Presence, but not type or degree of extension, of a cytoplasmic halo has a significant influence on preimplantation development and implantation behaviour

Background: Since there is considerable disagreement in grading cytoplasmic haloes, this prospective study was set up to evaluate if certain subtypes of haloes are related to further development. Methods: Out of a total of 152 patients, 713 zygotes could be checked for the formation of a halo. Where present, haloes were subdivided into concentric (symmetric) and polar (asymmetric) types. In addition, each halo was measured accurately to see if the extension of the halo might influence further development. In parallel, pronuclear patterns were checked. Results: Halo-positive zygotes did not differ from halo-negative ones in terms of embryo quality and blastocyst formation rate. However, quality of blastocysts (assessed by their inner cell mass consistency) was significantly increased (P<0.001) if a halo appeared at zygote stage. This phenomenon was not related to type of halo or degree of halo. In terms of pronuclear pattern, pattern 0 (0A, 0B) led to significantly more blastocysts (P<0.001) of better quality (P=0.002) compared with patterns 1-5. A stepwise logistic regression showed no relationship between different halo types and pronuclear pattern 0. Conclusions: The present study indicates that any halo has a positive prognostic value on blastocyst quality, irrespective of the fact that it is light or extreme, polar or concentric. In addition, the developmental advantage of pattern 0 is confirmed.