Blastocyst development rate influences implantation and live birth rates of similarly graded euploid blastocysts

Irani, Mohamad; O’Neill, C.; Palermo, Gianpiero D.; Xu, Kangpu; Zhang, Chenhui; Xia, Qin; Zhan, Qiansheng; Clarke, Rachel; Ye, Zhen; Zaninović, Nikica; Rosenwaks, Zev

doi:10.1016/j.fertnstert.2018.03.032

Cited by 84 publications

(61 citation statements)

References 44 publications

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“…The final inclusion was 13 studies that met the selection criteria for our meta‐analysis. Hence, 23 studies were included in the following meta‐analyses . The main characteristics and assessment for risk of bias of the included studies are presented in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Although all studies have reported the pregnancy outcomes following transfer of frozen‐thawed blastocysts that had developed to blastocyst stage on day 5 or day 6, studies included in present meta‐analysis varied in terms of the number of embryo transferred and the chromosomal status of blastocysts. Only three studies transfer euploid blastocysts . Five studies only transfer one embryo per cycle, while remaining studies transfer no more than two blastocysts or more than two blastocysts per cycle .…”

Section: Resultsmentioning

confidence: 99%

“…Hence, 23 studies were included in the following meta-analyses. 4,6,7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The main characteristics and assessment for risk of bias of the included studies are presented in Table 1.…”

Section: Results Of the Searchesmentioning

confidence: 99%

“…Only three studies transfer euploid blastocysts. 13,16,22 Five studies only transfer one embryo per cycle, [12][13][14]16,23 while remaining studies transfer no more than two blastocysts 11,[18][19][20]22,24,27,28 or more than two blastocysts per cycle. 29,30 The decision of when blastocyst was transferred in all included studies was dependent on the day of expansion.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Wang²,

Sun

et al. 2020

J of Obstet and Gynaecol

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Aim To compare the pregnancy outcomes after day 5 blastocyst‐stage embryo transfers (BET) versus day 6 BET following vitrified‐warmed cycle and to evaluate whether the number of embryos transferred and the chromosomal status of embryo influence effect estimates. Methods A literature search (PubMed, Embase and MEDLINE) up to January 2019 was conducted to identify studies where women with day 6 BET were compared to women with day 5 BET. Only studies published in English language, on peer‐reviewed journal were considered eligible. The following subgroup analyses were performed: (i) number of embryos transferred and (ii) chromosomal status of embryo. Results From a total of 1956 articles identified, 23 observational studies were included in the meta‐analysis. We observed that day 6 BET were associated with lower implantation rate (risk ratio, RR: 1.17, 95% confidence interval, CI: 1.10–1.24), clinical pregnancy rate (RR: 1.17, 95% CI: 1.10–1.24), ongoing pregnancy rate (RR: 1.15, 95% CI: 1.07–1.24) and live birth rate (RR: 1.22, 95% CI: 1.11–1.33) than day 5 BET following vitrified‐warmed cycle. The subgroup analysis found that the superiority of day 5 BET compared with day 6 BET is influenced by the number of embryos transferred and chromosomal status of embryos. Conclusion Current evidence shows that day 5 BET is superior to day 6 BET following vitrified‐warmed cycle in clinical practice. Due to the overall low quality of available evidence, more larger and well‐conducted studies are needed to compare the pregnancy outcomes between day 5 and day 6 BET before drawing a clear conclusion.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Results Of the Searchesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Wang²,

Sun

et al. 2020

J of Obstet and Gynaecol

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“…Thus, trophectoderm and ICM morphologic grades are likely to be effective supplementary parameters to consider during embryo selection [8] . Moreover, in a study by Mohamad evaluating the role of blastocyst development rate in euploid embryo selection, day 5 euploid blastocysts had higher implantation rates and live birth rates compared with similarly graded day 6 blastocysts [9] .…”

Section: Objectivementioning

confidence: 99%

Association Between Morphologic Grading and Implantation Rate of Euploid Blastocyst

Lou

Guan

et al. 2020

Preprint

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Objective: To determine the association between the morphologic grading and implantation rate of euploid blastocysts in single frozen-thawed embryo transfer (SET) cycles.Design: Retrospective cohort study.Setting: Single university-based fertility centerPatient(s): Women aged 20–40 years undergoing euploid SET from January 2017 to December 2019 were identified. Main Outcomes Measure(s): Implantation rate (IR) Result(s): A total of 271 euploid SET cycles were included. 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). Good-quality blastocysts yielded statistically signiﬁcantly higher implantation rates than poor-quality embryos (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.

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Number of embryos transferred could possibly be associated with angular pregnancy in in vitro fertilization‐embryo transfer

Chen,

Shao,

Liu

et al. 2023

Intl J Gynecology & Obste

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ObjectiveThe probability of embryo implantation in an abnormal location is significantly higher in assisted reproductive technology (ART) than in natural pregnancies. Angular pregnancy is an eccentric intrauterine pregnancy with embryo implantation in the lateral superior angle of the uterine cavity. Cycle‐level factors associated with angular pregnancy in patients conceived with ART needed to be explored.MethodsA total of 11 336 clinical pregnancies cycles were included. Angular pregnancy rate was compared among groups according to the type of embryos transferred. Among them, 53 cases of angular pregnancy and 159 cases of normal intrauterine pregnancy were screened out using propensity score matching. Risk factors of angular pregnancy were explored.ResultsThe angular pregnancy rate was 0.31% (14/4572) in the day 5 blastocyst transfer group, 0.58% (39/6764) in non‐day 5 embryo transfer group, with 0.55% (29/5280) in day 3 embryo transfer and 0.67% (10/1484) in the day 6 blastocyst group, respectively. A multifactor regression analysis was performed and indicated that the number of embryos transferred was significantly associated with angular pregnancy (P = 0.031, OR, 2.23, 95% CI: 1.09–4.68).ConclusionMultiple embryo transfer could possibly be associated with an increased incidence of angular pregnancy in patients conceived with ART.

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Blastocyst development rate influences implantation and live birth rates of similarly graded euploid blastocysts

Abstract: In addition to aneuploidy assessment, the speed of embryo development to the blastocyst stage and an evaluation of blastocyst morphology are critical to selecting the best embryo.

Cited by 84 publications

References 44 publications

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Association Between Morphologic Grading and Implantation Rate of Euploid Blastocyst

Number of embryos transferred could possibly be associated with angular pregnancy in in vitro fertilization‐embryo transfer

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