Association between blastocyst morphology and pregnancy and perinatal outcomes following fresh and cryopreserved embryo transfer

Bakkensen, Jennifer B.; Brady, Paula C.; Carusi, Daniela; Romanski, Phillip A.; Thomas, Ann; Racowsky, Catherine

doi:10.1007/s10815-019-01580-0

Cited by 58 publications

(36 citation statements)

References 28 publications

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“…The present study has a limitation of the small sample size, not enough to clarify the effect of transferring blastocysts arising from PQE on birth defects. A recent single-center retrospective cohort study displayed that the higher ICM quality of blastocysts among FET cycles was associated with increased chance of preterm birth (25). Therefore, further research is required to ensure the safety of transfer of blastocysts arising from PQE.…”

Section: Perinatal Outcomes Of Blastocysts Arising From Day 3 Pqementioning

confidence: 99%

Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos

Xia

Zhao

et al. 2020

Front. Endocrinol.

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Embryos with low morphological scores can still develop to the blastocyst stage and result in good clinical outcomes. However, no studies have reported the possible effects of transferring cryopreserved blastocysts developed from poor-quality cleavage stage embryos on pregnancy and perinatal outcomes. In this retrospective study, the clinical value of transferring blastocysts derived from day 3 poor-quality cleavage stage embryos during in vitro fertilization and embryo transfer procedures was evaluated. According to the quality of embryos on day 3 from which the transferred blastocyst originated, patients were divided into three groups: poor-quality (111 cycles, group A), good-quality (235 cycles, group B), and top-quality (119 cycles, group C). Group A experienced the highest miscarriage rate (30.2%) which was increased when compared to group C (12.5%) (P = 0.03). The clinical pregnancy rates and live birth rates were not significantly different among the three groups. However, good blastocyst originating from top day 3 embryos resulted in higher live birth rate. Of the 218 live births, no differences in obstetric and perinatal outcomes were noted among the three groups. The results showed that extended culture of poor-quality cleavage stage embryos could resulted in favorable clinical pregnancy rates but at a higher incidence of miscarriages. Meanwhile, the risk of adverse perinatal outcomes was not increased.

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Section: Perinatal Outcomes Of Blastocysts Arising From Day 3 Pqementioning

confidence: 99%

Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos

Xia

Zhao

et al. 2020

Front. Endocrinol.

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“…Assisted reproductive technology (ART) is determined to promote live birth rate of infertile couples and reduce the pregnancy loss. Blastocyst morphology was identified to be correlated to implantation, pregnancy and live birth for fresh and frozen blastocyst transfer cycles [8][9][10][11]. However, the mechanism underlying the grade of morphology parameters and miscarriage is still not fully understood.…”

Section: Discussionmentioning

confidence: 99%

“…Top quality blastocyst transfer is associated with the higher implantation and ongoing pregnancy rate compared with non-top quality blastocyst [7]. Three morphologic parameters, the blastocoele expansion degree and the grade of ICM and TE, have been reported to predict clinical pregnancy and live birth for fresh and frozen blastocyst transfer cycles in various studies [8][9][10][11], which provide convenient guidance in the selection of viable embryos. Another important pregnancy outcome is miscarriage, as an unexpected condition, which even troubles many infertile couples lasting for years.…”

Section: Introductionmentioning

confidence: 99%

Association between the quality of inner cell mass and first trimester miscarriage after single blastocyst transfer

Shi

Zhang

et al. 2020

Reprod Biol Endocrinol

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Background: The blastocyst morphology provided valuable roles for predicting pregnancy and live birth, but was still not fully understood for evaluating miscarriage. The aim of this study was to explore the association between blastocyst morphologic evaluation and first trimester miscarriage combined with karyotype of miscarried conceptus. Methods: This retrospective cohort study included a total of 2873 clinical pregnancy cycles with single blastocyst transfer performed from January 2013 to April 2019. Chromosome karyotype of miscarried conceptus was analyzed via single nucleotide polymorphism array analysis. Miscarriage and karyotype of miscarried conceptus associated with blastocyst morphology were analyzed by chi-square and logistic regression analysis. Results: A total of 354 (12.3%) cycles resulted in first trimester miscarriage. Miscarriage rates increased with trophectoderm (TE) grade from A to C (P = 0.012), while three morphologic parameters (blastocoele expansion degree, inner cell mass (ICM) and TE) showed no statistical significance with miscarriage after multivariable analysis. The rate of aneuploidy was 47.7% (83 of 174) in total miscarried conceptuses. For euploid miscarriages, the grade B of ICM occupied a higher proportion compared with aneuploidy, with OR of 2.474, (95% CI, 1.311-4.699), P = 0.005. Conclusions: Chromosomal aberration of embryo is an important genetic factor for first trimester miscarriage, and the quality of ICM is a potential indicator for euploid miscarriage. Blastocysts with grade A of ICM should be given priority during single blastocyst transfer to reduce potential miscarriage.

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“…Embryo quality was classi ed based on a modi cation of Gardner's system (15), which assessed for stage based on degree of expansion (Stages 5 through 8) and quality of the inner cell mass (ICM; A through D) and trophectoderm (TE; a through d), as previously described (16). Embryos were then classi ed as good, fair, or poor quality.…”

Section: Clinical Outcomesmentioning

confidence: 99%

The Clinical Relevance of Luteal Phase Progesterone Support in True Natural Cycle Cryopreserved Blastocyst Stage Embryo Transfers: A Retrospective Cohort Study

Waldman

Racowsky

Disler

et al. 2021

Preprint

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Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles to luteinize the endometrium and prepare it for implantation, but little data is available to show if this is beneficial in true natural cycles. We evaluated the use of luteal phase progesterone supplementation for cryopreserved/warmed blastocyst transfers in true natural cycles not using an ovulatory trigger.Methods: Retrospective cohort study in a single academic medical center. We studied the use of luteal phase progesterone supplementation in patients undergoing true natural cycle cryopreserved blastocyst embryo transfers. Our primary outcome measure was ongoing pregnancy rate, with other pregnancy outcomes being evaluated (i.e. implantation rate, miscarriage rate, ectopic rate, and multifetal gestation). Categorical data were analyzed utilizing Fisher’s exact test and all binary variables were analyzed using log-binomial regression to produce a risk ratio. Results: 229 patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p=0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p= 0.7483), positive HCG rate (62.4% vs. 57.5%, p=0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p=0.2622), ectopic pregnancy rate (0% vs. 1.3%, p=0.3493), or multifetal gestations (7.4% vs. 3.8%, p=0.3166).Conclusion(s): The addition of luteal phase progesterone support in true natural cycle cryopreserved blastocyst embryo transfers did not improve pregnancy outcomes and therefore the routine use in practice cannot be recommended based on this study, but the utilization should not be discouraged without further studies. Capsule: Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.

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Association between blastocyst morphology and pregnancy and perinatal outcomes following fresh and cryopreserved embryo transfer

Cited by 58 publications

References 28 publications

Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos

Miscarriage Rate Is High With Frozen-Thawed Blastocysts Arising From Poor-Quality Cleavage Stage Embryos

Association between the quality of inner cell mass and first trimester miscarriage after single blastocyst transfer

The Clinical Relevance of Luteal Phase Progesterone Support in True Natural Cycle Cryopreserved Blastocyst Stage Embryo Transfers: A Retrospective Cohort Study

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