Early embryo development: the current perspective in molecular evaluation and clinical status.

Journal: Systems biology in reproductive medicine
Published Date: Aug 26, 2025

Abstract

Early embryo development and competence mechanisms are paramount to ART's success but are still underexplored in human-relevant animal models. Clinical embryo evaluation remains largely based on subjectively evaluated morphological characteristics. In the current era of biomarkers and low-input high-throughput technologies, it is possible to investigate the multi-complex molecular landscape of the embryo during development from the zygote up to the blastocyst stage. The scope of this article is to review the underlying molecular mechanisms of pre-implantation embryo development. In addition, we briefly explore the latest advances in embryo quality assessment - including molecular and epigenetic evaluation and technical advances such as time-lapse imaging and artificial intelligence - together with clinical challenges for selecting the best embryo for single embryo transfer.

Authors

  • Sevastiani Antonouli
    Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece.
  • Dimitrios Ioannou
    Department of Basic Sciences, College of Medicine, Roseman University of Health Sciences, Las Vegas, NE, USA.
  • Valentina Di Nisio
    Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
  • Christina Messini
    Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece.
  • Georgia Kokkali
    Reproductive Medicine Unit, Genesis Athens Clinic, Athens, Greece.
  • Katerina Chatzimeletiou
    1st Department of Obstetrics & Gynaecology, Aristotle University Medical School, Papageorgiou General Hospital, Thessaloniki, Greece.
  • Peter Sutovsky
    Department of Obstetrics, Gynecology and Women's Health, Division of Animal Sciences, University of Missouri, Columbia, MO, USA.
  • Alexandos Daponte
    Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece.
  • George Anifandis
    Department of Histology and Embryology, Faculty of Medicine, University of Thessaly, 3, Panepistimiou, 41500, Larissa, Greece.

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