Correlation between Morphologic Grading and Euploidy Rates of Blastocysts, and Clinical Outcomes in In Vitro Fertilization Preimplantation Genetic Screening

Abstract

BackgroundThe standard morphological evaluation has been widely used for embryo selection, but it has limitations. This study aimed to investigate the correlation between morphologic grading and euploidy rate of in vitro fertilization (IVF) preimplantation genetic screening (PGS) and compare the pregnancy rates in young and old ages.MethodsThis is a retrospective study using the medical records of patients who underwent IVF procedures with PGS between January 2016 and February 2017 in a single center. The embryo grades were categorized into 4 groups: excellent, good, fair, and poor. Basic characteristics, euploidy rates, clinical pregnancy (CP) rates and ongoing pregnancy rates were analyzed.ResultsThe excellent group had significantly higher rate of euploid embryos than fair group (47.82% vs. 29.33%; P = 0.023) and poor group (47.82% vs. 29.60%; P = 0.005). When the four groups were recategorized into two groups (excellent and good vs. fair and poor), they also showed significant difference in euploidy rates (44.52% vs. 29.53%; P = 0.002). When the patients were divided into two groups by age 35, the CP rates for those under and over 35 years old were 44.74% and 47.83%, respectively, which showed no significant difference.ConclusionThe significant differences among the euploidy rates of different morphologic embryo grades demonstrated the positive correlations between the morphologic grading of the embryo and the euploidy rate of PGS. Additionally, there was no significant difference between the younger and older patients' CP rates. These findings emphasize the fact that old age patients might benefit from PGS whatever the indication of PGS is.

Does duration of cryostorage affect survival rate, pregnancy, and neonatal outcomes? Large‐scale single‐center study of slush nitrogen (SN2) vitrified‐warmed blastocysts

“…The quality and grading of the embryo were determined by a method similar to that described by Kim et al 16 The quality of warmed blastocyst was assessed 16–24 h post‐culture on the inverted microscope by two independent embryologists. Blastocysts were graded according to the degree of expansion, inner cell mass, and trophectoderm morphology.…”

Clinical Usability of Embryo Development Using a Combined Qualitative and Quantitative Approach in a Single Vitrified-Warmed Blastocyst Transfer: Assessment of Pre-Vitrified Blastocyst Diameter and Post-Warmed Blastocyst Re-Expansion Speed

“…Dynamic change in speed is a potential indicator of developmental potential because the embryo changes prominently within a short period [ 42 , 43 ]. Most significantly, our previous study showed that morphological characteristics are the most important indicators of clinical outcomes and live birth [ 30 , 44 ]. Concordantly, in this study, we demonstrated that blastocyst diameter and re-expansion speed are closely related to embryo quality.…”

Timing day-3 vitrification for PGT-M embryos: pre- or post-blastomere biopsy?

“…This might also explain their lower fertilization rate. It is well established, for example, that patients suffering from polycystic ovary syndrome are known to achieve higher oocytes yield, with lower fertilization rate (reduced quality) and same number of topquality embryos for transfer [16]. These observations justified the more conservative approach applying the freeze-all policy in patients who vigorously respond to OS and are at risk to develop severe OHSS.…”