The Graduated Embryo Score (GES) predicts blastocyst formation and pregnancy rate from cleavage-stage embryos*

Fisch, Jeffrey D; Rodriguez, H.F.; Ross, Richard; Overby, Gail; Sher, Geoffrey

doi:10.1093/humrep/16.9.1970

Cited by 135 publications

(90 citation statements)

References 16 publications

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“…On days 3 or 5 after oocyte retrieval, depending on the number of good quality embryos, a total of 1-3 embryos were transferred into the uterine cavity under the ultrasound guidance with a flexible catheter (Wallace; Irvine Scientific, Santa Ana, CA). Embryo scoring was performed as described previously [5]. Total number of oocytes was defined as the total number of oocytes collected at oocyte pick-up.…”

Section: Methodsmentioning

confidence: 99%

Serum anti-Mullerian hormone levels correlate with ovarian response in idiopathic hypogonadotropic hypogonadism

Sönmezer

Özmen

Atabekoglu

et al. 2012

J Assist Reprod Genet

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Purpose The role of serum AMH levels in prediction of ovarian response in idiopathic hypogonadotropic hypogonadism (IHH) was evaluated. Material method(s) Twelve patients with IHH underwent controlled ovarian hyperstimulation (COH) for IVF were enrolled in this prospective study. Serum AMH levels were studied on the 2nd or 3rd day of an induced menstrual cycle by a preceding low-dose oral contraceptive pill treatment. A fixed dose (150-300 IU/day) of hMG was given in all COH cycles. Correlations between serum AMH levels, COH outcomes and embryological data were investigated. Results Mean serum AMH levels was 3.47±2.15 ng/mL and mean serum peak estradiol was 2196±1705 pg/mL. Mean number of follicles >14 mm, >17 mm on hCG day and MII oocytes were 4.14±3.2, 4±2.5 and 7.28±3.5, respectively. Mean number of grade A embryos and transferred embryos were 3.28 ± 2.4 and 2.5 ± 0.7, respectively. The clinical pregnancy rate per patient was 41.6 % (5/12). Positive correlations were observed between serum AMH levels and MII oocytes (r00.84), grade A embryos (r00.85), serum peak estradiol levels (r00.87), and number of follicles >14 mm (r00.83) and >17 mm (r00.81) on hCG day, respectively. Conclusion AMH appears as a promising marker of ovarian response in patients with IHH undergoing IVF.

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Section: Methodsmentioning

confidence: 99%

Serum anti-Mullerian hormone levels correlate with ovarian response in idiopathic hypogonadotropic hypogonadism

Sönmezer

Özmen

Atabekoglu

et al. 2012

J Assist Reprod Genet

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“…Embryos were evaluated on Day 2 and Day 3 of culture, and were scored using either a new combined scoring system (CSS) or a traditional cumulative embryo score (CES) system. The CSS is a modification of the graduated embryo scoring system (Fisch et al, 2001; and is the combination of evaluations of early development at three intervals: the presence of nucleolar alignment along the pronuclear axis 16~18 h after insemination, the presence of regular and symmetrical cleavage 25~29 h after insemination, and cell number and fragmentation on Day 3 of culture. A detailed description of CSS is shown in Table 1.…”

Section: Ivf Procedures and Embryo Evaluationmentioning

confidence: 99%

Accuracy of a combined score of zygote and embryo morphology for selecting the best embryos for IVF

Qian

et al. 2008

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To evaluate the accuracy of a scoring system combining zygote and embryo morphology in predicting the outcome of in vitro fertilization (IVF) treatment. Methods: In a study group, 117 consecutive IVF or intracytoplasmic sperm injection (ICSI) cycles with embryo transfer were carried out and 312 embryos were scored using a combined scoring system (CSS) of zygote and embryo morphology before transplantation. In a control group, a total of 420 IVF or ICSI cycles were carried out and 1176 embryos were scored using a cumulative embryo score (CES). The effects of the combined scoring system on the embryo implantation rate and pregnancy rate per cycle were analyzed. Results: Using the combined scoring system, the embryo implantation rate (27.6%) and the clinical pregnancy rate (48.7%) were significantly higher than those in the control group (20.8% and 38.6%, respectively). Also, the implantation rate of embryos scoring ≥70 (38.5%: 82 sacs/213 embryos) was significantly higher (P<0.001) than that of embryos scoring <70 (4%: 4 sacs/99 embryos). The pregnancy rate of patients with embryos scoring ≥70 using the combined scoring system (66.7%) was significantly higher (P<0.001) than that of patients with embryos scoring ≥20 using the cumulative embryo score (59.0%). Conclusion: The results suggest that selecting embryos with a high score (≥70) using the combined scoring system could increase the implantation rate and pregnancy rate, and that using a scoring system combining assessments of human zygotes and pre-implantation embryos might predict IVF outcomes more accurately than using a cumulative embryo score.

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“…Multiple studies of embryo morphology have identified features indicative of better implantation potential in fresh cycles using cleavage-stage embryos [4][5][6][7]. Embryos with eight blastomeres or at compacting stage on day 3 generally have been shown to perform better than those with fewer blastomeres [5].…”

Section: Introductionmentioning

confidence: 99%

Developmentally delayed cleavage-stage embryos maintain comparable implantation rates in frozen embryo transfers

Burks

Buckbinder

Francis-Hernandez

et al. 2015

J Assist Reprod Genet

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Purpose In fresh IVF cycles, embryos reaching the eight-cell stage on day 3 of development are thought to have a higher chance of implantation than those reaching this stage on day 4. To determine whether this difference persists after cryopreservation, we compared pregnancy and implantation rates between frozen embryo transfer (FET) cycles using delayed cleavage-stage embryos (cryopreserved day 4) and normal cleavage-stage embryos (cryopreserved day 3). Methods Participants underwent FET between 2008 and 2012 using embryos cryopreserved on either day 3 (n=76) or day 4 (n=48), depending on the length of time needed to achieve the eight-cell stage. All embryos, regardless of day of cryopreservation, were thawed and transferred on the 4th day of vaginal progesterone following endometrial preparation with oral estradiol. Chi-square and Mann-Whitney U tests were used to compare patient demographics and cycle outcomes. Results More women in the day 4 group had diminished ovarian reserve (44 vs 16 %, p=0.003). Pregnancy outcomes in preceding fresh cycles were not different between the two groups. Pregnancy, implantation, and live birth rates following FET did not differ between the day 3 and day 4 groups. Conclusions This is the first study to address outcomes using day 3 versus day 4 cryopreserved embryos. Despite a higher prevalence of diminished ovarian reserve (DOR) in the day 4 group, delayed cleavage-stage embryos utilized in FET cycles performed as well as embryos growing at the normal rate, suggesting delayed embryo development does not affect embryo implantation as long as endometrial synchrony is maintained.

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The Graduated Embryo Score (GES) predicts blastocyst formation and pregnancy rate from cleavage-stage embryos*

Abstract: Predicting which cleaved embryos will form blastocysts could permit the high success rates associated with blastocyst transfer to be achieved from day 3 embryo transfer.

Cited by 135 publications

References 16 publications

Serum anti-Mullerian hormone levels correlate with ovarian response in idiopathic hypogonadotropic hypogonadism

Serum anti-Mullerian hormone levels correlate with ovarian response in idiopathic hypogonadotropic hypogonadism

Accuracy of a combined score of zygote and embryo morphology for selecting the best embryos for IVF

Developmentally delayed cleavage-stage embryos maintain comparable implantation rates in frozen embryo transfers

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