The Effect of Morphological Parameters on IVF Outcomes in Single Blastocyst Transfer Cycles
AbstractAim: Our aim is to evaluate the effect of three morphological parameters (Blastocoel expansion, trophectoderm (TE) morphology grade, and inner cell mass (ICM) morphology grade) on clinical pregnancy in single blastocyst transfers.Methods: The study included 74 fresh day 5 single blastocyst transfers in a two-year period. There were 30 women with clinical pregnancy (Group 1). Women that failed to get pregnant after IVF/ICSI procedure were included in the non-pregnant group (n = 44) (Group 2). The blastocysts were graded according to Gardner and Schoolcraft. Age of the couple, body mass index, infertility duration, day 3 follicle stimulating hormone, luteinizing hormone, number of days of gonadotropin stimulation, total gonadotropin dose, estradiol level on the day of hCG administration, number of oocytes retrieved, number of metaphase II oocytes, number of 2PN, TE morphology, ICM morphology, blastocoel expansion were recorded. These outcomes were compared between the two groups. Statistical comparisons were carried out by Chi-square test and Student “t” test. Regardless of the statistical test, only a p value ≤ 0.05 was considered significant.Results: During the study period, 702 embryo transfers were performed; of these 74 (10.5%) were on Day 5. While number of oocytes retrieved, number of metaphase II oocytes and 2PN increased in pregnant group, estradiol level on the day of hCG administration, total gonadotropin dose, blastocoel expansion were similar in both groups. ICM and TE morphology were significantly associated with pregnancy (p<0.05).Conclusion: The clinical pregnancy rate seems to be affected by both ICM and TE morphology.
Blake DA, Farquhar CM, Johnson N, Proctor M. Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst Rev 2007;4:CD002118.
Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Mortimer JR, editor. Toward Reproductive Certainty: Infertility and Genetics Beyond 1999. Carnforth, UK, Parthenon Press; 1999: 378-88.
Dokras A, Sargent IL, Barlow DH. Human blastocyst grading: an indicator of developmental potential? Hum Reprod 1993;8:2119-27.
Shapiro BS, Harris DC, Richter KS. Predictive value of 72-hour blastomere cell number on blastocyst development and success of subsequent transfer based on the degree of blastocyst development. Fertil Steril 2000;73:582–6.
Yoon HJ, Yoon SH, Son WY, Im KS, Lim JH. High implantation and pregnancy rates with transfer of human hatching day 6 blastocysts. Fertil Steril 2001;75:832–3.
Richter KS, Harris DC, Daneshmand ST, Shapiro BS. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril 2001;76:1157–67.
Shapiro BS, Richter KS, Harris DC, Daneshmand ST. A comparison of day 5 and day 6 blastocyst transfers. Fertil Steril 2001;75:1126–30.
Zaninovic N, Berrios R, Clarke RN, Bodine R, Ye Z, Veeck LL. Blastocyst expansion, inner cell mass (ICM) formation, and trophectoderm (TM) quality: is one more important for implantation? Fertil Steril 2001;76:S8.
Zhang H, Zhou Y, Li Y, Zheng Y, Xiao S, Wu Y, et al. Prediction of clinical pregnancy in vitrified-warmed single blastocyst transfer cycles by pre-freeze morphology. Iran J Reprod Med. 2014;12:567–72.
Richter KS, Harris DC, Daneshmand ST, Shapiro BS. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril 2001; 76: 1157-67.
Kovacic B, Vlaisavljevic V, Reljic M, Cizek-Sajko M. Developmental capacity of different morphological types of day 5 human morulae and blastocysts. Reprod Biomed Online 2004; 8: 687-94.
Ahlstrom A, Westin C, Reismer E, Wikland M, Hardarson T. Trophectoderm morphology: an important parameter for predicting live birth after single blastocyst transfer. Hum Reprod 2011;12:3289–96.
Van den Abbeel E, Balaban B, Ziebe S, Lundin K, Cuesta MJ, Klein BM, Helmgaard L, Arce JC. Association between blastocyst morphology and outcome of single-blastocyst transfer. Reprod Biomed Online. 2013;27:353-61.
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