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. 2021 Jan 23;14(1):18.
doi: 10.1186/s13048-021-00770-8.

Association between morphologic grading and implantation rate of Euploid blastocyst

Hua Lou  1 , Na Li  1 , Yichun Guan  1 , Yuchao Zhang  1 , Dayong Hao  1 , Shihong Cui  2
Affiliations

Association between morphologic grading and implantation rate of Euploid blastocyst

Hua Lou et al. J Ovarian Res. .

Abstract

Background: Standard morphologic evaluation has been the most widely adopted approach to embryo selection, and remains the most common strategy.The objective of the study to determine the association between the morphologic grading and implantation rate of euploid blastocysts in single frozen-thawed embryo transfer (SET) cycles.

Methods: A total of 271 patients aged 20-40 years undergoing euploid SET from January 2017 to December 2019 were included in retrospective cohort study.The cycles were divided into three groups based on their morphologic grading before cryopreservation: good-quality (n = 58), average-quality (n = 88) and poor-quality blastocysts (n = 125). The pregnancy outcome of the three morphologic groups were analyzed and a logistic regression of implantation rate was conducted.

Results: Good-quality blastocysts yielded statistically significantly higher implantation rates than poor-quality (79.31% vs. 48%; P<0.001). Planned subgroup analyses by age and the day of TE biopsy were conducted. Logistic regression analyses that adjusted for these variables identified higher implantation rates (adjusted odds ratio(aOR) = 4.083, 95% confidence interval (CI):1.836-9.082, P<0.001) for the good-quality blastocysts than for those that underwent poor-quality cycles in women aged < 35 years, but not in women aged ≥35 years (aOR = 6.074, 95% CI: 0.456-80.919, P = 0.172). The implantation rates were higher among women with good-quality blastocysts on both Day 5 and Day 6 of TE biopsy than among those with poor-quality blastocysts (Day 5, aOR = 3.294, 95% CI:1.260-8.616, P = 0.015; Day 6, aOR = 4.179, 95% CI:1.004 ~ 17.399, P = 0.049). Day 5 euploid blastocysts had no significant difference in implantation potential and early spontaneous abortion rate compared with similarly graded Day 6 euploid blastocysts.

Conclusions: Blastocyst morphologic grading was associated with implantation rate for euploid embryo transfers after adjustment for potential confounders. These findings suggest that evaluating blastocyst morphology is critical when selecting the best euploid blastocyst.

Keywords: Blastocyst morphologic grading; Day of trophectoderm biopsy; Euploid; Implantation rate; Single frozen-thawed embryo transfer.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Implantation rates and early spontaneous abortion rates according to blastocyst morphologic grade.Good-quality blastocysts yielded statistically significantly higher implantation rates than poor-quality (P < 0.05)
Fig. 2
Fig. 2
Implantation rates of different blastocyst morphologic grade that were biopsied on either day 5 or day 6. There was no significant difference in implantation rate among the 3 morphologic grade groups
Fig. 3
Fig. 3
Early spontaneous abortion rates of different blastocyst morphologic grade that were biopsied on either day 5 or day 6. There was no significant difference in implantation rate among the 3 morphologic grade groups
See this image and copyright information in PMC

References

    1. Cimadomo D, Delgado A, Fabozzi G, Gallego RD, Minasi MG, Rienzi L, et al. Time of morulation and trophectoderm quality are predictors of a live birth after euploid blastocyst transfer: a multicenter study. Fertil Steril. 2019;112(6):1080–1093. doi: 10.1016/j.fertnstert.2019.07.1322. - DOI - PubMed
    1. Bhattacharya S, Marjoribanks J, Ozturk O, Pandian Z, Serour G. Number of embryos for transfer following in vitro fertilisation or intra-cytoplasmic sperm injection. The Cochrane database of systematic reviews. 2013;7:CD003416. - PMC - PubMed
    1. Bolton Virginia N, Christine L, Harper Joyce C, Rachel C, Stephen H. How should we choose the 'best' embryo? A commentary on behalf of the British Fertility Society and the Association of Clinical Embryologists. Human fertility (Cambridge, England). 2015;18(3):156–64. - PubMed
    1. Forman Eric J, Franasiak Jason M, Goodman Linnea R, Juneau Caroline R, Morin Scott J, Neal Shelby A, et al. Preimplantation genetic testing for aneuploidy is cost-effective, shortens treatment time, and reduces the risk of failed embryo transfer and clinical miscarriage. Fertil Steril. 2018;110(5):896–904. doi: 10.1016/j.fertnstert.2018.06.021. - DOI - PubMed
    1. Blakemore J, Goldman KN, Grifo JA, Kramer Y, Lawson A, McCulloh DH. Beyond the biopsy: predictors of decision regret and anxiety following preimplantation genetic testing for aneuploidy. Hum Reprod. 2019;34(7):1260–1269. doi: 10.1093/humrep/dez080. - DOI - PubMed

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