Blastocyst expansion score and trophectoderm morphology strongly predict successful clinical pregnancy and live birth following elective single embryo blastocyst transfer (eSET): a national study

PurposeTo determine which characteristics of blastocyst embryo morphology may predict clinical pregnancy and live birth rates.MethodsA retrospective analysis of data from 3,151 cycles of fresh, non-donor eSET cycles from 2008 to 2009 was performed. Data were obtained from the Society for Assisted Reproductive Technologies (SART) underwent. All eSET were performed at the blastocyst stage. Main outcome measures were clinical pregnancy and live birth rates.ResultsTrophectoderm morphology, embryo stage and patient age are highly significant independent predictors of both clinical pregnancy and live birth. Neither inner cell mass morphology nor embryo grade predicted clinical pregnancy or live birth.ConclusionsBetter trophectoderm morphology, younger patient age and further blastocyst progression all result in higher clinical pregnancy and live birth rates. Therefore, trophectoderm morphology and blastocyst stage should preferentially be used as the most important factors in choosing the best embryo for transfer.

[1]  Multiple gestation associated with infertility therapy: an American Society for Reproductive Medicine Practice Committee opinion. , 2012, Fertility and sterility.

[2]  N. Zaninovic,et al.  Blastocyst expansion, inner cell mass (ICM) formation, and trophectoderm (TM) quality: is one more important for implantation? , 2001 .

[3]  C. Racowsky,et al.  Day 3 and day 5 morphological predictors of embryo viability. , 2003, Reproductive biomedicine online.

[4]  Veljko Vlaisavljevic,et al.  Developmental capacity of different morphological types of day 5 human morulae and blastocysts. , 2004, Reproductive biomedicine online.

[5]  B. Carr,et al.  Late stages of embryo progression are a much better predictor of clinical pregnancy than early cleavage in intracytoplasmic sperm injection and in vitro fertilization cycles with blastocyst-stage transfer. , 2007, Fertility and sterility.

[6]  A. Birmingham,et al.  The Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Assisted Reproductive Technology , 2006 .

[7]  K S Richter,et al.  Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. , 2001, Fertility and sterility.

[8]  D. Wells,et al.  The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. , 2011, Fertility and sterility.

[9]  Dk Gardner,et al.  In-vitro culture of human blastocysts , 1999 .

[10]  C. Racowsky,et al.  Utility of the national embryo morphology data collection by the Society for Assisted Reproductive Technologies (SART): correlation between day-3 morphology grade and live-birth outcome. , 2011, Fertility and sterility.

[11]  Barry Behr,et al.  Standardization of grading embryo morphology. , 2010, Fertility and sterility.

[12]  D. Gardner,et al.  A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. , 1998, Human reproduction.

[13]  A. Nuhoğlu,et al.  The effect of pronuclear morphology on embryo quality parameters and blastocyst transfer outcome. , 2001, Human reproduction.

[14]  R. Alvero,et al.  The morphology of human pronuclear embryos is positively related to blastocyst development and implantation. , 2000, Human reproduction.

[15]  N. Johnson,et al.  Cleavage stage versus blastocyst stage embryo transfer in assisted conception. , 2005, The Cochrane database of systematic reviews.

[16]  M. Hill,et al.  Trophectoderm grade predicts outcomes of single-blastocyst transfers. , 2013, Fertility and sterility.

[17]  A. Pinborg,et al.  Neonatal outcome in a Danish national cohort of 8602 children born after in vitro fertilization or intracytoplasmic sperm injection: the role of twin pregnancy , 2004, Acta obstetricia et gynecologica Scandinavica.

[18]  Tsuyoshi Saito,et al.  Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed single-blastocyst transfer cycle in vitro fertilization. , 2012, Fertility and sterility.

[19]  D. Walmer,et al.  Relationship between pre-embryo pronuclear morphology (zygote score) and standard day 2 or 3 embryo morphology with regard to assisted reproductive technique outcomes. , 2005, Fertility and sterility.

[20]  D. Gardner,et al.  Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. , 2000, Fertility and sterility.

[21]  M. Wikland,et al.  Trophectoderm morphology: an important parameter for predicting live birth after single blastocyst transfer. , 2011, Human reproduction.