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A group with PCOS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948 embryos) was compared to a control group with uterine, tubal factor or idiopathic infertility (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009400 embryos). Times from the two-cell stage to blastocyst expansion, eight intervals for embryonic cell cycle (ECC) duration and synchronicity and four cleavage synchronicity (CS) and DNA replication time ratios were analysed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PCOS patients were younger (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.023) with higher anti-M\u00fcllerian hormone levels (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) than controls. No statistically noticeable influence of PCOS on absolute times was observed. The intervals from the 3- to 4-cell (synchronicity of cell cycle 2, s2;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.013), the 5- to 8-cell (synchronicity of cell cycle 3, s3;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032) and the 4- to 8-cell stage (ECC3;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.043) were longer in the PCOS group. The relative CS ratio from the 2- to 8-cell stage (CS2-8) was lower (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003) and from the 2- to 4-cell stage (CS2-4) was higher (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) in PCOS embryos.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Whilst absolute times remained unaffected, relative morphokinetic intervals and ratios, potentially indicating poorer cleavage synchronicity, were altered in PCOS embryos. This is the first study examining the influence of PCOS on relative morphokinetic ratios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08335-0","type":"journal-article","created":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T06:09:57Z","timestamp":1770530997000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Polycystic ovary syndrome (PCOS) affects relative embryo morphokinetics observed by time-lapse imaging: an observational study"],"prefix":"10.1007","volume":"313","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7096-7864","authenticated-orcid":false,"given":"Vera Monika","family":"Gar\u00e7on","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0022-9502","authenticated-orcid":false,"given":"Jens Erik","family":"Dietrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7024-855X","authenticated-orcid":false,"given":"Thomas","family":"Strowitzki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8223-5166","authenticated-orcid":false,"given":"Alexander","family":"Freis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"issue":"10","key":"8335_CR1","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1038\/nbt.1686","volume":"28","author":"CC Wong","year":"2010","unstructured":"Wong CC, Loewke KE, Bossert NL, Behr B, De Jonge CJ, Baer TM et al (2010) Non-invasive imaging of human embryos before embryonic genome activation predicts development to the blastocyst stage. 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TS is an Editorial Board Member of Archives of Gynecology and Obstetrics but was not involved in the editorial review or the decision to publish this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. There was a positive ethical approval for this study from the ethical commission of the Heidelberg University Medical Faculty (reference no. S-649\/2016, 21 December 2016). For this retrospective study, only anonymised data were used that were collected during routine clinical treatment.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"83"}}