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PLoS One. 2019 Aug 1;14(8):e0220529. doi: 10.1371/journal.pone.0220529. eCollection 2019.

Endometriosis accelerates synchronization of early embryo cell divisions but does not change morphokinetic dynamics in endometriosis patients.

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Das Kinderwunsch Institut Schenk GmbH, Dobl, Austria.
Institute of Human Genetics, Medical University of Graz, Graz, Austria.
Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.



The pathology of endometriosis and its impact on embryo development is still a black box in reproductive medicine. In this time-lapse study we investigated the influence of endometriosis on morphokinetic parameters of embryo development, taking variables of dynamic monitoring into account. Furthermore we evaluated reproductive medicine treatment outcome such as fetal heartbeat and live birth rate.


1148 embryos (control: n = 596, endometriosis: n = 552) were retrospectively analyzed. Patients were stimulated with GnRH antagonist protocol. After fertilization, embryos were incubated in a time-lapse system (EmbryoScope).


The mixed-model analysis revealed a significant main effect of time (p<0.001), with post-hoc tests showing that any time needed to reach a specific developmental stage was significantly different from all the others (all p<0.001). Embryos of endometriosis patients showed the same absolute morphokinetic time parameters as the control group, however, synchronization of early embryo cell divisions (s2) was faster in endometriosis patients compared to the control group.


In general, endometriosis does not induce changes in early embryo morphokinetics. However, observed acceleration in cell cycle synchronization of embryo cleavage patterns might be a missing explanation for contradicting results in literature regarding the impairments in reproductive medicine treatment outcome of endometriosis patients.

Conflict of interest statement

The affiliation to the private clinic “Das Kinderwunsch Institut Schenk GmbH” does not alter our adherence to PLOS ONE policies on sharing data and materials.

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