,"prefix":"","firstName":"Yuanhua","middleName":"","lastName":"Huang","suffix":""}],"badges":[],"createdAt":"2024-04-30 13:17:33","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4349351/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4349351/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":56169918,"identity":"e409d137-aee6-450f-932f-b07833df866a","added_by":"auto","created_at":"2024-05-09 11:30:49","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1100300,"visible":true,"origin":"","legend":"\u003cp\u003ePronuclei Evaluation\u003c/p\u003e","description":"","filename":"Fig.1PronucleiEvaluation.png","url":"https://assets-eu.researchsquare.com/files/rs-4349351/v1/25d65a76ca2500d184a65f3e.png"},{"id":56169982,"identity":"38ab529c-ba00-4d7d-b474-bc49630fe850","added_by":"auto","created_at":"2024-05-09 11:31:38","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1144749,"visible":true,"origin":"","legend":"\u003cp\u003eCell Fragment\u003c/p\u003e","description":"","filename":"Fig.2CellFragment.png","url":"https://assets-eu.researchsquare.com/files/rs-4349351/v1/d4c43cc3007df237c450f067.png"},{"id":56169911,"identity":"e45c906d-b2c0-45b5-a911-aa400bdcf473","added_by":"auto","created_at":"2024-05-09 11:30:47","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":575859,"visible":true,"origin":"","legend":"\u003cp\u003eHeterogeneity of Blastomere\u003c/p\u003e","description":"","filename":"Fig.3HeterogeneityofBlastomere.png","url":"https://assets-eu.researchsquare.com/files/rs-4349351/v1/7d0a4ba0af68cfedef1a4500.png"},{"id":56169978,"identity":"654089c2-86f1-4711-8a7f-c796c1b0ef83","added_by":"auto","created_at":"2024-05-09 11:31:35","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":1204763,"visible":true,"origin":"","legend":"\u003cp\u003eGardner Criteria\u003c/p\u003e","description":"","filename":"Fig.4GardnerCriteria.png","url":"https://assets-eu.researchsquare.com/files/rs-4349351/v1/9e1192b77a61a0ccf9172ac1.png"},{"id":56170005,"identity":"f1a05ba8-e4e1-4e70-af20-61ced45d9b9b","added_by":"auto","created_at":"2024-05-09 11:32:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":6527117,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4349351/v1/4bdc4c61-24e3-4376-b565-2c3167feccdb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A retrospective investigation of the effects of chromosome aneuploidy on preimplantation embryos’ development: base on time-lapse","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eEmbryonic development is a manifestation of genome functionality following a programmed sequence. In other words, the genome controls the developmental process of an embryo. Consequently, embryos with normal genomes may exhibit developmental differences compared to those with abnormal genomes at specific stages. Previous research has suggested that the activation of the embryonic genome occurs during the 4-cell to 8-cell stage\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Prior to embryonic genome activation, maternally inherited genetic material carried by the oocyte controls embryo development. However, recent research suggests that genome activation takes place between the 2-cell and 4-cell stage, with the gradual clearance of maternal mRNA during the blastocyst stage\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Abnormal genome activation or excessive methylation can result in the developmental arrest of the embryo \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. In recent years, time-lapse incubator has gained extensive usage in the field of assisted reproduction. It combines an optical microscopy system with an embryo incubator to automatically capture images of embryos at defined intervals, accurately documenting the complete process from fertilization to blastocyst formation, and even hatching\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Consequently, it enables the observation of continuous morphological changes throughout embryo development and the precise timing of reaching distinct stages. Based on time-lapse, previous studies have established correlations between embryo morphology, development speed, and embryo chromosomal ploidy \u003csup\u003e[\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. For example, Y. Kumtep et al. discovered that the development speed of euploid embryos (at time points t2, t8, and tB) was faster than that of aneuploid embryos\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. BRAGA D et al. discovered that aneuploid embryos showed significantly longer tPNf, t2, t3, t4, t6, t7, t8, tM, tsB, and tB compared with euploidy embryos\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e.Using time-lapse, it was observed that euploid embryos had a faster development speed, higher scores for the quality of the trophectoderm and inner cell mass\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. However, various studies have reported statistically significant parameters that differ from one another.\u003c/p\u003e \u003cp\u003eIn conclusion, the utilization of time-lapse incubator allows the observation of chromosomal aneuploidy's impact on early embryo development. Nevertheless, not all genes participate in early embryo development. This study aims to retrospectively analyze the developmental parameters of embryos that underwent chromosomal aneuploidy screening using a time-lapse incubator. By analyzing the morphological and morphokinetic between euploid and aneuploid embryos, and combining the results of preimplantation genetic testing, our aim is to investigate the effects of specific chromosomal aneuploidy on preimplantation embryos.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003e\u003cstrong\u003ePatients and Study Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients who underwent preimplantation genetic testing (PGT) at the Reproductive Center of the First Affiliated Hospital of Hainan Medical University were enrolled in this study between June 2019 and September 2022. Inclusion criteria:\u0026nbsp;All embryos cultured in the time-lapse incubator Embryo Scope Plus (Vitrolife; Sweden)\u0026nbsp;until the 5th or 6th day followed by laser drilling for trophectoderm biopsy for genetic testing, Exclusion criteria:\u0026nbsp;(1) Embryos with mostly missing images; (2) Embryos with \u0026ge;2 morphokinetic parameters that cannot be annotated; (3)\u0026nbsp;Embryos that form blastocysts on the 7th day.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOvarian stimulation, oocyte retrieval, fertilization procedures, embryo culture and biopsy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ovarian stimulation protocol is selected based on the specific condition of the patient, and can include long protocol, short protocol, antagonist protocol, mild stimulation protocol. Gonadotropin included rFSH(Merck-Serono; Switzerland or GeneScience; China),FSH(Livzon; China),HMG(Livzon; China).\u0026nbsp;Antagonist was Cetrorelix(Baxter Oncology GmbH; Germany).The dosages were\u0026nbsp;adjusted according to a variety of clinical factors, including sex hormone levels, follicle count and follicle size. Oocytes were collected 32 to 36 h after triggering using hCG(Livzon; China). All oocytes were inseminated using intracytoplasmic sperm injection (ICSI) after the removal of cumulus cells, and all embryos were cultured until day 5 or 6 using time-lapse\u0026nbsp;incubator\u0026nbsp;(6% CO2,6% O2,37\u0026deg;C).\u0026nbsp;Three to five trophectoderm cells located farthest from the inner cell mass were gently aspirated and separated from the blastocyst through a zona pellucida opening created using a laser system.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGenetic testing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe biopsied cells were subjected to whole-genome amplification using the SurePlex or MDA. High-throughput sequencing was performed using the Ion Torrent sequencing system and Ion 318 Chip v2 (Thermo Fisher, USA) with a detection resolution of 4 Mb. The data was further analyzed using the PGXCloud bioinformatics platform (Jabrehoo; China).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMorphological and morphokinetic parameters\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"570\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.1\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eDefinition of morphological parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.82456140350877%\" valign=\"top\"\u003e\n \u003cp\u003eMorphological parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"80.17543859649123%\" valign=\"top\"\u003e\n \u003cp\u003eDescription\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.82456140350877%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePronuclei Evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"80.17543859649123%\" valign=\"top\"\u003e\n \u003cp\u003eZ1: The number and size of the nucleoli equal, and arranged in parallel at the junction of the two pronuclei; Z2: The number and size of the nucleoli are equal, and scattered in the two pronuclei; Z3: The number and size of the nucleoli are different, and arranged in parallel or scattered in the two pronuclei; Z4: Abnormal pronuclei morphology, two pronuclei scattered in the zygote, or different sizes (small pronuclear volume less than 1/2 of the volume of large pronuclear volume). As shown in\u003cstrong\u003e\u0026nbsp;Fig.1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.82456140350877%\" valign=\"top\"\u003e\n \u003cp\u003eCell Fragment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"80.17543859649123%\" valign=\"top\"\u003e\n \u003cp\u003eFragment in the embryo, which is cytoplasm wrapped by cell membrane without nucleus, divided into four grades: 0% ~ 5%, 6% ~ 20%, 21% ~ 50% and \u0026gt; 50%. As shown in \u003cstrong\u003eFig.2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.82456140350877%\" valign=\"top\"\u003e\n \u003cp\u003eHeterogeneity of Blastomere\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"80.17543859649123%\" valign=\"top\"\u003e\n \u003cp\u003eDivided into A, B and C grades (A: the two cells were round and similar in size; C: The volume of one blastomere is less than half that of the other or the blastomere is irregular; B is somewhere in between), as shown in \u003cstrong\u003eFig. 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.82456140350877%\" valign=\"top\"\u003e\n \u003cp\u003eGardner Criteria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"80.17543859649123%\" valign=\"top\"\u003e\n \u003cp\u003eRank according to the arrangement and the number of cells in the inner cell mass and trophoblast cells (A: more cells, closely arranged; B: Slightly fewer cells, loose connections; C: Very few cells).As shown in \u003cstrong\u003eFig.4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"582\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.2\u0026nbsp;\u003c/strong\u003eDefinition of morphokinetic parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003eMorphokinetic parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eDescription\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003etPB2（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eAppearance of second polar body\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003etPNa（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eAppearance of the first pronuclei\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003etPNf（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime when both pronuclei had faded\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003et2～t8（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime to 2-cell～8-cell blastomere\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003eCC2（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime of second cell cycle(t4-t3), from 2 to 4 cells\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003eS2（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime of synchrony of the second cycle (t4-t3), from 3 to 4 cells\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003eCC3（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime of third cell cycle (t8-t4), from 4 to 8 cells\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003eS3（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime of synchrony of the third cycle (t8-t5), from 5 to 8 cells\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003etSB（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime from insemination to start blastulation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003etB（h）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime form insemination to formation of a full blastocyst\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003etB-t8(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime from 8-cell blastomere to full blastocyst\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.83848797250859%\" valign=\"top\"\u003e\n \u003cp\u003etB-tSB(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.16151202749141%\" valign=\"top\"\u003e\n \u003cp\u003eTime from start blastulation to full blastocyst\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003et0: Time of insemination, when ICSI started\u003c/p\u003e\n\u003cp\u003eICSI: Intracytoplasmic sperm injection\u003c/p\u003e\n\u003cp\u003eCaptions of Fig.1to Fig.4 are described in \u003cstrong\u003e\u003cem\u003eTable.1\u003c/em\u003e\u003c/strong\u003e \u0026ldquo;Definition of morphological parameters\u0026rdquo;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSPSS (version 25.0; IBM, USA) was used for statistical analysis. Statistical methods included the Mann-Whitney U test (Since the quantitative data did not follow a normal distribution) and Chi-Square test.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eMorphological parameters and euploidy rates\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePronuclei evaluation\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e The embryos were classified into four groups (Z1 to Z4) based on the D1\u0026nbsp;pronuclei evaluation. A comparison was made between the inter-group euploidy rates to investigate potential differences in the D1\u0026nbsp;pronuclei evaluation\u0026nbsp;between euploid and aneuploid embryos. To account for the influence of maternal age on embryo euploidy\u003csup\u003e[11, 12]\u003c/sup\u003e, we conducted separate Chi-Square tests for the age groups \u0026lt;35 years and \u0026ge;35 years. The results, displayed in Table.3, indicated that all p-values were \u0026gt;0.05, signifying that the variations in euploidy rate across the Z1 to Z4 groups were not statistically significant. Thus, there was no observed distinction in the D1\u0026nbsp;pronuclei evaluation\u0026nbsp;between euploid and aneuploid embryos.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"547\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.3\u0026nbsp;\u003c/strong\u003ePronuclei Evaluation and Euploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.130841121495326%\"\u003e\n \u003cp\u003e\u0026nbsp;Female Age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.065420560747665%\"\u003e\n \u003cp\u003ePronuclei Evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.39252336448598%\"\u003e\n \u003cp\u003eEuploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.411214953271028%\"\u003e\n \u003cp\u003eChi-Square test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.130841121495326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.065420560747665%\"\u003e\n \u003cp\u003e\u0026nbsp;Z1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.39252336448598%\"\u003e\n \u003cp\u003e36.76% (25/68)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.411214953271028%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=5.001\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003cem\u003eP\u003c/em\u003e=0.172\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.326370757180158%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026lt;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.631853785900784%\"\u003e\n \u003cp\u003eZ2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"48.04177545691906%\"\u003e\n \u003cp\u003e44.12% (105/238)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.66433566433567%\"\u003e\n \u003cp\u003eZ3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"64.33566433566433%\"\u003e\n \u003cp\u003e47.89% (193/403)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.326370757180158%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"26.631853785900784%\"\u003e\n \u003cp\u003eZ4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"48.04177545691906%\"\u003e\n \u003cp\u003e32.00% (8/25)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.130841121495326%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"19.065420560747665%\"\u003e\n \u003cp\u003eZ1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.39252336448598%\"\u003e\n \u003cp\u003e30.19% (16/53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.411214953271028%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=0.210\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.976\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.326370757180158%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026ge;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.631853785900784%\"\u003e\n \u003cp\u003eZ2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"48.04177545691906%\"\u003e\n \u003cp\u003e30.93% (60/194)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.66433566433567%\"\u003e\n \u003cp\u003eZ3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"64.33566433566433%\"\u003e\n \u003cp\u003e31.09% (74/238)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.326370757180158%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"26.631853785900784%\"\u003e\n \u003cp\u003eZ4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"48.04177545691906%\"\u003e\n \u003cp\u003e25.00% (3/12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eCell Fragment:\u0026nbsp;\u003c/strong\u003eThe embryos were divided into three groups based on the degree of cell fragmentation on D2 and D3 (0% to 5%, 6% to 20%, 21% to 50%), and no embryos with cell fragmentation greater than 50% were collected. As shown in Table.4, all P-values were \u0026gt;0.05, demonstrating that the differences in euploidy rates among the three groups of embryos were not statistically significant. Therefore, the degree of cell fragmentation on D2 and D3 does not reflect the euploidy of embryos.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable.4\u0026nbsp;\u003c/strong\u003eCell Fragment and Euploidy Rate\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"547\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.256410256410257%\"\u003e\n \u003cp\u003eFemale Age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.003663003663004%\"\u003e\n \u003cp\u003eCell Fragment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.71062271062271%\"\u003e\n \u003cp\u003eD2 Euploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.835164835164836%\" valign=\"top\"\u003e\n \u003cp\u003eChi-Square test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.71062271062271%\"\u003e\n \u003cp\u003eD3 Euploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.483516483516482%\" valign=\"top\"\u003e\n \u003cp\u003eChi-Square test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.256410256410257%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.003663003663004%\"\u003e\n \u003cp\u003e0%-5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.71062271062271%\"\u003e\n \u003cp\u003e44.14% (241/546)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.835164835164836%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=0.983\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.71062271062271%\" valign=\"top\"\u003e\n \u003cp\u003e43.68% (197/451)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.483516483516482%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=1.641\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.440\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.933333333333334%\"\u003e\n \u003cp\u003e\u0026lt;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.933333333333334%\"\u003e\n \u003cp\u003e6%-20%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\"\u003e\n \u003cp\u003e47.40% (82/172)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e48.41% (122/252)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.933333333333334%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"18.933333333333334%\"\u003e\n \u003cp\u003e21%-50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\"\u003e\n \u003cp\u003e53.33% (8/15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e41.38% (12/29)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.256410256410257%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"13.003663003663004%\"\u003e\n \u003cp\u003e0%-5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.71062271062271%\"\u003e\n \u003cp\u003e32.19% (122/379)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.835164835164836%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=1.212\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.538\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.71062271062271%\" valign=\"top\"\u003e\n \u003cp\u003e32.72% (107/327)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.483516483516482%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=2.964\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.933333333333334%\"\u003e\n \u003cp\u003e\u0026ge;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.933333333333334%\"\u003e\n \u003cp\u003e6%-20%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\"\u003e\n \u003cp\u003e26.79% (30/112)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e26.14% (40/153)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.933333333333334%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"18.933333333333334%\"\u003e\n \u003cp\u003e21%-50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\"\u003e\n \u003cp\u003e28.57% (2/7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.06666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e41.18% (7/17)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e#\u003c/sup\u003eFor 33.33% of theoretical frequency \u0026lt;5, Pearson Chi-square test is not applicable, so Monte Carlo approximation is used to calculate Chi-square value and asymptotic significance\u003c/p\u003e\n\u003cp\u003eD2: The second day after ICSI, D3: The third day after ICSI\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHeterogeneity of Blastomere:\u003c/strong\u003e The embryos were classified into three groups (A, B, C; description shown in Table.1) based on the heterogeneity of blastomere on D2 and D3. The results, as shown in Table.5, indicated that the P-values for the Chi-Square tests for the euploidy rates among the three groups of D2 embryos were all \u0026gt;0.05, demonstrating that the differences were not statistically significant. For the D3 embryos, when the woman\u0026apos;s age was \u0026ge;35y, the P-values were all \u0026gt;0.05, showing no statistically significant difference. However, for embryos of women aged \u0026lt;35y, the P-value was \u0026lt;0.05, indicating a significant difference in the euploidy rates among the three groups. Comparing the three groups pairwise, the difference in euploidy rate was statistically significant between groups A and B, while the differences between groups A and C, and B and C, were not statistically significant.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"571\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.5\u0026nbsp;\u003c/strong\u003eHeterogeneity of\u0026nbsp;Blastomere\u0026nbsp;and Euploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.664335664335665%\" valign=\"top\"\u003e\n \u003cp\u003eFemale Age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.132867132867133%\" valign=\"top\"\u003e\n \u003cp\u003eHeterogeneity of\u0026nbsp;Blastomere\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.62937062937063%\" valign=\"top\"\u003e\n \u003cp\u003eD2 Euploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25874125874126%\" valign=\"top\"\u003e\n \u003cp\u003eChi-Square test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.454545454545453%\"\u003e\n \u003cp\u003eD3 Euploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86013986013986%\" valign=\"top\"\u003e\n \u003cp\u003eChi-Square test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.664335664335665%\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.132867132867133%\" valign=\"top\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.62937062937063%\" valign=\"top\"\u003e\n \u003cp\u003e50.00% (40/80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25874125874126%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=2.679\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.454545454545453%\" valign=\"top\"\u003e\n \u003cp\u003e62.71% (37/59) \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86013986013986%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=8.202\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.017\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.48223350253807%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.873096446700508%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.949238578680202%\" valign=\"top\"\u003e\n \u003cp\u003e43.55% (253/581)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.695431472081218%\" valign=\"top\"\u003e\n \u003cp\u003e43.24%(243/562)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.48223350253807%\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"24.873096446700508%\" valign=\"top\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.949238578680202%\" valign=\"top\"\u003e\n \u003cp\u003e52.05% (38/73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.695431472081218%\" valign=\"top\"\u003e\n \u003cp\u003e45.95%(51/111)\u003csup\u003ea,b\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.664335664335665%\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"17.132867132867133%\" valign=\"top\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.62937062937063%\" valign=\"top\"\u003e\n \u003cp\u003e34.29% (24/70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25874125874126%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=0.886\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.642\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.454545454545453%\" valign=\"top\"\u003e\n \u003cp\u003e40.48% (17/42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86013986013986%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=4.349\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e=0.114\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.48223350253807%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.873096446700508%\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.949238578680202%\" valign=\"top\"\u003e\n \u003cp\u003e29.87% (115/385)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.695431472081218%\" valign=\"top\"\u003e\n \u003cp\u003e31.28% (127/406)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.48223350253807%\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"24.873096446700508%\" valign=\"top\"\u003e\n \u003cp\u003eC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.949238578680202%\" valign=\"top\"\u003e\n \u003cp\u003e34.88% (15/43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.695431472081218%\" valign=\"top\"\u003e\n \u003cp\u003e20.41% (10/49)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003eSignificant differences by two-tailed Pearson chi-square test\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea,b\u0026nbsp;\u003c/sup\u003eDifferent superscript letters indicate significant differences among groups (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05)\u003c/p\u003e\n\u003cp\u003eD2: The second day after ICSI, D3: The third day after ICSI\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGardner Criteria:\u0026nbsp;\u003c/strong\u003eBlastocysts were categorized into four groups based on Gardner Criteria of inner cell mass (ICM) and trophectoderm (TE) for comparison of their euploidy rates. The groups included Top group = AA (n=595), Good group = AB, BA, BB (n=823), Fair group = AC, BC, CA, CB (n=465), and Poor group = CC (n=5). For the small number of embryos in the poor group (n=5), they were excluded from the analysis. As shown in Table.6, regardless of maternal age, the euploidy rate of embryos decreased with a decrease in Gardner grading levels, with all P-values \u0026lt; 0.001. There was a significant difference in euploidy rates among the three groups. Further pairwise comparisons revealed that when the woman was \u0026lt;35y, the differences between the Top and Good groups, as well as between the Good and Fair groups, were statistically significant, while the difference between the Top and Good groups was not statistically significant. When the woman was \u0026ge;35y, the differences between the Top and Fair groups, as well as between the Top and Good groups, were both statistically significant, while the difference between the Good and Fair groups was not statistically significant. In conclusion, the Gardner Criteria of blastocysts is associated with the euploidy of embryos, especially for older women. The euploidy rate for the Fair group (AC, BC, CA, CB) was 15.75%. When either the ICM or TE is graded as C, the euploidy rate significantly decreases.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"543\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.6\u0026nbsp;\u003c/strong\u003eGardner Criteria and Euploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.3646408839779%\"\u003e\n \u003cp\u003eFemale Age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.941068139963168%\"\u003e\n \u003cp\u003eGardner Criteria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.70165745856354%\"\u003e\n \u003cp\u003eEuploidy Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.992633517495396%\"\u003e\n \u003cp\u003eChi-Square test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.3646408839779%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"23.941068139963168%\" valign=\"top\"\u003e\n \u003cp\u003eTop\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.70165745856354%\"\u003e\n \u003cp\u003e53.25% (131/246)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.992633517495396%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=17.410\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.948849104859335%\"\u003e\n \u003cp\u003e\u0026lt;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.248081841432224%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"46.80306905370844%\"\u003e\n \u003cp\u003e45.10% (152/337)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.948849104859335%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"33.248081841432224%\" valign=\"top\"\u003e\n \u003cp\u003eFair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"46.80306905370844%\"\u003e\n \u003cp\u003e31.79% (48/151)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.3646408839779%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"23.941068139963168%\" valign=\"top\"\u003e\n \u003cp\u003eTop\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.70165745856354%\"\u003e\n \u003cp\u003e55.78% (82/147)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.992633517495396%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e=62.451\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.948849104859335%\"\u003e\n \u003cp\u003e\u0026ge;35y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.248081841432224%\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"46.80306905370844%\"\u003e\n \u003cp\u003e23.21% (52/224)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.948849104859335%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"33.248081841432224%\" valign=\"top\"\u003e\n \u003cp\u003eFair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"46.80306905370844%\"\u003e\n \u003cp\u003e15.75% (20/127)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003eSignificant differences by two-tailed Pearson chi-square test\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea,b\u0026nbsp;\u003c/sup\u003eDifferent superscript letters indicate significant differences among groups (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMorphokinetic parameters and euploidy rates\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFemale Age:\u003c/strong\u003e The female age was grouped by whether it was advanced maternal age or not. The differences in 18 morphokinetic parameters and 2 AI scores between groups were compared. As shown in Table.7, the differences in parameters such as tPB2, tPNa, t3, t4, t5, t6, t7, t8, tSB, tB, tB-tSB, KIDScore, iDAScore, were statistically significant with P \u0026lt; 0.05. Combined with the median, it can be seen that embryos from females aged \u0026lt;35y develop faster at time points such as tPB2, tPNa, t3, t4, t5, t6, t7, t8, tSB, tB, with the time interval from blastocyst formation to blastocyst formation being shorter compared to embryos from females aged \u0026ge;35y, and both KIDScore and iDAScore scores are higher.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"598\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.7\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eFemale Age and\u0026nbsp;Morphokinetic Parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMorphokinetic Parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;35y（n=1044）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;35y（n=844）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.712854757929883%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMann-Whitney U test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.525252525252526%\"\u003e\n \u003cp\u003eM（P25，P75）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.93939393939394%\"\u003e\n \u003cp\u003eM（P25，P75）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\" valign=\"top\"\u003e\n \u003cp\u003eZ-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.353535353535353%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eP-\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etPB2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e3.54(2.97,4.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e3.71(3.06,4.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.685\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.007\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etPNa(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e18.85(17.82,19.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e19.33(18.20,20.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-5.972\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etPNf(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e23.22(21.44,25.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e23.44(21.79,25.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.832\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e25.73(23.84,27.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e25.83(24.11,27.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.452\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et3(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e35.91(33.00,38.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e36.41(33.99,38.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026nbsp;0.007\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et4(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e37.25(33.00,38.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e37.62(35.32,40.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.074\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.038\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eCC2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e11.57(10.69,12.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e11.69(10.86,12.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.774\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eS2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e0.42(0.21,1.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e0.42(0.21,1.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-0.444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.657\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et5(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e48.72(43.80,53.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e49.45(45.17,53.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.785\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.005\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et6(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e55.30(50.96,61.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e55.96(51.62,63.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.031\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et7(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e55.57(51.20,61.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e56.23(51.91,63.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.032\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et8(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e55.63(51.22,61.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e56.28(51.94,63.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.033\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eCC3(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e17.58(14.82,23.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e17.77(15.36,23.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.891\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eS3(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e5.47(2.50,15.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e5.18(2.52,14.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-0.545\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.586\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etSB(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e97.20(91.80,103.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e98.31(92.69,104.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.027\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etB(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e105.80(100.13,113.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e107.74(102.09,114.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-3.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etB-t8(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e49.36(43.67.55.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e50.27(444.36,57.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etB-tSB(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e8.85(6.42,11.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e9.40(6.50,11.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.812\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.005\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eKIDScore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e6.20(4.60,8.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e5.80(4.40,7.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.741\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.006\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eiDAScore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e8.50(7.30,9.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e8.30(7.00,9.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.034\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003eSignificant differences by two-tailed\u0026nbsp;Mann-Whitney U test\u003c/p\u003e\n\u003cp\u003eM=\u0026nbsp;Median, P25= Lower Quartile, P75= Upper Quartile\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEmbryonic Euploidy\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eAs shown in Table.8, comparing the 18 parameters and 2 AI scores between\u0026nbsp;euploidy\u0026nbsp;embryos and aneuploidy\u0026nbsp;embryos, the results indicate that the\u0026nbsp;euploid\u0026nbsp;develops faster at time points such as t5, t6, t7, t8, tSB, and tB compared to aneuploid, with a shorter time interval from the 8-cell stage to blastocyst formation, and from the initiation of blastocyst formation to formation. The third cleavage cycle (CC3) also takes less time, and the differences are statistically significant. The KIDScore and iDAScore\u0026nbsp;scores\u0026nbsp;are also significantly higher.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"598\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.8\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eEmbryonic Euploidy\u0026nbsp;and\u0026nbsp;Morphokinetic Parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMorphokinetic Parameters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\" valign=\"top\"\u003e\n \u003cp\u003eEuploid（n=724）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\" valign=\"top\"\u003e\n \u003cp\u003eAneuploid（n=1164）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.712854757929883%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMann-Whitney U test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.525252525252526%\"\u003e\n \u003cp\u003eM（P25，P75）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.93939393939394%\"\u003e\n \u003cp\u003eM（P25，P75）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\" valign=\"top\"\u003e\n \u003cp\u003eZ-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.353535353535353%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eP-\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etPB2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e3.63(3.07,4.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e3.59(3.00,4.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-0.934\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etPNa(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e19.03(17.99,20.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e19.05(18.00,20.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-0.927\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.354\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etPNf(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e23.30(21.58,25.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e23.35(21.63,25.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.074\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.283\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e25.77(23.94,27.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e25.82(23.90,27.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-0.643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et3(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e35.93(33.18,38.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e36.35(33.70,38.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.790\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et4(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e37.19(35.06,39.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e37.51(35.15,40.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eCC2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e11.56(10.71,12.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e11.66（10.82,12.60）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.584\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.113\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eS2(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\" valign=\"top\"\u003e\n \u003cp\u003e0.42(0.21,1.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\" valign=\"top\"\u003e\n \u003cp\u003e0.42（0.21,1.18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\" valign=\"top\"\u003e\n \u003cp\u003e-0.485\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\" valign=\"top\"\u003e\n \u003cp\u003e0.627\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et5(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e48.53(43.82,52.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e49.42（44.85,53.44）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-2.476\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.013\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et6(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e54.94(50.96,60.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e56.06（51.29,63.47）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-3.107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.002\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et7(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e55.16(51.10,60.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e56.37（51.62,63.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-3.491\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003et8(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e55.20(51.14,60.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e56.40(51.66,63.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-3.531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eCC3(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e17.15(14.84,21.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e18.22(15.17,25.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-3.568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eS3(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e5.04(2.46,14.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e5.71(2.56,15.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-1.479\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.139\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etSB(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e96.56(91.18,102.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e98.36(92.70,104.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-4.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etB(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e105.44(99.49,111.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e107.86(101.72,115.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-5.782\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etB-t8(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e48.65(43.75,54.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e50.48(44.14,57.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-3.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e0.002\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003etB-tSB(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e8.71(6.45,10.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e9.41(6.45,12.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-4.127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eKIDScore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e6.7(4.9,8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e5.6(4.3,7.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-7.804\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.362270450751254%\" valign=\"top\"\u003e\n \u003cp\u003eiDAScore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.87813021702838%\"\u003e\n \u003cp\u003e8.8(7.8,9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.046744574290486%\"\u003e\n \u003cp\u003e8.2(6.7,9.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.025041736227045%\"\u003e\n \u003cp\u003e-7.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.687813021702839%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003eSignificant differences by two-tailed\u0026nbsp;Mann-Whitney U test\u003c/p\u003e\n\u003cp\u003eM=\u0026nbsp;Median, P25= Lower Quartile, P75= Upper Quartile\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSingle Chromosome Abnormal:\u003c/strong\u003e The development process of the embryo is controlled by the genome. As indicated in Table.8, it is known that the non-ploidy of embryonic chromosomes has an impact on the early development of the embryo. However, not all genes affect the early development of the embryo. We want to further explore the effects of specific chromosome aneuploidy on pre-implantation embryos. Therefore, the morphokinetic parameters of embryos with aneuploidy in single chromosomes were analyzed and compared with euploidy embryos.\u003c/p\u003e\n\u003cp\u003eThe morphokinetic parameters of embryos with aneuploidy in single chromosomes were separately compared with euploid using the Mann-Whitney U test. Due to the large number of original data tables, it is not possible to present them one by one, so the statistically significant differences in morphokinetic parameters are summarized in Table. 9. As shown in Table. 9, based on the data included in this study, there is no evidence to suggest that single chromosome aneuploidies, such as\u0026nbsp;chr-3,\u0026nbsp;chr-7,\u0026nbsp;chr-8,\u0026nbsp;chr-10,\u0026nbsp;chr-11,\u0026nbsp;chr-12,\u0026nbsp;chr-13,\u0026nbsp;chr-15,\u0026nbsp;chr-18,\u0026nbsp;chr-20, and\u0026nbsp;chr-21, have any influence on the morphokinetic of embryos from fertilization to the preimplantation stage.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"585\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable.9\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eMorphokinetic Parameters between Euploid and Single Chromosome Abnormal Embryos\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eAbnormal Chromosome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eMorphokinetic Parameters that Have\u0026nbsp;Significant Differences by\u0026nbsp;Mann-Whitney U test Between Groups\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 1（n=18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003et7、t8、CC3、S3、tSB、tB、\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 2（n=21）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003etPNf、t2、t4、tSB、tB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome3（n=17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 4（n=22）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003et6、t7、t8、CC3、tB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 5（n=14）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003et5、t7、t8、CC3、\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 6（n=6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003et6、tB-t8、KIDScore\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 7（n=20）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 8（n=12）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 9（n=19）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003et6、t7、t8、CC3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome10（n=10）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 11（n=21）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 12（n=8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 13（n=25）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome 14（n=27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003etSB、tB、tB-t8、tB-tSB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome15（n=27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome16（n=45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003etB-tSB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome17（n=9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003etPNa、tB、tB-t8、tB-tSB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome18（n=7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome19（n=24）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003etB-tSB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome20（n=7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome21（n=27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome22（n=49）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003etB-tSB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome X（n=9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003etPB2、t8、CC3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.11965811965812%\" valign=\"top\"\u003e\n \u003cp\u003eChromosome Y（n=3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.88034188034188%\"\u003e\n \u003cp\u003eS3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe development of the embryo is controlled by the genome. Before the activation of the embryonic genome, the development of the embryo is controlled by maternal genetic material. Research by Braude et al. in 1988 suggested that the human embryonic genome is activated during the 4-cell to 8-cell stage\u003csup\u003e[1]\u003c/sup\u003e. Subsequent studies have also confirmed that the activation of the embryonic genome mainly occurs during the 4-cell to 8-cell stage\u003csup\u003e[13]\u003c/sup\u003e. Some studies have indicated the activation of the embryonic genome before the 4-cell stage. For example, YAO Y et al. found that the transcription-related genes of zygote began to be expressed 24 hours after fertilization\u003csup\u003e[14]\u003c/sup\u003e, and Asami M et al. discovered the activation of the embryonic genome at the 1-cell stage\u003csup\u003e[15]\u003c/sup\u003e. In 2023, Hernandez JR et al.found through single-cell sequencing that the expression of the male sex-determining gene (SRY) peaks at the 2-cell stage, the eukaryotic transcription initiation factor (EIF1AY) gradually activates from the 2-cell stage to the blastocyst stage, and maternal mRNA in the oocyte is gradually cleared at the blastocyst stage, confirming the activation of the embryonic genome during the 2-cell to 4-cell stage\u003csup\u003e[2]\u003c/sup\u003e. However, the activation of the embryo\u0026apos;s genome does not mean that the embryo\u0026rsquo;s development shifts from being controlled by maternal genetic material to being controlled by the embryo\u0026rsquo;s genome completely.\u003c/p\u003e\n\u003cp\u003eFrom Table.4 to Table.6, it is evident that regardless of whether the woman is advanced maternal age or not, there is no statistically significant difference in the D1\u0026nbsp;pronuclei evaluation, D2 or D3 cell fragmentation, as well as the cell\u0026nbsp;heterogeneity\u0026nbsp;of D2 between euploid and aneuploid embryos. In the case of the\u0026nbsp;heterogeneity\u0026nbsp;of D3, when the maternal age is less than 35y, the rate of euploidy in embryos graded as A is higher than those graded as B or C, with the difference between A and B being statistically significant, while the difference between A and C is not statistically significant. The difference in the rate of euploidy between B and C embryos is also not statistically significant. At D3, embryos are generally at the 8-cell stage, with the embryonic genome already activated. Therefore, the difference in the rate of euploidy between embryos graded as A and B is statistically significant, while the differences between A and C, and B and C are not significant. This may be due to the fact that the sample size of A and C is less than B, and further research is needed to increase the data for verification. When the woman\u0026apos;s age is 35y or older, there is also no statistically significant difference in the rate of euploidy among the three groups, perhaps because the increased rate of aneuploidy due to advanced maternal age has masked the differences among the groups.\u003c/p\u003e\n\u003cp\u003eIn the blastocyst stage, maternal mRNA gradually degrades, indicating a shift in embryonic development from maternal control to embryonic genome control, with morphological manifestations of aneuploidy. When the woman is under 35y, there is no significant statistical difference in euploidy rates between groups with ICM and TE graded as A or B; however, a significant decrease in euploidy rates is observed when either the ICM or TE is graded as C. In women aged 35y or older, there is no significant statistical difference in euploidy rates between groups with ICM and TE graded as B or C, but both are significantly lower than those graded as AA. As mentioned prior the grading of ICM and TE in blastocysts is closely associated with embryonic euploidy, with lower rates of euploidy linked to poorer grading. This is particularly noticeable in older women, where the influence of age on the embryonic euploidy rate is compounded. Notably, when either the ICM or the TE is assigned a C grade (i.e., AC, BC, CA, CB), there is a significant decrease in euploidy rates to 15.75%. This is consistent with many studies\u003csup\u003e[16-19]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eAs shown in Table.7, the differences in the morphokinetic\u0026nbsp;parameters\u0026nbsp;between groups were compared according to whether the woman was of advanced maternal age. It was found that the woman\u0026apos;s age has an impact on the embryonic dynamics from the appearance of the second polar body(tPB2) to the formation of the blastocyst(tB). Combining the median values, it was observed that the embryos of women aged \u0026lt;35y develop faster than those of women aged \u0026ge;35y, with higher AI model scores. This further confirms that the development before embryonic genome activation is controlled by maternal genetic material, and the maternal mRNA gradually clears until the blastocyst stage, indicating the maternal genetic material\u0026apos;s influence on the embryo from fertilization until implantation.\u003c/p\u003e\n\u003cp\u003eShown in Table.8, it was found that the differences in t5, t6, t7, t8, CC3, tSB, tB, tB-t8, and tB-tSB between aneuploidy embryos and euploidy embryos were statistically significant，and euploidy embryos developed faster than aneuploidy embryos, requiring less time to transition from one cellular state to another. The results of the dynamic analysis suggest that the impact of embryo chromosomal aneuploidy on its development begins at the 5-cell stage and aligns with the theory of embryonic genome activation and the above morphological analysis results.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFrom Table.8, it is evident that the aneuploidy of embryonic chromosomes affects the early development of embryos, but not all genes are involved in the early development of embryos. As shown in Table.9, based on the data included in this study,\u0026nbsp;there is no evidence to suggest that single chromosome aneuploidies, such as chr-3, chr-7, chr-8, chr-10, chr-11, chr-12, chr-13, chr-15, chr-18, chr-20, and chr-21, have any influence on the morphokinetic of embryos from fertilization to the preimplantation stage.\u0026nbsp;This suggests that for embryos that have developed to the blastocyst stage, the aforementioned chromosomal aneuploidies are not sufficient to impact the embryo from fertilization to the D5/D6 blastocyst stage; clinically, individuals with 8-trisomy\u003csup\u003e[20]\u003c/sup\u003e, 13-trisomy\u003csup\u003e[21]\u003c/sup\u003e, 18-trisomy\u003csup\u003e[22]\u003c/sup\u003e, 13-trisomy combined with 18-trisomy\u003csup\u003e[23, 24]\u003c/sup\u003e, and 21-trisomy can survive. It is necessary to further study whether other chromosomal abnormalities that do not affect early embryo development influence the embryo from implantation to birth.\u003c/p\u003e\n\u003cp\u003eIn comparison with euploidy embryos, most single chromosomal abnormal embryos that show statistically significant differences start to differ from t5 to t6. Among them,\u0026nbsp;chr-16,\u0026nbsp;chr-19, and\u0026nbsp;chr-22 only affect the stage from blastocyst formation to the beginning of blastocyst formation. Numerous studies suggest that the most common chromosomal abnormalities leading to early miscarriage are 16-trisomy and 22-trisomy, which may have some connection and deserve our further exploration\u003csup\u003e[25-28]\u003c/sup\u003e. Chromosome 2 abnormality affects an even earlier stage of embryo development (tPNf, t2, t4). Therefore, if patients undergo PGT for chromosomal structural abnormalities, focusing on the statistically significant\u0026nbsp;morphokinetic\u0026nbsp;parameters corresponding to the abnormal chromosomes of both spouses when observing embryos would be more favorable for selecting embryos with a higher likelihood of being euploid.\u003c/p\u003e\n\u003cp\u003eThere are two limitations of this study, one is the embryos included in this study have all developed to the blastocyst stage. It was found that single aneuploidy in chr-3, chr-7, chr-8, chr-10, chr-11, chr-12, chr-13, chr-15, chr-18, chr-20 or chr-21 does not have an impact on the morphology or morphokinetic of embryos from fertilization to the blastocyst stage on the 5th or 6th day. However, for embryos that could not reached the blastocyst stage, further research is needed to determine the impact of the mentioned chromosomes on their development. And another is due to the limited sample size, this study only addresses single-chromosome abnormalities. The next step should involve enlarging the sample size to further investigate whether the impact of the absence or addition of a single chromosome on embryo development is consistent, and to identify specific chromosomal segments that effects embryos\u0026rsquo; development in pre-implantation stage.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics Committee of the First Affiliated Hospital of Hainan Medical University (the PDF file is uploaded in the \u003cem\u003eRelated files\u003c/em\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFunded by the Major Science and Technology Program of Hainan Province (ZDKJ2021037).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSupported by the specific research fund of The Innovation Platform for Academicians of Hainan Province.\u003c/p\u003e\n\u003cp\u003eProject supported by Hainan Province Clinical Medical Center.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during the current study are available.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declared that there is no conflict of interest that could be perceived as prejudicial to\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ethe impartiality of the reported research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors agreed to publish the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors sincerely thank all participation in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYH, YZ conceived and supervised the study, ZC, YY, and QZ collected datas, ZC worte the manuscript and YY, YM offered help. All authors read and approved the final version.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBRAUDE P, BOLTON V, MOORE S. Human gene expression first occurs between the four- and eight-cell stages of preimplantation development [J]. Nature, 1988, 332(6163): 459-61.\u003c/li\u003e\n\u003cli\u003eHERNANDEZ MORA J R, BUHIGAS C, CLARK S, et al. Single-cell multi-omic analysis profiles defective genome activation and epigenetic reprogramming associated with human pre-implantation embryo arrest [J]. Cell reports, 2023, 42(2): 112100.\u003c/li\u003e\n\u003cli\u003eYUAN P, GUO Q, GUO H, et al. The methylome of a human polar body reflects that of its sibling oocyte and its aberrance may indicate poor embryo development [J]. Human reproduction (Oxford, England), 2021, 36(2): 318-30.\u003c/li\u003e\n\u003cli\u003eGIM\u0026eacute;NEZ C, CONVERSA L, MURRIA L, et al. Time-lapse imaging: Morphokinetic analysis of in vitro fertilization outcomes [J]. Fertility and sterility, 2023, 120(2): 218-27.\u003c/li\u003e\n\u003cli\u003eBAMFORD T, BARRIE A, MONTGOMERY S, et al. Morphological and morphokinetic associations with aneuploidy: a systematic review and meta-analysis [J]. Human reproduction update, 2022, 28(5): 656-86.\u003c/li\u003e\n\u003cli\u003eDESAI N, GOLDBERG J M, AUSTIN C, et al. Are cleavage anomalies, multinucleation, or specific cell cycle kinetics observed with time-lapse imaging predictive of embryo developmental capacity or ploidy? [J]. Fertility and sterility, 2018, 109(4): 665-74.\u003c/li\u003e\n\u003cli\u003eMINASI M G, COLASANTE A, RICCIO T, et al. Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study [J]. Human reproduction (Oxford, England), 2016, 31(10): 2245-54.\u003c/li\u003e\n\u003cli\u003eKUMTEPE \u0026Ccedil;OLAKOĞLU Y, T\u0026uuml;FEK\u0026ccedil;I M, \u0026Ccedil;ıNAR YAPAN \u0026Ccedil;, et al. Correlation Between Aneuploidy, Mosaicism and Morphokinetic Development in 1550 Biopsied Blastocysts [J]. Reproductive BioMedicine Online, 2019, 39.\u003c/li\u003e\n\u003cli\u003eBRAGA D, SETTI A S, GUILHERME P, et al. Time-lapse monitoring: An adjunct tool to select embryos for preimplantation genetic testing [J]. Molecular reproduction and development, 2023, 90(6): 389-96.\u003c/li\u003e\n\u003cli\u003eQING-YUN S, YUAN-JIE D, YUE W, et al. Correlation between blastocyst evaluation parameters and euploidy rate in PGT cycles of chromosomal structural abnormality[in chiese] [J]. Journal of Reproductive Medicine, 2021, 30(3): 304-12.\u003c/li\u003e\n\u003cli\u003eFRANASIAK J M, FORMAN E J, HONG K H, et al. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening [J]. Fertility and sterility, 2014, 101(3): 656-63.e1.\u003c/li\u003e\n\u003cli\u003eVERDYCK P, ALTARESCU G, SANTOS-RIBEIRO S, et al. Aneuploidy in oocytes from women of advanced maternal age: analysis of the causal meiotic errors and impact on embryo development [J]. Human reproduction (Oxford, England), 2023, 38(12): 2526-35.\u003c/li\u003e\n\u003cli\u003eNOTHIAS J Y, MAJUMDER S, KANEKO K J, et al. Regulation of gene expression at the beginning of mammalian development [J]. The Journal of biological chemistry, 1995, 270(38): 22077-80.\u003c/li\u003e\n\u003cli\u003eYAO Y Q, XU J S, LEE W M, et al. Identification of mRNAs that are up-regulated after fertilization in the murine zygote by suppression subtractive hybridization [J]. Biochemical and biophysical research communications, 2003, 304(1): 60-6.\u003c/li\u003e\n\u003cli\u003eASAMI M, LAM B Y H, MA M K, et al. Human embryonic genome activation initiates at the one-cell stage [J]. Cell stem cell, 2022, 29(2): 209-16.e4.\u003c/li\u003e\n\u003cli\u003eYUAN Z, YUAN M, SONG X, et al. Development of an artificial intelligence based model for predicting the euploidy of blastocysts in PGT-A treatments [J]. Scientific reports, 2023, 13(1): 2322.\u003c/li\u003e\n\u003cli\u003eBAMFORD T, EASTER C, MONTGOMERY S, et al. A comparison of 12 machine learning models developed to predict ploidy, using a morphokinetic meta-dataset of 8147 embryos [J]. Human reproduction (Oxford, England), 2023, 38(4): 569-81.\u003c/li\u003e\n\u003cli\u003eMAJUMDAR G, MAJUMDAR A, VERMA I C, et al. Relationship Between Morphology, Euploidy and Implantation Potential of Cleavage and Blastocyst Stage Embryos [J]. Journal of human reproductive sciences, 2017, 10(1): 49-57.\u003c/li\u003e\n\u003cli\u003eYOSHIDA I H, SANTOS M, BERTON C Z, et al. Can trophectoderm morphology act as a predictor for euploidy? [J]. JBRA assisted reproduction, 2018, 22(2): 113-5.\u003c/li\u003e\n\u003cli\u003eGAGLIARDI A R, TAJARA E H, VARELLA-GARCIA M, et al. Trisomy 8 syndrome [J]. Journal of medical genetics, 1978, 15(1): 70-3.\u003c/li\u003e\n\u003cli\u003eHU R S, HEFFERNAN J, SIMS J, et al. Trisomy 13: Survival beyond the NICU [J]. NeoReviews, 2023, 24(1): 51-6.\u003c/li\u003e\n\u003cli\u003eSALDARRIAGA W, RENGIFO-MIRANDA H, RAM\u0026iacute;REZ-CHEYNE J. [Trisomy 18 syndrome: A case report] [J]. Revista chilena de pediatria, 2016, 87(2): 129-36.\u003c/li\u003e\n\u003cli\u003eCAREY J C. Survival Outcomes of Infants with the Trisomy 13 or Trisomy 18 Syndromes [J]. The Journal of pediatrics, 2022, 247: 11-3.\u003c/li\u003e\n\u003cli\u003eWEAVER M S, ANDERSON V, BECK J, et al. Interdisciplinary care of children with trisomy 13 and 18 [J]. American journal of medical genetics Part A, 2021, 185(3): 966-77.\u003c/li\u003e\n\u003cli\u003eJIA C W, WANG L, LAN Y L, et al. Aneuploidy in Early Miscarriage and its Related Factors [J]. Chinese medical journal, 2015, 128(20): 2772-6.\u003c/li\u003e\n\u003cli\u003eYUAN S, LIAO C, LI D, et al. Chorionic villus cell culture and karyotype analysis in 1983 cases of spontaneous miscarriage[in Chinese] [J]. Chinese Journal of Obstetrics and Gynecology, 2017, 52(7): 461-6.\u003c/li\u003e\n\u003cli\u003eQU S, WANG L, CAI A, et al. Exploring the cause of early miscarriage with SNP-array analysis and karyotyping [J]. The journal of maternal-fetal \u0026amp; neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet, 2019, 32(1): 1-10.\u003c/li\u003e\n\u003cli\u003eWANG Y, CHENG Q, MENG L, et al. Clinical application of SNP array analysis in first-trimester pregnancy loss: a prospective study [J]. Clinical genetics, 2017, 91(6): 849-58.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Time-lapse, Chromosome aneuploidy, Preimplantation genetic testing, Morphokinetic, Morphology","lastPublishedDoi":"10.21203/rs.3.rs-4349351/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4349351/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003ePurpose\u003c/b\u003e\u003c/p\u003e \u003cp\u003eTo investigate the effects of chromosomal aneuploidy on preimplantation embryos\u0026rsquo; development by analyzing the morphological and morphokinetic parameters between euploid embryos and aneuploid embryos.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eConducted a retrospective analysis of the morphological and morphokinetic parameters of embryos cultured in the Embryo Scope Plus time-lapse incubator and underwent trophectoderm cell sampling for preimplantation genetic testing (PGT) at the Reproductive Center of the First Affiliated Hospital of Hainan Medical University from June 2019 to September 2022. Statistical methods, including the Mann-Whitney U test and Chi-Square test, were used to analyze the data.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003e1. A total of 1888 embryos from 487 cycles were included, with 724 being euploid embryos (38.30%) and 1164 being aneuploid embryos (61.70%). 2.In embryos that has become blastocysts, aneuploidy of embryonic genome had no effect on morphology of D1 and D2 embryos, had moderate effect on D3 embryos but significantly affects blastocysts, the worse the Gardner score, the higher the aneuploidy rate. 3. The influence of aneuploidy on the morphokinetic of the embryo becomes apparent at t5, with euploid embryos exhibiting faster development compared to aneuploid embryos. 4.There is no evidence to suggest that single chromosome aneuploidies, such as chr-3, chr-7, chr-8, chr-10, chr-11, chr-12, chr-13, chr-15, chr-18, chr-20, and chr-21, has any influence on the morphokinetic of embryos.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eGenomic aneuploidy has an impact on embryo development, but not every stage is affected. Additionally, certain specific single chromosome aneuploidies does not influence embryo development during the preimplantation stage.\u003c/p\u003e","manuscriptTitle":"A retrospective investigation of the effects of chromosome aneuploidy on preimplantation embryos’ development: base on time-lapse","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-09 11:28:13","doi":"10.21203/rs.3.rs-4349351/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0b48b79d-6df5-4090-ae51-6507e2b84f60","owner":[],"postedDate":"May 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-09T11:30:08+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-09 11:28:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4349351","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4349351","identity":"rs-4349351","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}